HRT Cost Calculator: Estimate Your 90-Day and Year-One Cost

Use this HRT cost calculator to estimate what may leave your account today, during the first 90 days, and during year one for menopause care, medication, labs, and shipping. A $149 plan billed every 28 days annualizes to about $1,942 and can produce 14 charges in 365 days if the first charge lands on day zero.

That is why this page gives you more than a monthly price. It separates what is due now, what can leave your account in the first 90 days, what 90 days of treatment costs on a normalized basis, your first-year comparison total, and your ongoing baseline. It also marks plans you may not be eligible to use, because a price you cannot purchase is not a useful price.

The HRT Index is the independent decision resource for online menopause and HRT care — comparing telehealth providers on clinical legitimacy, care quality, medication fit, price transparency, and access, with every claim verified and dated, so women can choose the path that fits their situation before their first consult.

Best for you / not for you

Answer capsule: This page is for U.S. women trying to budget menopause hormone therapy before a consult or checkout. It is not a dosage tool, diagnosis tool, TRT calculator, gender-affirming-care calculator, or guide to non-U.S. pricing.

Use this page if	You are budgeting menopause hormone therapy in the United States and want to compare real billing cycles, visit fees, medication costs, insurance variables, labs, and eligibility limits—not a generic “$10 to $500 a month” range.
This page is not for you if	You want gender-affirming hormone therapy pricing, men's testosterone replacement pricing, or UK/NHS costs. Those involve different services, medicines, coverage rules, and controlled-substance requirements. This calculator also cannot tell you whether hormone therapy is medically appropriate for you.

Everything below is U.S. pricing for menopause care for women. It is not a prescription recommendation, and choosing “patch,” “pill,” “gel,” or “vaginal estrogen” in the calculator does not mean a clinician will prescribe that route.

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What does this HRT cost calculator include?

Answer capsule: A useful HRT cost calculator must separate the care fee, medication, labs, shipping, and billing cadence. This one returns five cost figures plus an eligibility result, so a low monthly equivalent cannot hide an annual prepayment, a quarterly draft, a 28-day refill cycle, a separate prescription bill, or a plan you cannot use.

1. Amount due now

This is what may hit your card when you start—not the monthly equivalent printed in the headline.

Examples from current public pages:

• Alloy's estradiol patch is listed at $100 for a one-month supply, shipped and billed every three months, with a $49 one-time doctor fee. The modeled opening payment is therefore $349 before any separately prescribed product.^[1]
• Pandia Health advertises its annual care membership as $34.99 a month, but the page states that $419.88 is billed annually and medication is separate.^[2]
• Winona lists its patch from $149 per 30-day supply and says a 30-day prescription is processed every 28 days.^{[3] [4]}
• Hers advertises oral treatment from $79 a month with a 12-month plan and patches from $134 a month with a 12-month plan. Its public article does not establish the amount charged at checkout, so this calculator labels that field confirm at checkout rather than guessing.^[5]

2. Cash paid in the first 90 days

This is every scheduled charge that can land from day zero through day 89.

A 28-day plan can produce charges on days 0, 28, 56, and 84. That means Winona's $149 patch can create $596 in cash charges during the first 90 days if the first charge lands on day zero and uninterrupted renewals continue—even though 90 days of treatment annualizes to a lower figure.

3. Ninety-day treatment-equivalent cost

This normalizes different billing intervals so you can compare them without pretending every provider uses calendar months.

For a $149 charge every 28 days:

$149 × 90 ÷ 28 = $478.93 of treatment for 90 days.

That is not the same as the possible $596 cash outflow in the first 90 days. Both figures are true. One measures treatment time; the other measures what can leave your account.

4. First-year comparison total

This adds the public care price, published medication price when included, one-time fees, and the provider's actual cadence. It is a comparison model, not a promise that every person needs exactly one follow-up, one dose, or one product.

Whenever follow-up frequency, pharmacy price, lab work, checkout timing, or the eventual prescription is unknown, the calculator leaves that field editable or labels it confirm at intake or checkout.

5. Ongoing baseline

This removes one-time consult fees and introductory discounts so you can see what staying on the same published plan may cost after the first year.

Inner Balance's Oestra page lists $199 a month for the first six months and $99.50 a month after that. That produces a published-price model of $1,791 in year one and $1,194 for a later 12-month period if the price and dose do not change.^[6]

6. Eligibility result

The calculator does not rank an unavailable option as “cheapest.” It checks the public gates we could verify, including age, state, and federal-benefit restrictions, and displays the reason a route is unavailable.

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Run your HRT cost calculator

Answer capsule: The calculator uses six inputs—state, age, payment type, deductible position, expected medication route, and whether you have a uterus—to build price scenarios without pretending to diagnose you. It requires no email, runs in your browser, and does not place health answers in URLs, analytics events, session replay, advertising pixels, or persistent storage.

Six questions. About 60 to 90 seconds.

1. Your state — determines which clinicians can legally treat you.
2. Your age — some services publish age limits.
3. How you would pay — commercial insurance, Marketplace coverage, Medicare, Medicaid, TRICARE, or cash.
4. Whether you have met your deductible — because coverage and current out-of-pocket cost are not the same question.
5. Which route you expect to discuss — pill, patch, gel, or local vaginal estrogen.
6. Whether you have a uterus — because a clinician may prescribe a progestogen with systemic estrogen to reduce endometrial risk. The calculator can price that possible second line; it does not decide that you need it.^[7]

What the calculator gives you

For every eligible scenario, it returns:

• amount due now;
• possible cash paid in the first 90 days;
• normalized 90-day treatment cost;
• modeled first-year total;
• ongoing baseline;
• care fee and medication separated;
• billing interval named in plain English;
• source date and source-status label;
• the specific reason an unavailable option is excluded.

What it cannot tell you

It cannot know your formulary tier, negotiated allowed amount, pharmacy price, prior-authorization result, clinician's prescription, dose, or medically appropriate route. Those remain user-entered or marked confirm during intake, at the pharmacy, or at checkout.

Privacy rule for the live tool

Nothing is saved, sent, or required to get a result. The calculator runs locally in the browser. State, age, coverage type, deductible position, route, and uterine status do not appear in URL parameters, analytics event labels, session replay, advertising pixels, or local storage.

Privacy Policy · Consumer Health Data Privacy Policy

Run your number before you compare providers

See what may be due now, what may leave your account during the first 90 days, and which figures still need a pharmacy or insurance quote. No email required.

Run the free HRT cost calculator →

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The right online HRT provider is not the same for every woman

Answer capsule: Price cannot decide this by itself. The right starting point depends on symptoms, age, uterine status, medication route, risk history, insurance, state, and whether a situation needs in-person evaluation before telehealth care makes sense.

The right online HRT provider isn't the same for every woman — it depends on your symptoms, your age and whether you have a uterus, your medication route preference (patch, pill, gel, or vaginal estrogen), your risk history, your insurance or cash-pay situation, and your state. Some situations belong with an in-person clinician first. Because a general answer can't resolve those for you, use The HRT Index's Find My HRT Path tool to match your situation to the right provider — and to flag when online care isn't the right starting point — before your first consult.

Cost is one of five things we weigh, and it is fourth in line. Our named process is The HRT Index Verification Standard: we read every published price, separate FDA-approved from compounded, verify state availability and insurance language, record the billing cadence, and re-check top providers monthly and the full roster quarterly.

We evaluate providers on exactly five pillars, in this order: clinical legitimacy, care quality, medication fit, price transparency, access. The standard is not a numeric score, and we do not invent provider ratings that imply false precision.

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Why “$149 a month” can cost more than $1,788 a year

Answer capsule: Winona says payment for a 30-day supply is processed every 28 days, not every calendar month. Its $149 patch therefore annualizes to about $1,942 for 365 days of treatment, while an uninterrupted schedule beginning on day zero can place 14 charges—$2,086—inside the first 365-day cash window.

This is the finding that made us build a calculator instead of another monthly-price table.

The Winona 28-day ledger — verified August 2026

Published route	Recurring charge	Possible first-90-day cash*	90-day treatment equivalent	365-day treatment equivalent	Possible first-365-day cash*
Estradiol patch	$149	$596	$478.93	$1,942.32	$2,086
Patch + progesterone capsules	$188	$752	$604.29	$2,450.71	$2,632
Estrogen tablets	$54	$216	$173.57	$703.93	$756
Estrogen tablets + progesterone capsules	$93	$372	$298.93	$1,212.32	$1,302
Estrogen + progesterone body cream — compounded	$89	$356	$286.07	$1,160.18	$1,246

*Cash-window figures assume the first charge occurs on day zero, renewals continue without a pause or cancellation, and every scheduled charge lands on time. The 365-day treatment-equivalent column is the cleanest annual comparison. The cash-window column answers a different question: how many charges can land before the window closes.^{[3] [4]}

The combined rows above are arithmetic on current public product prices. They are not a recommendation that any reader needs both products.

The line to remember

A monthly-looking price and a calendar-month price are not automatically the same thing. Neither one tells you what is due today.

Winona's own FAQ states the cadence clearly: 30-day supplies process every 28 days and 90-day supplies every 84 days. The problem is not that the cadence is secret. The problem is that most comparison pages still multiply the sticker by 12.

The 90-day cash trap

Take Winona's $54 estrogen-tablet route. Ninety days of treatment annualizes to $173.57. But a day-zero refill schedule can charge on days 0, 28, 56, and 84—$216 out of your account before day 90 closes.

Neither number is wrong. But if a page gives you only $162 from “$54 × 3,” it has answered neither question correctly.

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What we actually verified

Answer capsule: We checked provider pricing, billing language, medication inclusion, insurance model, eligibility, labs, cancellation terms, and material regulatory distinctions on official pages in August 2026. Every number is labeled as a verified public price, our calculation, a user-entered variable, a checkout confirmation, or an unresolved official-source conflict.

The five labels used on this page

Label	What it means
Verified public price	The provider or authoritative source published the figure on a live page, and we recorded the verification date.
Calculated from published terms	The arithmetic uses a verified price and a verified billing interval; the formula is visible.
User-entered	The correct number is personal, such as your copay, pharmacy quote, coinsurance, deductible remaining, or lab bill.
Confirm at intake or checkout	The provider does not publish enough information to calculate the figure without guessing.
Source conflict — recheck before paying	Two official pages or statements cannot be reconciled, so we print the conflict instead of silently choosing one.

What changed during verification

Our working draft carried several figures that looked clean and were not publishable:

• Alloy's live patch product page lists $100 a month, billed every three months. We removed the draft's claim of a precisely timed 33% increase because the public pages do not prove when the price changed.^[1]
• Alloy lists progesterone separately, starting at $23 for a one-month supply. We removed the draft's claim that it was included free with estradiol.^[8]
• MyMenopauseRx lists self-pay visits at $150, not $99.^[9]
• Pandia's current menopause page prices the care membership, not the medication. We removed medication totals that were not supported by the live page.^[2]
• Hers publishes monthly equivalents with a 12-month plan but not enough public checkout detail to state that the full annual amount is always charged upfront. The calculator now leaves “due today” as a checkout confirmation.^[5]

Official conflicts we will not hide

• Alloy's current patch product page and HRT page show $100 a month, while an Alloy article updated July 17, 2026 still contains an embedded $74.99 patch card before later displaying $100. The calculator uses the direct product price and treats the article card as stale conflicting content—not proof of a precisely dated price jump.^{[1] [10]}
• Inner Balance identifies the pharmacy behind Oestra as a 503A pharmacy on live pages while other live company pages identify it as 503B. Oestra remains clearly labeled compounded here, and the named dispensing pharmacy and federal section status must be confirmed before payment.^[6]
• Sesame's direct menopause service displays $59 a month, while partner or channel-specific offers may show a different figure. This page uses the direct service price and treats a partner price as a separate offer, not the same plan.^[11]
• Provider pharmacy prices, insurance estimates, and discount-card prices can move by ZIP code, pharmacy, strength, quantity, and date. They are never locked into the calculator as universal quotes.

What we earn

We may earn a commission if you begin care through some links on this page. Partner links are labeled where they appear. Providers do not buy a position in the calculator, and compensation does not change source status, formulas, or eligibility rules.

The damaging admission is built into the data: the highest-paying partner can be the most expensive published route in the table. We leave it there because removing it would make every cheaper recommendation less trustworthy.

Found a price or policy that changed? Email partners@thehrtindex.com. We date material corrections and re-run the affected scenarios.

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What do online menopause providers actually charge?

Answer capsule: Online menopause care is sold in at least four different ways: one-time consults, per-visit care, monthly memberships with medication separate, and bundled medication plans. Comparing them requires separate columns for care, medication, billing cadence, amount due now, and what remains unknown.

The HRT Index True-Cost Ledger — verified August 2026

The table below is an assembled comparison dataset, not a quote. A “12-month comparison” is included only when it can be reproduced from published terms. It does not assume that every woman needs the same number of visits, the same prescription, or continuous treatment for a year.

Provider / path	What the published price covers	Billing cadence	Possible first-90-day care or plan cash	Reproducible 12-month comparison	Medication included?	Material condition
Wisp menopause consult	Consult, follow-ups, and three months of care-team access	One payment	$99	Not published beyond the three-month care window	No; local pharmacy	Do not turn $99 into an annual total without a published continuation schedule.[12]
MyMenopauseRx self-pay	Virtual clinical visit	Per visit	$150 for one visit	$300 if you model one initial and one follow-up	No; local pharmacy	Follow-up frequency and insurance cost depend on care and plan.[9]
Midi self-pay	Initial or continued-care visit	Per visit	$250–$400 if one follow-up occurs within 90 days	$400 for one initial + one continued-care visit	No; medication and labs separate	No mandatory membership; actual follow-up count is clinical.[13]
Elektra self-pay	Initial or follow-up clinical visit	Per visit	$249–$398 if one follow-up occurs within 90 days	$398 for one initial + one follow-up	No; medication and labs separate	Selected states and plans; Healthfirst network participation ends September 30, 2026.[14]
PlushCare self-pay scenario	$19.99 monthly membership + $129 initial visit	Monthly membership + per visit	$188.97 for one visit + three months of membership	$497.88 for 12 months + two $129 visits	No; medication and labs separate	Visit count is a model, not a published treatment schedule.[15]
Sesame menopause membership	Video visits as needed, messaging, and five specified basic labs if ordered	Monthly	$177 at $59 × 3	$708 at $59 × 12	No; local pharmacy	Federal-program beneficiary restriction and state lab exceptions apply.[11] [16]
Pandia monthly	Menopause-care membership	Monthly	$207	$828	No	Medication varies with prescription and insurance.[2]
Pandia quarterly	Menopause-care membership	$177 every three months	$177	$708	No	Cancellation must be made 30 days before the next billing period; early cancellation fee may apply.[2]
Pandia annual	Menopause-care membership	$419.88 annually	$419.88	$419.88	No	The advertised $34.99 is a monthly equivalent, not the amount due.[2]
Alloy estradiol pill	One-month medication supply; ongoing messaging while prescription active	Public product price; confirm exact draft timing	Confirm checkout	$528.88 estrogen-only floor: $39.99 × 12 + $49	Yes, estradiol pill only	Separately prescribed progesterone starts at $23/month; exact total depends on regimen.[8]
Alloy estradiol patch	One-month medication supply, dispensed as three months; one-time doctor fee	Billed every three months	$349 modeled opening payment	$1,249 estrogen-only: $100 × 12 + $49	Yes, patch only	Progesterone is separate when prescribed.[1] [8]
Hers oral plan	Eligible oral estradiol/progesterone treatment and platform access	12-month plan	Confirm checkout	$948 annual-plan equivalent	Bundled plan	Public page does not establish the exact opening charge or renewal terms.[5]
Hers patch plan	Eligible patch/progesterone treatment and platform access	12-month plan	Confirm checkout	$1,608 annual-plan equivalent	Bundled plan	Confirm total charged today, renewal date, and cancellation terms before paying.[5]
Inner Balance Oestra — compounded	Compounded prescription cream, shipping, and follow-up	$199 monthly for 6 months, then $99.50	$597 for first three monthly charges	$1,791 year one; $1,194 later 12-month baseline	Yes, compounded cream	Dose adjustments may cost more; confirm dispensing pharmacy and 503A/503B status.[6]
Winona	Prescription, clinician review, messaging, shipping, and selected medication	Every 28 days for 30-day supplies	See dedicated cadence table	See 365-day treatment and cash columns above	Yes	Age 35–59; served-state limits; FDA-approved products and compounded products are labeled separately.[3] [4]

A current Hers billing and privacy action belongs in the cost decision

On July 29, 2026, the Federal Trade Commission, Utah, and California filed a federal complaint alleging that Hims & Hers misled consumers about billing, cancellation, and health-data privacy. The complaint is pending; the allegations are not court findings, and the case will be decided by the court. Hims & Hers calls the claims baseless and says it will vigorously defend itself.^[17]

That does not make every Hers transaction improper. It does mean a reasonable buyer should capture the amount due today, refill date, cancellation path, and privacy disclosures before submitting an intake form or payment details. The calculator does not infer those facts from a “12-month plan” label.

What the ledger does not do

It does not add a generic pharmacy estimate to every provider and call the result “your total.” That creates false precision because the prescription, dose, quantity, pharmacy, coupon, formulary tier, deductible status, and refill count are not known yet.

Instead, the calculator lets you enter the actual pharmacy quote or use a dated benchmark as a placeholder. The result remains visibly labeled until you replace it.

The four business models hiding under one search result

1. One-time consult: low opening care fee, prescription sent to your pharmacy, but future renewal cost may be unclear.
2. Per-visit care: no automatic monthly membership, but follow-up frequency matters.
3. Care membership: predictable access fee, medication usually separate.
4. Bundled medication plan: medication and care may be wrapped into one number, but formulation, billing cadence, cancellation terms, and cash-only status matter more.

A comparison that collapses those into a single “monthly HRT cost” column is not simplifying the decision. It is deleting the decision.

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What do the hormones themselves cost at a pharmacy?

Answer capsule: Pharmacy prices can be far below bundled telehealth prices, but they are not a complete treatment cost because you still need a prescription and may need follow-up care. Current published 90-day benchmarks range from $8.10 for oral estradiol through Cost Plus Drugs to $60–$180 for twice-weekly patches through GoodRx, depending on route and source.

Dated 90-day pharmacy benchmarks

MyMenopauseRx published the following comparison on a page updated in August 2026. These are benchmarks, not universal quotes.^[18]

Route	Cost Plus Drugs 90-day price	GoodRx 90-day cash range
Oral estradiol tablet	$8.10	$18–$25
Twice-weekly estradiol patch	$133.48	$60–$180
Once-weekly estradiol patch	$95.36	$150

Prices can change by manufacturer, strength, quantity, pharmacy, ZIP code, shipping, and date. The calculator therefore treats the live quote from your pharmacy as stronger evidence than any national benchmark.

The access cost is often larger than the drug cost

A low pharmacy price does not include:

• the visit that creates the prescription;
• a membership or platform fee;
• follow-up needed to renew or adjust treatment;
• labs ordered for another clinical reason;
• shipping or pharmacy delivery;
• a second prescription, such as a progestogen when prescribed.

That is why “the patch is $60” and “the program is $149” can both be accurate. They are not selling the same bundle.

Local vaginal estrogen and systemic hormone therapy are not interchangeable

Low-dose vaginal estrogen is used for genitourinary symptoms such as vaginal dryness and painful sex. Systemic therapy reaches levels intended to address symptoms throughout the body, including hot flashes. A cheap local product is not a substitute for systemic therapy, and a systemic plan should not be sold as the automatic answer to isolated vaginal symptoms.^[19]

The calculator keeps those routes in separate lanes. It does not rank local vaginal estrogen as the “cheapest HRT” for someone modeling hot-flash treatment.

Why a pharmacy coupon can beat your copay—and why that is not always the best annual choice

Insurance and discount cards use different pricing arrangements. Ask the pharmacist to run the prescription through your insurance and as a cash/discount-card transaction, then compare both.

A discount-card purchase is generally not processed through your insurance and does not automatically count toward your deductible. Some plans may let you submit the receipt, so confirm the rule before deciding which route is cheaper for the year, not just for today's fill.^[20]

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Will insurance actually pay for HRT?

Answer capsule: Insurance coverage depends on three separate approvals: the clinician must be in network, the prescribed product must be covered under the formulary or medical benefit, and the dispensing pharmacy or service must meet plan rules. A plan can “cover HRT” while still leaving you with a deductible, coinsurance, copay, prior authorization, or an uncovered formulation.

The three-layer insurance check

Before you assume a price is covered, verify all three:

1. Is the visit in network? A company “accepting insurance” does not mean your exact plan is in network.
2. Is the prescribed product on your formulary, and at what tier? Brand, generic, route, quantity, and prior-authorization rules can change the result.
3. Is the pharmacy or dispensing path in network? A prescription sent to your local pharmacy is billed differently from a cash bundle shipped by a partner pharmacy.

One yes is not three yeses.

What your deductible changes

KFF's 2025 Employer Health Benefits Survey found:^[21]

Employer-plan deductible fact	2025 figure
Covered workers enrolled in a plan with a general annual deductible for single coverage	88%
Average deductible among workers in plans with a deductible	$1,886
Average at firms with 10–199 workers	$2,631
Average at larger firms	$1,670
Covered workers in plans with a deductible of $2,000 or more	34%

Those numbers do not mean every office visit and prescription is paid in full until the deductible is met. KFF also found that large shares of workers in plans with a deductible receive office-visit or prescription coverage before the general deductible. They do mean that “covered” cannot be translated into a personal dollar amount without checking your benefits.

Why the month can change the cheapest path

A cash program can look competitive early in the plan year when you have a large deductible remaining. Later in the year, an in-network visit and covered prescription can become much cheaper after more of the deductible or out-of-pocket maximum has been met.

The calculator asks for your remaining deductible because the same plan, medication, and woman can produce a different answer in January and November.

Midi as the insurance-first path

Midi publishes $250 for an initial self-pay visit and $150 for continued care, says it is in network with most PPO plans, and charges no mandatory subscription. Coverage, copays, coinsurance, and deductibles still depend on the plan; medication and labs are separate.^[13]

Does this sound like your situation? Check your exact plan before you book.

Midi can be a strong starting point when you want an insurance-billed menopause visit and a prescription sent through your own pharmacy benefit. The advantage disappears if your plan is out of network or your deductible makes the visit expensive today.

Check coverage and read the Midi review →

Midi is a partner, and we may earn a commission. Midi cannot treat Medicaid or Medi-Cal patients. Medicare beneficiaries may use self-pay but cannot submit claims related to Midi visits, medications, or associated services.

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Can you actually use the lowest-cost option?

Answer capsule: The cheapest published number may be unavailable because of age, state licensure, coverage type, or the service's own terms. The calculator applies verified gates before price so it does not recommend a plan that will reject the reader during intake.

Verified eligibility and access gates

Gate	Practical effect
Winona: ages 35–59	Winona says it provides HRT plans only to women ages 35 through 59.[4]
Winona: named service area	Winona currently lists AZ, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KY, ME, MD, MA, MI, MN, MO, MT, NE, NV, NH, NJ, NY, NC, OH, OK, OR, PA, SC, TN, TX, VA, WA, WI, WY, and Puerto Rico.[4]
Midi: Medicaid and Medi-Cal	Midi says it cannot treat Medicaid or Medi-Cal patients.[13]
Midi: Medicare	Medicare beneficiaries may be seen self-pay, but Midi-related claims cannot be submitted to Medicare.[13]
Sesame: federal-program beneficiaries	Sesame's terms require users to certify that they are not Medicare, Medicaid, or TRICARE beneficiaries.[16]
Elektra: selected states and networks	Elektra publishes state- and plan-specific availability, including selected Medicare and Medicaid plans. It is not a universal national benefit.[14]
Pandia: membership commitment	Annual and quarterly plans have different payment timing; cancellation must be made 30 days before the next billing period and an early cancellation fee may apply.[2]

One worked example

A 61-year-old woman in Alabama with Medicaid could see Winona's $149 patch, Midi's insurance messaging, and Sesame's $59 membership in a general comparison table.

Those rows are not equally available to her:

• Winona's public HRT age range ends at 59, and Alabama is not on its served-state list.
• Midi states it cannot treat Medicaid patients.
• Sesame's terms require the user to certify that she is not a Medicaid beneficiary.

Her next step is not “pick the lowest monthly price.” It is to check an eligible local or virtual clinician, her Medicaid network, and whether an in-person starting point is safer or more realistic.

Testosterone is outside this calculator

This page does not price testosterone therapy. Testosterone is a Schedule III controlled substance in the United States and requires a prescription from a licensed clinician. Menopause estrogen/progesterone pricing should not be used as a proxy for TRT or testosterone care.^[22]

Check the gates before you compare prices

Find My HRT Path → uses age, state, symptoms, route preference, coverage, and safety flags to narrow the starting path before a checkout page does it for you.

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What is the cheapest legitimate way to get HRT without insurance?

Answer capsule: There is no honest universal total without knowing the prescription and pharmacy quote. The lowest published care entry point in this comparison is Wisp's $99 three-month care window, while per-visit and membership models range from $150 a visit to $419.88 paid annually before medication; the cheapest complete route depends on the actual prescription cost.

Start with the model, not a made-up national total

Cash-pay situation	Published care cost	Medication	What you can calculate now
Existing clinician willing to prescribe	Your actual visit price	Your pharmacy quote	Enter both; this is often the lowest total when no new specialist access is needed.
Wisp menopause consult	$99 once	Paid at local pharmacy	First three months of care access + actual pharmacy quote; annual continuation unknown.[12]
MyMenopauseRx	$150 per visit	Paid at local pharmacy	One visit + quote, or model two visits at $300 care.[9]
Midi self-pay	$250 initial; $150 continued care	Paid at local pharmacy	One initial + modeled follow-up = $400 care, medication/labs separate.[13]
Pandia annual membership	$419.88 due annually	Separate	Care membership + actual medication price.[2]
Alloy pill	From $39.99/month + $49 one-time fee	Estradiol included; progesterone separate if prescribed	$528.88 estrogen-only annual floor before any separate prescribed product.[8]
Alloy patch	$100/month equivalent + $49 one-time fee	Patch included; progesterone separate if prescribed	$1,249 estrogen-only year-one model.[1] [8]
Oestra — compounded	$199/month for 6 months, then $99.50	Compounded cream included	$1,791 year one at the published rate; dose adjustment may add cost.[6]

If you already have a clinician, use that advantage

The cheapest access route is often the one you do not need to rebuild. Ask your existing clinician whether the visit can address menopause symptoms, whether a separate appointment is needed, and whether the prescription can go to your normal pharmacy.

There is no honest national dollar total for this path. The correct figures are your visit price and live pharmacy quote.

If you want one payment and your own pharmacy, Wisp is the cleanest published entry point

Wisp publishes $99 for a menopause consult that includes follow-ups and three months of care-team access. Medication is paid separately at the pharmacy.^[12]

The damaging admission for the “cheapest online” label is that three months of care access is not twelve months. Wisp does not publish enough on that page to calculate a full year of renewals. So the honest result is $99 + medication for the first care window, not a made-up annual total.

If you want annual access, Pandia's annual payment is clear—but medication is not included

Pandia's $34.99 monthly equivalent requires $419.88 billed annually. It includes care access and refills, not the medication. The annual plan is therefore easy to model for cash flow and incomplete as a treatment total until the prescription price is known.^[2]

Put your pharmacy quote into the calculator

A $99 consult and a $419.88 annual membership can reverse order once the prescription, follow-up schedule, and amount due today are included. Use the real quote instead of a generic national average.

Compare your cash-pay paths →

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The most expensive route here can belong to the company that pays us the most

Answer capsule: Winona's published patch price is $149 per 30-day supply, processed every 28 days. That annualizes to about $1,942 for 365 days of treatment, or about $2,451 with $39 progesterone capsules, making it one of the highest verified bundled routes in this comparison despite Winona being a commercial partner.

We need to say this plainly because the rest of the page depends on you believing us.

Winona is a high-paying partner, and its patch can sit near the bottom of a cost-only result.

If the lowest annualized number is your only priority, do not choose it because we earn a commission. Start with an existing clinician, a one-time consult, or an insurance-billed provider and use your own pharmacy quote.

What the higher price actually buys

Winona's bundled price includes the prescription process, medication fulfillment, standard shipping, clinician messaging, and automatic refills. It does not require hormone testing before prescribing, although the physician still determines eligibility and treatment.^[4]

That can be worth paying for when the buyer values:

• one predictable bundled charge;
• no separate pharmacy pickup;
• no insurance claim or prior-authorization process through the service;
• automatic fulfillment;
• a clinician channel for treatment questions;
• a cash-pay route that is not tied to deductible timing.

That is a real product. It is not the cheapest product.

The outside-pharmacy door

Winona's help center says patients may send a prescription to an outside pharmacy, although Winona does not recommend it, and a $50 monthly platform fee applies in addition to medication. The fee covers continued care with the Winona doctor.^[23]

Do not convert that into a universal savings claim. The outside pharmacy must be able and willing to fill the prescribed product, the actual medication price is unknown, and compounded preparations may not be transferable. Use this route only after getting the exact prescription, platform cadence, and pharmacy quote in writing.

The cancellation window is short

Winona says an order can receive a full refund only inside its 24-hour processing window. After that window, the order cannot be cancelled, refunded, or returned. Subscriptions can be cancelled in account settings to stop future refills.^[4]

That is not a side note. It changes how much certainty you should demand before the first order processes.

If bundled cash care is what you want, verify the gate and cadence first

Winona's HRT program is for women ages 35–59 in its served states and territory. Its public product list separates FDA-approved options such as its estradiol patch, estrogen tablets, and progesterone capsules from compounded creams. A 30-day supply processes every 28 days.

Check Winona availability and current pricing →

Winona is a partner, and we may earn a commission. It does not bill insurance. Confirm the exact amount, refill cadence, medication classification, and 24-hour cancellation window before approving the order.

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Will the price change after you sign up?

Answer capsule: Six events can change the total after intake: the prescribed route, a dose or quantity change, adding another medication, introductory pricing ending, lab or shipping charges, and a required follow-up before renewal. Every one can be asked about before payment, even when the provider cannot quote the final prescription yet.

1. The clinician prescribes a different route

A pill, patch, gel, spray, vaginal product, and combination regimen can carry different prices. The calculator selection is a planning scenario, not a prescription promise.

2. The dose or quantity changes

Flat-rate services may keep the price stable across strengths. Pharmacy prices may change with strength, quantity, manufacturer, or refill timing. Some compounded programs state that dose adjustments may add cost.^[6]

Ask: “If the dose or quantity changes, does the recurring charge change?”

3. A second medication is added

For a woman with a uterus using systemic estrogen, a clinician may prescribe a progestogen to reduce endometrial risk. FDA explains that estrogen increases endometrial-cancer risk and adding progestin lowers it.^[7]

This can be a second line item:

• Winona lists progesterone capsules from $39 per 30-day supply.
• Alloy lists progesterone separately from $23 per one-month supply.
• Some bundled plans include multiple medications in one advertised plan, but the exact prescribed combination still must be confirmed.

4. An introductory rate ends

Oestra's public rate is $199 a month for six months, then $99.50. Quoting only $99.50 hides $597 of additional first-year cost compared with multiplying the later rate by 12.^[6]

5. Labs or shipping appear

Several providers publish free standard shipping, but expedited delivery can cost more. Winona, for example, lists optional expedited rates from $15 to $75 while standard ground shipping is free.^[4]

Labs may be included, separately billed, or not ordered at all. Do not assume “care included” means “labs included.”

6. The refill requires another visit

The most important question is not “What is the first payment?” It is:

“What do I have to pay to still have an active prescription in month seven?”

A one-time consult may cover only a defined care window. A per-visit clinic may require follow-up. A membership may continue automatically. A medication bundle may refill on a 28-day or quarterly cycle.

The five questions to ask before paying

1. What is the total charged today, what recurs, and on what exact date?
2. Is the cycle 28 days, a calendar month, quarterly, or an annual plan?
3. If the prescription, dose, or quantity changes, does the price change?
4. If another medication is prescribed, what is its separate cost and cadence?
5. What will I pay to renew or refill in month seven, and is another visit required?

Write down three separate figures: monthly equivalent, plan length, and amount due today. They are not the same number.

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Why compounded HRT and FDA-approved HRT must stay in separate lanes

Answer capsule: FDA-approved hormone products have been reviewed for the finished product's safety, effectiveness, and manufacturing quality. Compounded drugs are not FDA-approved, and FDA does not verify their safety, effectiveness, or quality before marketing; they should not be described as generics or as equivalent substitutes for an approved finished product.

The marketing in this category blurs terms that change both clinical evidence and cost.

• FDA-approved product: FDA reviewed the specific finished product and approved it for its labeled use.
• Generic drug: an FDA-approved product that meets applicable requirements for equivalence to its reference product.
• Compounded drug: a pharmacy prepares a product for a prescription under compounding law; the finished product is not FDA-approved.
• 503A and 503B: federal compounding categories with different conditions and oversight. Registration or inspection language does not convert a compounded drug into an FDA-approved product.
• “Bioidentical”: a marketing and scientific descriptor used in different ways. FDA-approved products containing hormones identical to hormones produced by the body exist; “bioidentical” does not mean “compounded.”

FDA recommends FDA-approved hormone therapies and says it does not have evidence that compounded “bioidentical” hormones are safer or more effective than FDA-approved hormone therapy.^[7] ACOG recommends FDA-approved menopausal hormone therapies over compounded products when approved options meet the clinical need.^[24] The Menopause Society likewise warns that custom-compounded therapy is not proven safer or more effective and can have unpredictable absorption or potency.^[19]

Why the distinction changes cost

Compounded programs are commonly cash-pay bundles. FDA-approved prescriptions may be eligible for a pharmacy benefit, formulary pricing, or discount-card comparison. That does not mean every approved product is covered or cheap; it means there is a different coverage pathway.

Oestra's official-status conflict

Inner Balance clearly markets Oestra as a compounded prescription cream. Its current pages use both 503A and 503B terminology. The correct action is not to choose whichever label sounds stronger. It is to ask, before paying:

1. Which named pharmacy will dispense my prescription?
2. Is it operating for this prescription under section 503A or as a 503B outsourcing facility?
3. What are the exact estradiol and progesterone amounts in my prescribed dose?
4. If I have a uterus, what specifically provides endometrial protection and how will that plan be monitored?
5. Does any dose adjustment change the price?

If the answer remains vague, do not let a low later-month price resolve a clinical question it cannot answer.

We do not place a provider CTA here. Unresolved pharmacy-status and endometrial-protection questions need answers before a price should drive the click.

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Does Medicare, Medicaid, TRICARE, or VA cover HRT?

Answer capsule: Federal prescription coverage and telehealth-clinic eligibility are separate. A Medicare Part D plan may cover a prescribed FDA-approved hormone product on its formulary, while the online clinic itself may not participate in Medicare; Medicaid, TRICARE, and VA rules also depend on program, state, network, and service terms.

Medicare Part D

For 2026, CMS sets the annual Part D out-of-pocket threshold at $2,100 for covered Part D drugs. No Part D plan may have a deductible above $615, and some plans have no deductible.^[25]

That is not a guarantee that a specific estradiol, progesterone, route, brand, or quantity is covered. Check the plan formulary and pharmacy network.

The clinic can still be the blocker

Service	Verified federal-program position
Midi	Medicare is out of network. Medicare beneficiaries may self-pay but cannot submit claims related to Midi visits, medications, or associated services. Midi cannot accept Medicaid or Medi-Cal patients.[13]
Sesame	Terms require users to certify they are not Medicare, Medicaid, or TRICARE beneficiaries.[16]
Elektra	Accepts selected Medicare and Medicaid plans in specified states; check the exact plan and state before booking.[14]
Cash-pay bundled providers	Paying cash does not make the clinic or drug reimbursable by a federal program. Confirm provider enrollment, claim restrictions, and pharmacy coverage separately.

The practical next step

For many federal-program beneficiaries, the best path may be:

• an in-network primary-care, gynecology, or menopause clinician;
• a federally qualified health center;
• a clinician found through The Menopause Society's practitioner directory;
• a covered prescription filled through the program's pharmacy benefit.

That may not create an affiliate click. It can still be the correct answer.

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Can you pay for HRT with an HSA or FSA?

Answer capsule: Prescribed medication and medical visits are generally qualified medical expenses under IRS rules, so HSA or health FSA funds can often be used. An HSA owner should keep records, while health FSA claims require substantiation and a debit-card transaction can still trigger a documentation request.

HSA

You are responsible for keeping records that show a distribution paid or reimbursed a qualified medical expense and was not otherwise reimbursed. A payment card does not erase the need for documentation if the IRS later asks.^[26]

Health FSA

IRS guidance says health FSA expenses must be verified by an independent third party. Some debit-card transactions auto-substantiate; others require additional documentation. If a requested expense is not substantiated in time, the plan administrator must deactivate the card.^[27]

Keep:

• itemized provider receipt;
• date of service;
• description of service or prescribed product;
• amount paid;
• pharmacy receipt;
• any letter of medical necessity your plan requests.

What the tax benefit is—and is not

HSA/FSA eligibility does not reduce the sticker price at checkout. It changes which funds you can use and, depending on the account and your tax situation, the tax treatment of those funds.

Do not subtract a guessed tax percentage from every provider row. The calculator can show an optional after-tax illustration only after the user enters her own marginal rate, and it must remain labeled tax illustration—not tax advice.

See the sticker price and the optional after-tax illustration separately

Run the HSA/FSA scenario →

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Do you have to pay for lab work?

Answer capsule: Lab policy varies by provider: some require no routine bloodwork for menopause prescribing, some order tests only when clinically indicated, and some include a defined basic panel. A price comparison must state whether labs are included, separately billed, or simply not required.

Provider	Published lab position
Winona	Says hormone testing or bloodwork is not required for an HRT plan.[4]
Wisp	The consult page does not add a routine lab bundle to the $99 price; the clinician determines care and sends prescriptions to a local pharmacy.[12]
Midi	Labs may be part of care and are not included in the self-pay visit price; coverage and cost vary.[13]
MyMenopauseRx	Publishes discounted self-pay lab access; exact tests and cost depend on the order.[9]
Sesame	Includes five basic labs if the provider orders them: CBC, A1c, thyroid function, lipid panel, and comprehensive metabolic panel. State payment exceptions apply.[11]
Oestra	Says labs are optional; dose adjustments may add cost.[6]

None of Sesame's five listed included tests is a sex-hormone panel. That matters because “labs included” can sound like something the published list does not contain.

Many menopause evaluations are driven by age, symptoms, menstrual pattern, and medical history rather than a single hormone level. NICE recommends diagnosing perimenopause or menopause without laboratory tests in otherwise healthy people age 45 or older who have menopause-associated symptoms.^[28] A clinician may still order tests to investigate thyroid disease, anemia, pregnancy, abnormal bleeding, metabolic risk, or another cause of symptoms.

The price question to ask is:

“Which test are you ordering, what clinical question does it answer, who bills it, and what will I owe if insurance denies it?”

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What do women actually report paying?

Answer capsule: A 2025 GoodRx Research survey of 1,500 U.S. women found that 76% spent under $50 a month on menopause prescription medication, about 19% spent $50–$100, and 5.4% spent over $100. Those figures describe prescription spending—not telehealth memberships, visits, supplements, labs, or total care.

GoodRx's February 2025 survey also found:^[29]

• 21% had delayed or skipped menopause-related care because of cost;
• 12% had cut back on essentials to afford care;
• 41% reported at least some financial strain from prescription costs;
• only 26% said menopause prescriptions were fully covered, while 60% reported a copay.

That helps explain why bundled cash plans above $100 per cycle and population prescription spending below $50 can both appear in the same market. One is describing a care-and-medication service; the other is describing prescription medication spending.

What we will not do for social proof

We looked for a documented, independently verifiable first-person account showing the complete first-year cost of online menopause care.

We did not find one strong enough to use as evidence, and we are not going to manufacture it.

A company-published quote can show what the company chose to publish about access. It cannot prove typical cost, clinical quality, or treatment results. Midi publishes the patient quote, “I got a same day appointment and they took my insurance.” That is company-curated access feedback, not independent evidence that every plan is covered or every patient gets a same-day visit.^[30]

No testimonial on this page is used to establish safety, efficacy, or a typical outcome.

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How did The HRT Index calculate these numbers?

Answer capsule: We multiply provider-published prices by the provider's actual billing interval, keep cash flow separate from treatment-equivalent cost, and refuse to fill unknown fields with an unlabeled average. When official pages conflict, the conflict stays visible until the provider resolves it.

The HRT Index Verification Standard

We:

1. read current official pricing, product, FAQ, help-center, terms, and insurance pages;
2. separate FDA-approved products from compounded products;
3. verify state, age, insurance, and federal-program language;
4. record the exact billing cadence beside the price;
5. separate care, medication, labs, and shipping;
6. re-check top providers monthly and the full roster quarterly;
7. label every calculation and every unresolved variable.

We evaluate providers on clinical legitimacy, care quality, medication fit, price transparency, access—in that order. The framework is not a score.

Source hierarchy

When sources disagree, we use this order and keep the conflict visible:

1. current official pricing, product, or plan page;
2. current official FAQ;
3. current official help-center or terms page;
4. primary government or regulatory source;
5. peer-reviewed or authoritative clinical guidance;
6. reputable third-party reporting only when a primary source does not publish the fact, labeled as third-party.

The formulas

• 28-day annualized treatment cost = recurring charge × 365 ÷ 28
• 84-day annualized treatment cost = recurring charge × 365 ÷ 84
• 90-day treatment equivalent = recurring charge × 90 ÷ cadence days
• First-90-day cash = every scheduled payment whose charge date falls from day 0 through day 89
• First-year comparison = verified one-time fees + verified recurring charges inside the stated model
• Ongoing baseline = later 12-month cost at the current non-introductory rate, excluding one-time fees

What we exclude unless the reader enters it

• unknown pharmacy price;
• unknown copay, coinsurance, or allowed amount;
• labs not included in the published plan;
• expedited shipping;
• dose-dependent price changes;
• added prescriptions;
• non-HRT medicines and supplements;
• taxes or account-specific tax effects;
• any follow-up not established by the selected scenario.

What we got wrong and fixed before publication

Our working file used an older Alloy patch figure, treated Alloy progesterone as included, listed MyMenopauseRx at $99, and attached unsupported medication totals to Pandia. The live sources did not support those claims. We corrected them before publication and changed the calculator structure so the same error is harder to repeat.

The standard is not “never make a mistake.” It is date the evidence, expose the formula, re-check it, and correct the record before a reader pays based on it.

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Which HRT cost path fits your situation?

Answer capsule: The right cost path depends on whether you already have a prescriber, whether you want insurance billed, whether you prefer your own pharmacy or a bundled shipment, how much you can pay today, and whether the service can treat you. Use this table to choose the first scenario to run—not to choose a medication.

If this is your situation	Start by modeling	Why
You have an established clinician willing to address menopause care	Your actual visit price + your pharmacy quote	No new membership or access layer may be needed.
You want a one-time online entry point and your own pharmacy	Wisp: $99 + medication	Clear three-month care-window price; annual continuation remains unknown.
You want self-pay per-visit specialist care	MyMenopauseRx, Midi, or Elektra	No need to pretend a visit fee is a monthly plan; model the actual follow-up count.
You want commercial insurance billed	Check Midi, MyMenopauseRx, Elektra, or an in-network local clinician	Exact network and deductible status matter more than the published cash fee.
You want annual care access and can prepay	Pandia annual: $419.88 + medication	Clear annual cash timing; medication remains separate.
You want medication shipped in a bundled cash route	Alloy, Winona, Hers, or another verified bundle	Compare formulation, amount due today, billing cadence, cancellation, and medication classification—not only the monthly equivalent.
You want a compounded all-in-one cream	Keep compounded results in a separate lane	No FDA-approved-equivalence assumption; confirm pharmacy, dose, evidence, endometrial plan, and cash-only cost.
You have Medicare or Medicaid	Check plan-specific in-network care first	Most national cash platforms are not a substitute for federal-program participation.
Your symptoms are vaginal dryness or painful sex without hot flashes	Discuss local vaginal therapy as its own scenario	Local and systemic therapy are not interchangeable; the clinical route changes the cost category.
You need a refund safety net	Read the cancellation window before the price	Winona's first-order refund window is 24 hours; annual plans can have advance-cancellation or early-fee terms.

Still comparing two or three paths?

Run the same prescription quote, follow-up assumption, and time window across all of them. The calculator will show which total is verified, which is your input, and which still needs checkout confirmation.

Open the HRT cost calculator →

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Frequently asked questions

Answer capsule: These are the short answers to the follow-up questions that change an HRT cost estimate most often: monthly cost, insurance, billing cadence, Medicare, HSA/FSA, labs, compounded products, cancellation, and whether the calculator is making a medical recommendation.

How much does HRT cost per month?

There is no single complete monthly price. GoodRx found that 76% of surveyed women spent under $50 a month on menopause prescription medication, but total care may also include visits, memberships, labs, shipping, and a second prescription. A provider's monthly equivalent may also be billed every 28 days, quarterly, or annually.^[29]

How much does HRT cost without insurance?

The care layer in this comparison starts at $99 for Wisp's three-month consult window, $150 per MyMenopauseRx visit, $250 for Midi's initial self-pay visit, and $419.88 paid annually for Pandia's annual membership. Medication is separate in those examples. Bundled medication routes can exceed $1,000 a year, depending on product and cadence.

What is the cheapest legitimate way to get HRT online?

The lowest published online care entry point in this verified set is Wisp's $99 consult, with medication paid separately. That does not establish a full-year total. The cheapest complete path depends on the prescription, pharmacy quote, renewal requirement, and whether you already have a clinician.

Is HRT covered by insurance?

Some FDA-approved hormone products and menopause visits are covered by some plans, but the exact answer depends on network, formulary, route, pharmacy, prior authorization, deductible, copay, and coinsurance. A compounded cash bundle should not be presented as having the same coverage path as an FDA-approved prescription.

Why can a “monthly” HRT plan charge me 13 or 14 times?

A 28-day cycle repeats every four weeks. It annualizes to 365 ÷ 28 = 13.04 treatment cycles. If the first charge occurs on day zero, scheduled charges can land on days 0 through 364 fourteen times inside the first 365-day cash window.

Does a 12-month plan mean I pay the full amount today?

Not automatically. It can describe a commitment, a pricing tier, a shipment term, or an upfront payment. Unless the checkout or terms state the exact amount charged today, the calculator labels it confirm at checkout.

Does Medicare cover menopause hormone therapy?

A Medicare Part D plan may cover a prescribed FDA-approved product on its formulary. The online clinic may still be out of network or unable to bill Medicare. In 2026, the Part D out-of-pocket threshold for covered Part D drugs is $2,100.^[25]

Can I use an HSA or FSA for HRT?

Prescribed medication and medical visits are generally qualified medical expenses. Keep itemized records. Health FSA transactions can require third-party substantiation even when an FSA debit card works at checkout.^[27]

Why is my pharmacy copay higher than a coupon price?

Insurance and discount cards use different pricing arrangements. Ask the pharmacy to run both. A cash or discount-card transaction ordinarily does not count toward the insurance deductible or out-of-pocket maximum, so compare the annual effect as well as today's price.

Do compounded hormones cost more?

They are commonly sold through cash-pay programs and are often not covered through the same pharmacy-benefit pathway as FDA-approved products. Compounded drugs are not FDA-approved, and FDA does not verify the finished product's safety, effectiveness, or quality before marketing.^[7]

Is compounded HRT the same as generic HRT?

No. A generic is an FDA-approved drug that meets applicable equivalence requirements. A compounded finished product is not FDA-approved and should not be represented as a generic equivalent.

Do I need blood tests before starting HRT?

Not every provider requires routine hormone testing. A clinician may order tests when the history or symptoms raise another question. Ask which test is being ordered, why, who bills it, and whether it is included.

Does a woman with a uterus always need progesterone?

A clinician generally considers endometrial protection when prescribing systemic estrogen to a woman with a uterus, but the exact progestogen, dose, route, and need belong to the prescriber. The calculator prices a possible second line without making that clinical decision.^[7]

Is vaginal estrogen the cheapest form of HRT?

It may be a low-cost route for local genitourinary symptoms, but it is not interchangeable with systemic therapy used for symptoms such as hot flashes. The cheapest clinically irrelevant route is not the cheapest answer.

Can a provider change the price after a dose adjustment?

Yes. Some services use flat product pricing, some pharmacy prices change with strength or quantity, and some compounded programs state that adjustments may add cost. Ask for the rule in writing before approving the first order.

Can I cancel an HRT subscription at any time?

“Cancel anytime” usually stops future renewals; it does not guarantee a refund for medication already processing or an annual commitment already billed. Winona publishes a 24-hour first-order cancellation/refund window, while Pandia says cancellations must be made 30 days before the next billing period and an early cancellation fee may apply.^{[4] [2]}

Is this calculator a medical recommendation?

No. It is a cost and access model. A licensed clinician must decide whether hormone therapy is appropriate and which product, route, dose, and monitoring plan fit your history.

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Before you book anything

Answer capsule: Three checks prevent most HRT pricing surprises: look up your remaining deductible, eliminate providers that cannot treat you, and write down the amount due today plus the renewal cost. Do those before a long intake so the final checkout is a confirmation, not a reveal.

1. Check your deductible and pharmacy benefit

Log into your insurer's portal. Record:

• deductible remaining;
• specialist copay or coinsurance;
• pharmacy deductible, if separate;
• formulary status for the exact product and route;
• preferred pharmacy;
• prior-authorization or step-therapy requirement.

2. Check the gates before the prices

Confirm age range, state, insurance restriction, federal-program status, and whether the service offers the route you want to discuss.

3. Ask what month seven costs

Take this sentence into the consult or support chat:

“What will be charged today, what renews, on what date, and what will I have to pay to keep an active prescription in month seven?”

That answer is the price. Everything else may be only the opening payment.

For a broader explanation of the market rather than a personal calculation, read How Much Does HRT Cost in 2026?. For a provider-level comparison, see The Best Online HRT Providers for Menopause.

If every affiliate link disappeared, the 28-day math, payment-timing distinction, official-source conflicts, insurance model, and eligibility gates would still be useful. That is the standard this page must keep meeting after publication.

Still not sure which HRT program is right for you? Take our free 60-second matching quiz.

Find My HRT Path →

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Sources and verification notes

Answer capsule: Commercial facts below were checked against current provider pages on August 27, 2026; medical and regulatory claims use government or professional sources. Recheck provider prices, eligibility, insurance, and policies before publication and whenever the visible verification date changes.

¹ Alloy, Estradiol Patch, verified August 27, 2026. The page lists $100 for a one-month supply, shipping and billing every three months, a $49 one-time fee, free delivery, and prescription requirement.

² Pandia Health, Menopause Treatment, verified August 27, 2026. Used for $69 monthly, $177 quarterly, $419.88 annual billing, medication exclusion, cancellation timing, and possible early cancellation fee.

³ Winona, Menopause treatments, verified August 27, 2026. Current product pages list patch from $149, estrogen tablets from $54, progesterone capsules from $39, and compounded creams from $89.

⁴ Winona, Frequently Asked Questions, verified August 27, 2026. Used for 28/84-day processing, age range, served locations, no routine hormone-testing requirement, cancellation/refund window, standard and expedited shipping, and account cancellation.

⁵ Hers, Does Insurance Cover HRT for Menopause?, verified August 27, 2026. Used for oral treatment from $79/month and patches from $134/month with a 12-month plan. Checkout timing remains unverified here.

⁶ Inner Balance, Oestra HRT treatment page, FAQ, and perimenopause treatment page, verified August 27, 2026. Used for $199/month for six months, then $99.50; included medication/shipping/follow-up; optional labs; possible dose-adjustment charge; compounded status; and the unresolved 503A/503B company-language conflict.

⁷ U.S. Food and Drug Administration, Menopause and Compounding and the FDA: Questions and Answers, accessed August 27, 2026. Used for endometrial-risk language, FDA-approved therapy, and compounded-drug distinctions.

⁸ Alloy, Menopause treatment products, verified August 27, 2026. The page lists estradiol pill from $39.99 and progesterone separately from $23 for a one-month supply.

⁹ MyMenopauseRx, Treatment Costs, updated August 26, 2026 and verified August 27, 2026. Used for $150 self-pay visits, local-pharmacy prescriptions, insurance model, and pharmacy-cost separation.

¹⁰ Alloy, Oral vs. Transdermal Estrogen: Which HRT Form Is Right for You?, updated July 17, 2026 and verified August 27, 2026. An embedded card still shows $74.99 even though the same article later shows $100 and the direct product page lists $100.

¹¹ Sesame, Online Menopause Treatment, verified August 27, 2026. Used for the $59 direct-service price, medication exclusion, video/messaging features, included-lab list, state lab-payment exceptions, refund terms, and local-pharmacy prescribing.

¹² Wisp, Menopause Consult, verified August 27, 2026. Used for $99 payment, consultation/follow-up, three months of care-team access, all-50-state availability, and medication paid at a local pharmacy.

¹³ Midi Health, Pricing & Insurance and Assignment and Acknowledgment, verified August 27, 2026. Used for $250 initial self-pay, $150 continued care, insurance caveats, Medicare self-pay restrictions, and inability to accept Medicaid/Medi-Cal patients.

¹⁴ Elektra Health, Frequently Asked Questions, verified August 27, 2026. Used for $249 initial and $149 follow-up self-pay pricing, state/plan availability, selected Medicare/Medicaid participation, and the September 30, 2026 Healthfirst change.

¹⁵ PlushCare, Online Menopause Treatment, verified August 27, 2026. Used for $19.99 monthly membership, $129 self-pay initial visit, local-pharmacy prescription, and medication/lab exclusion.

¹⁶ Sesame, Terms of Service, verified August 27, 2026. Used for the Medicare, Medicaid, and TRICARE beneficiary certification.

¹⁷ Federal Trade Commission, FTC and States Act Against Hims & Hers for Deceptive and Unlawful Privacy Practices and Hims & Hers case page, July 29, 2026; Hims & Hers, Hims & Hers Responds to FTC Lawsuit, July 29, 2026. The case is pending; allegations are not findings.

¹⁸ MyMenopauseRx, Treatment Costs, updated August 26, 2026 and verified August 27, 2026. Pharmacy figures are the page's published 90-day benchmarks and can change.

¹⁹ The Menopause Society, Hormone Therapy, accessed August 27, 2026. Used for systemic versus local therapy and compounded-hormone guidance.

²⁰ GoodRx Help Center, Do purchases with GoodRx count toward my deductible?, accessed August 27, 2026. GoodRx payments do not automatically apply to the deductible; the user should ask the plan whether receipts may be submitted.

²¹ KFF, 2025 Employer Health Benefits Survey, published October 22, 2025.

²² U.S. Drug Enforcement Administration, Drug Fact Sheet: Testosterone, accessed August 27, 2026. Testosterone is a Schedule III controlled substance under federal law.

²³ Winona Help Center, Winona's Compounding Pharmacies, verified August 27, 2026. Used only for the outside-pharmacy option and $50 platform fee. This page also contains comparative medication claims that The HRT Index does not adopt as evidence.

²⁴ American College of Obstetricians and Gynecologists, Compounded Bioidentical Menopausal Hormone Therapy, accessed August 27, 2026.

²⁵ Centers for Medicare & Medicaid Services, Final CY 2026 Part D Redesign Program Instructions and How much does Medicare drug coverage cost?, accessed August 27, 2026.

²⁶ Internal Revenue Service, Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans, accessed August 27, 2026.

²⁷ Internal Revenue Service, Information Letter 2021-0003, released June 25, 2021. Used for independent substantiation, additional documentation, and debit-card deactivation.

²⁸ National Institute for Health and Care Excellence, Diagnosing perimenopause and menopause, accessed August 27, 2026.

²⁹ GoodRx Research, The Hidden Costs of Menopause: How Symptoms and Prescriptions Impact Women's Finances, published April 30, 2025. Survey fielded in February 2025 among 1,500 U.S. women.

³⁰ Midi Health, Reviews and Testimonials, accessed August 27, 2026. The quoted line is provider-published and is not used as evidence of typical cost or outcome.