Fem Excel HRT Cost: What You’ll Actually Pay Per Month

By The HRT Index Editorial Team · Last verified: July 27, 2026 · Editorial research — not medically reviewed.

Fem Excel is not one of our partners and we earn nothing if you sign up with them. This page contains affiliate links to a few alternatives, and we label every one. Affiliate disclosure. Compensation does not change the facts or our conclusions.

We opened seven pages on Fem Excel’s own website. The pricing page. The estradiol page. The FAQ. The insurance page. The About page. A promotional landing page. And the Terms and Conditions. We were trying to answer one simple question — what does this actually cost — and we found eight places where Fem Excel’s own pages don’t line up with each other.

Not small stuff. One page sells the starter package for $99. Another offers a near-identical bundle for $4.95 shipping. The FAQ promises a 90-day money-back guarantee. The Terms say all sales are final. One page calls the estradiol FDA-approved; two others describe compounded prescriptions.

So if you’ve been staring at their site feeling like you can’t pin the number down — you’re not being slow. The number genuinely isn’t in one place.

We put it in one place. Below is every published price, what actually hits your card and when, the one contract clause that quietly decides your medication cost, and how it compares with five other providers.

Best for you if:

• You want one team looking at estrogen, progesterone, testosterone and thyroid together
• You want a cream or suppository, not just a pill or patch
• You're paying cash no matter which provider you pick
• You've been brushed off before and want a clinician who'll take your symptoms seriously
• A bigger charge every other month fits your budget

Not for you if:

• You need insurance to help pay
• You want to fill your prescription at your own pharmacy — you can't, and we'll show you the clause
• You specifically want FDA-approved medication
• A roughly $400 month would hurt
• You live in Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Mississippi, New Hampshire or Rhode Island

What we actually verified

Fem Excel cost at a glance

Care and medication prices from femexcel.com/treatments/ and femexcel.com/faqs/, verified 27 July 2026. Monthly average column is our arithmetic, not a Fem Excel figure. Shipping and tax extra — no standard amount published. This table shows what plans cost, not what anyone should take.

How much does Fem Excel HRT cost per month in 2026?

Fem Excel charges $99 per month for its Excel Advantage membership, which covers consultations, provider messaging, and a hormone test kit every six months. Medication is billed separately: estradiol, progesterone, and thyroid are listed at $50 per month each, and testosterone cream starts at $15. Medication is billed every two months rather than monthly.

The membership is $99 a month. It bills monthly. Their pricing page says the first month is free.

The medication is separate. Their own pricing block says it in plain text: “Medications not included.”

Source: femexcel.com/treatments/, verified 27 July 2026.

Notice they stack. Each one is its own line item.

If you still have a uterus and you’re prescribed systemic estrogen, a progestogen is generally added to protect the lining of the uterus. That’s standard practice, not an upsell. At Fem Excel it’s also a second $50. (Low-dose local vaginalestrogen is a different situation and generally doesn’t require an added progestogen — so don’t assume every estradiol prescription doubles your medication bill.)

And here’s the detail that catches almost everyone: medication is billed every two months, not monthly. So a $50-a-month prescription arrives as a $100 charge. Two medications? A $200 charge.

What can push your real cost higher

• More medications. Thyroid is priced as a core medication. Testosterone cream, metformin, and spironolactone are listed as add-ons on top.
• Shipping. Their Terms say you agree to pay shipping and handling "shown at the time you make a purchase." No standard amount appears anywhere on the site. Don't assume it's free.
• Tax. Their Terms say tax is estimated at checkout and isn't collected in every state.
• A changed dose or formula. Fem Excel's own public reply to a customer review states that pricing can change if a provider adjusts a prescription for clinical reasons, and that this should always be explained. Ask what an adjustment does to your bill before you authorize it.
• A replacement test kit. Their Terms say a second collection kit may carry additional fees.

Why does Fem Excel pricing change depending on which page you read?

Fem Excel’s public pages state different prices and different inclusions in different places. Eight of these conflicts are between two live pages on its own website, and they cover medication status, entry price, stated value, state availability, and refunds. This is the main reason a straight answer about cost is hard to find.

All eight verified 27 July 2026. Each is a difference between two live Fem Excel pages, not between Fem Excel and a third party.

The $94 question nobody has asked

Look at rows two and three again.

On the pricing page, the consultation-and-test-kit package costs $99, described as a “$249 full retail value.”

On a separate landing page, an online assessment, an at-home Tasso test kit, and a video consultation with a licensed provider are free— you pay $4.95 shipping— described as “a $299 value.”

Both were live when we checked on 27 July 2026.

Be careful here, because they aren’t identical. The $99 package lists a customized treatment plan and a second consultation to review your results. The $4.95 page lists the assessment, the kit, and one video consult, and says a personalized treatment plan will be provided if you qualify. They overlap heavily. They aren’t word-for-word the same.

So we can’t promise you’ll save $94.05. What we can tell you is this: there are two live entry paths at wildly different prices, and you should ask which one applies to you before you pay for the more expensive one. That’s a two-minute question with a potentially $94 answer.

The second overlap nobody has resolved

The FAQ says membership includes initial and follow-up consultations and a hormone test kit. The pricing page charges $99 for a consultation-and-test-kit package as its own line item.

Those can both be technically true — an upfront intake charge can coexist with later membership inclusions. What the public pages never explain is which applies to you on day one: is the $99 your entry charge, is it waived under the promotion, is it credited against something, or is it charged on top of your first month? That’s about $99 of uncertainty. Ask.

What will Fem Excel actually charge my card each month?

Fem Excel bills membership monthly and medication every two months. If those charges land in the same month, a three-medication plan that averages $249 a month can appear as roughly $399 one month and $99 the next. The average and the amount on your statement are different numbers.

When a company says a plan runs “about $249 a month,” you picture $249 leaving your account every month. Steady. Easy to budget.

That’s not what this looks like.

Here’s six months for someone on estradiol, progesterone and thyroid:

Modeled on Fem Excel’s published prices and its stated two-month medication billing cycle, assuming a membership charge and a medication charge post in the same month. Confirm your actual charge dates at checkout. Shipping and tax not included.

Both are true. Only one shows up on your statement.

Budget for the peak, not the average.If a $399 month would hurt, this program doesn’t fit — and that is a completely legitimate reason to choose something else.

If your plan is bigger, the peak is bigger: three core medications plus testosterone cream models to roughly $429, and all six listed medications to roughly $495, before shipping.

What does the $99 Fem Excel membership include?

Fem Excel’s membership covers unlimited provider messaging, initial and follow-up consultations, check-ins every 60 days, and a hormone test kit every six months. It does not cover medication or shipping, and it does not let you fill your prescription anywhere other than Fem Excel’s contracted pharmacies.

What you get for $99 a month

• Video access to your provider
• Initial and follow-up consultations
• Unlimited messaging with your care team
• A symptom check-in every 60 days
• A hormone test kit every six months
• Testing run at Excel Medical Labs, the company's own CLIA-certified lab
• Sample collection with a Tasso+ device — capillary blood, not saliva

A precision point on the device:Fem Excel’s FAQ calls the Tasso+ “FDA-approved.” Their own testing page uses the more careful “FDA-registered and CLIA-compliant.” Neither is quite right. The FDA’s device record lists Tasso+ under 510(k) K221131 as a Class II blood lancet, cleared as substantially equivalent to an existing device — cleared, not approved. That clearance covers the lancet that pricks your skin. It says nothing about the accuracy of any hormone test run on the sample.

And here’s what the membership does not include

Medication. Stated on their own pricing block.

Shipping. No standard amount published.

Your choice of pharmacy. This one almost nobody writing about Fem Excel has mentioned, and it quietly shapes your medication bill more than anything else on this page.

Read that twice. You cannot move a Fem Excel prescription to Costco, or Walgreens, or your local independent. Under the current Terms, it stays inside their contracted pharmacy network for as long as you’re a member.

For context on scale: generic oral estradiol commonly runs about $10–$30 a month, and generic micronized progesterone often starts around $15, using retail discount-card cash prices in 2026. Those are FDA-approved products at retail pharmacies, which is not what Fem Excel dispenses, so this isn’t an apples-to-apples comparison. But it’s the reason at least one customer wrote that Fem Excel wouldn’t call in medications she could get cheaper locally.

One more line from the Terms worth knowing if there are kids or grandkids in your house: the pharmacies will not ship medication in child-resistant packaging. Plan storage accordingly.

Is the free Fem Excel test kit really free?

Fem Excel runs a promotion offering a free online assessment, a free at-home Tasso test kit, and a free video consultation for $4.95 shipping, described as a $299 value. The offer explicitly excludes medication. It does not state whether it enrolls you in the $99 monthly membership, when your first membership charge begins, or whether it can be combined with the advertised free first month.

The offer is real and it was live when we checked.

What it excludes, in their words: “This offer does not include medication. If you qualify, a personalized treatment plan will be provided.”

What it doesn’t say — and these are the questions that decide your first month:

1. Does taking this offer enroll me in the $99/month membership?
2. When does my first membership charge hit?
3. Can this be combined with the "first month free" offer?
4. Is a card required before the consultation?
5. Does medication get ordered automatically after approval, or do I approve it separately?

We can’t answer these from the public pages. Get the answers in writing before you enter a card.A screenshot of a chat reply is worth more than a phone call you can’t prove.

Are Fem Excel’s medications FDA-approved or compounded?

Fem Excel’s FAQ states it prescribes only bioidentical hormones that are compounded, and its About page describes “US-compounded prescriptions.” Its treatments page describes its estradiol as “FDA-approved.” Compounded medications are not FDA-approved, and the difference affects insurance, pharmacy options, and what happens if you leave.

What their own pages say

All verified 27 July 2026.

“FDA-registered” is not “FDA-approved.” Registration describes a facility. Approval describes a drug. A compounding pharmacy being registered with the FDA does not mean the FDA reviewed the medication that pharmacy makes for you.

The single most valuable question you can ask on your consult: “Is what you’re prescribing me a compounded product or an FDA-approved one, and what’s the manufacturer?”

What that actually costs you

1. Insurance is out. Fem Excel doesn't accept insurance, and its Terms include an agreement not to submit its services or products to any commercial or government payor.
2. You can't shop the price. Combined with the pharmacy clause above, you're inside their pricing.
3. Continuity is on you. An outside clinician isn't obligated to continue another prescriber's regimen, and Fem Excel's own FAQ says most primary care doctors "aren't trained in hormone optimization" and recommends staying in their program.
4. There's an open regulatory question. The FDA has been considering whether to restrict compounding of several bioidentical hormones. That's pending discussion rather than a final rule, so treat it as something to watch.

What the independent evidence says

In 2020, the National Academies of Sciences, Engineering, and Medicine reviewed compounded bioidentical hormone therapy and found a lack of rigorous safety and effectiveness evidence. It recommended limiting these products to two situations: allergy to an ingredient in an FDA-approved product, or a need for a dosage form no FDA-approved product offers.

ACOG’s 2023 clinical consensus takes a similar line, favoring FDA-approved menopausal formulations when an approved option can meet the patient’s needs.

Worth noticing: Male Excel — the men’s brand run by the same company — publishes a clear compounded-medication notice on its clinical pages. That disclosure doesn’t appear in the same places on the women’s pages.

If you want FDA-approved medication instead

Hers does not include routine hormone lab monitoring in its menopause plan, and its menopause program doesn’t list testosterone or thyroid. If lab-guided dosing across four hormones is what you want, Hers can’t do it and Midi Health is the better path.

But because Hers skips the labs and sticks to a short list of FDA-approved medications, it can put estradiol and micronized progesterone into a single flat monthly price with the medication included — from $79/month for oral or $134/month for the patch, on a 12-month plan. No separate medication bill. No two-month spikes. No pharmacy lock.

Before you decide: those Hers rates require a 12-month plan and are often billed several months upfront. Hers doesn’t publish a full list of the states it serves, so the eligibility check is where you’ll find out.

Does Fem Excel take insurance, HSA, or FSA?

Fem Excel does not accept commercial insurance, Medicare, or Medicaid. Its Terms state it is not enrolled in federal or state healthcare programs and that users agree not to submit claims to any healthcare program or commercial payor. Fem Excel says an FSA, HSA, or HRA may be usable, which you should confirm with your plan administrator rather than assume.

No insurance at all.Not commercial, not Medicare, not Medicaid. Their Terms are direct about it and even say that if you’re covered by a government health plan, you should consult a provider who participates in those plans.

And you agree not to submit claims. The Terms include an agreement that neither you nor their lab, medical group, or pharmacies will submit a reimbursement claim to a healthcare program or commercial payor.

HSA and FSA are a different mechanism.Those are your own pre-tax dollars, not an insurance claim, and Fem Excel’s FAQ says reimbursement “may be possible.” Ask your plan administrator:

1. Can I use the account card directly?
2. Will Fem Excel provide an itemized receipt?
3. Are membership fees and medication treated differently?
4. Does my plan need a letter of medical necessity?

The wording problem on their insurance page

Fem Excel’s insurance page describes the model as “Predictable, all-inclusive pricing” and lists lab tests as “Included”— while the pricing page says medications are not included, and the Terms allow shipping and tax to be added at checkout.

“All-inclusive” is the word that will cost you. Your medication is a separate bill. Plan for that, and the rest of their pricing is more honest than most.

If you need insurance to help pay

Midi Health is in-network with most PPO plans and its clinicians order and interpret labs. Self-pay is $250 for a first visit and $150 for follow-ups if your plan doesn’t apply.

Two limits to know: Midi is notenrolled with Medicare or Medicaid and cannot treat Medicaid patients even self-pay. And Midi prescribes both FDA-approved products and some compounded ones, so ask which you’re getting.

If you’re on Medicare or Medicaid, neither Fem Excel nor Midi can bill your plan. Your better path is a participating in-person provider.

What does Fem Excel cost in the first 90 days and the first year?

Using Fem Excel’s published prices, a two-medication plan models to roughly $500–$600 in the first 90 days and roughly $2,400–$2,500 in the first year, depending on which entry offer applies and whether the first membership month is waived. Shipping, tax, and any medication change are on top.

Our arithmetic from Fem Excel’s published prices. Excludes shipping (no published amount), tax, dose changes, and replacement kits. Assumes 12 months of continuous membership and medication.

One-medication plan: roughly $1,890 (standard) to $1,700 (promotional path) in year one. Three-medication plan: roughly $3,087 (standard) to $2,894 (promotional path) in year one.

Is Fem Excel available in my state?

Fem Excel’s FAQ states its providers prescribe in every state except Alaska, Arkansas, Connecticut, Hawaii, Idaho, Louisiana, Mississippi, New Hampshire, and Rhode Island — nine exclusions, implying 41 states. Its About page says the service is available in 43 states for women. The two figures don’t match, so confirm availability during intake.

If you’re in one of those, Fem Excel isn’t an option at any price. Stop comparing and go find someone who serves you.

Fem Excel doesn’t publish why it excludes these states. In our own state-by-state research, most of these states have unusually strict rules about how an online prescription can be issued. But if you’ve been wondering why so many online HRT companies won’t serve you, the pattern is real and it isn’t about you.

Midi Health operates in all 50 states.

How do I cancel Fem Excel, and what does the guarantee refund?

Fem Excel says members can cancel through the member portal or by phone, with support confirming the final membership date. Its FAQ describes a 90-day guarantee refunding membership fees if you complete your prescribed plan without improvement. Its Terms separately state that all sales are final and fees are not refundable. Those two statements conflict.

What the Excel Advantage Guarantee says it covers

In the three-medication model above, medication is roughly 60% of the 90-day spend. That portion sits outside the guarantee.

And then there’s the Terms

The Terms do add that they may “remedy customer issues and concerns on a case-by-case basis.”

So the FAQ promises a refund and the contract says fees aren’t refundable. What to do about it: if the guarantee is the reason you’re willing to try this, ask member support to confirm in writing what it covers, what conditions apply, and how to claim it — before you pay. Save the reply.

Also worth knowing: their Terms cap total liability at the greater of what you paid in the prior 12 months or $100.

The clause with a 30-day clock

How to cancel cleanly

1. Contact member support through your portal or by phone
2. Ask for the exact final date of your membership
3. Ask whether any medication order has already started processing
4. Get the confirmation in writing — email or portal message, not a phone call
5. Watch your statement for the next two billing cycles

Step four is the one that matters. Several public complaints involve charges continuing after a customer believed she’d cancelled. Written confirmation is your evidence.

What do customers say about Fem Excel’s cost?

Fem Excel’s Trustpilot profile showed roughly 4.5 out of 5 across approximately 756 reviews when we checked in July 2026. In the reviews we read, praise centred on the consultation experience. Recurring criticism centred on cost, billing, communication, and medication changes.

The critical reviews cluster around money.

Three caveats to apply to any review page

1. Trustpilot discloses that Fem Excel's profile was merged from more than one profile. Treat the aggregate accordingly.
2. Many five-star reviews are written before treatment starts — several say things like "I can't wait to get started." They're rating the consultation, not the outcome.
3. These are individual experiences. They aren't evidence a treatment works, and they don't predict what you'll be charged.

The testimonials on Fem Excel’s own website carry a disclosure: “Real Reviews, Actor Portrayal shown.” The words come from real reviews; the faces are actors. Fem Excel discloses it, which is the right thing to do.

How does Fem Excel’s cost compare to other online HRT providers?

Fem Excel sits in the upper-middle of the market on total cost, because care and medication are billed separately and each hormone adds a line item. Providers that bundle medication into one price are usually cheaper for a two-medication plan. Providers that bill insurance can be cheaper still.

Compiled from each provider’s published pages, verified July 2026. Prices and formularies move — confirm before you buy.

Find yourself in this list

Compare the full roster on our online HRT provider comparison, or see typical market pricing in our 2026 HRT cost guide.

What should I confirm before paying Fem Excel?

Ten questions. Screenshot the answers. Five minutes, and it’s the most valuable thing on this page.

1. Am I on the $99 package or the $4.95 offer? Ask which applies to me right now.
2. What exactly is charged today?
3. When does my first $99 membership charge hit?
4. Is my first month free, and does that combine with this offer?
5. What is my exact two-month medication total? Not per month — the number that hits my card.
6. What is shipping, and is tax added?
7. When is my first refill charged, and does it process automatically?
8. For each medication: what is it, what dose, what form, is it compounded or FDA-approved, and which pharmacy fills it?
9. What happens to my cost if my dose or formula changes mid-cycle?
10. How do I cancel, and will I get written confirmation?

Save everything. Screenshot the checkout page, the recurring-charge consent, the medication quote, the shipping line, your renewal date, and the cancellation instructions.

How did The HRT Index verify Fem Excel’s cost?

We built this page under The HRT Index Verification Standard— our documented process for reviewing providers. We read every published price, separated FDA-approved from compounded, checked state availability and insurance, and we re-check on a fixed schedule.

Who wrote it:The HRT Index Editorial Team. This is editorial research, not a clinical review. No clinician reviewed this page — our medical review policy explains what that means.

What we read, on 27 July 2026:Fem Excel’s treatments and pricing page, estradiol page, FAQ, insurance page, About page, promotional landing page, and Terms and Conditions. Plus the FDA’s guidance on compounded drugs and its device record for the Tasso+ collection device, the National Academies’ 2020 report on compounded bioidentical hormone therapy, ACOG’s guidance on hormone testing, and public review profiles.

What we did not do: we did not enroll, pay, receive treatment, or cancel.

What we earn:nothing from Fem Excel. We have no affiliate relationship with them. We do earn a commission if you start care through some other links on this page, at no extra cost to you — and it doesn’t change the prices we show, how we label FDA-approved versus compounded, or who we tell you to compare instead. See our affiliate disclosure.

Fem Excel HRT cost: frequently asked questions

The bottom line

Fem Excel is a real company with real clinicians, and plenty of women feel heard there for the first time in years. That matters, and we’re not going to talk you out of it.

But it is not a $99-a-month HRT program.It’s a $99 care membership with medication billed on top, every other month, at a price you can’t shop anywhere else. For two medications, plan on about $199 a month with a $200 medication charge landing every second month — and a modeled $299 in the months those two charges collide. For three, plan on about $249 a month and $399 spikes.

If that fits, go in with the ten questions above and get the answers in writing. You’ll have a better first consult than most people do.

If it doesn’t fit — because you need insurance, or FDA-approved medication, or your own pharmacy, or one predictable number — that’s not a failure. That’s you finding out before you paid, which is the entire point of this page.

Fem Excel is not an HRT Index partner and we receive no compensation from them. Prices verified 27 July 2026 from Fem Excel’s published pages and subject to change. This page is educational and is not medical advice. Talk to a licensed clinician about whether hormone therapy is right for you.

Also from The HRT Index: Full Fem Excel review · Compare all HRT providers · Cheapest online HRT providers · HRT cost guide 2026 · Best compounded HRT providers · Best FDA-approved HRT providers