Online HRT Available in All 50 States
How this guide is funded: We may earn a commission if you start care through some links here, at no extra cost to you. It never changes our coverage data or who we rank. We include Gennev because an honest all-50-states list should — and we earn nothing from them. Full methodology.
Online HRT is available in all 50 states — but not from every brand you've seen advertised. As of June 2, 2026, four telehealth paths cover the whole country: Midi Health (insurance-friendly, FDA-approved hormones), Gennev (insurance-friendly, menopause-trained OB/GYNs), Sesame (cash-pay, $59/month), and Inner Balance's Oestracream (a 50-state licensure claim, compounded). Two of the most-advertised names — Winona and Hers— do not cover all 50 states. We'd rather tell you that upfront than let you waste a click.
Quick pick: where to start, based on you
| If this is you | Start here | Why |
|---|---|---|
| You have PPO insurance and want clinician-led care | Midi Health | All 50 states + bills most PPO plans + FDA-approved hormones |
| You’re paying cash and want one flat, simple price | Sesame | All 50 states + DC, $59/month, labs included |
| You want an all-in-one bioidentical cream mailed to you | Inner Balance (Oestra) | 50-state licensure, $199/mo then $99.50/mo (compounded) |
| You want a non-affiliate all-50 option to compare | Gennev | All 50 states, insurance-accepted, menopause OB/GYNs |
| You like Winona | Check your state first | Strong where available — but 37 states, not all 50 |
| You want Hers menopause | Check availability first | Hers says it’s not available in all 50 states |
Can you actually get online HRT in all 50 states?
Yes — several online menopause providers serve all 50 states, but “available” doesn't mean the same thing for each one. It can mean the doctor is licensed where you live, that they take your insurance, that they'll mail your medicine, or that they'll send a prescription to your local pharmacy. Those are different promises.
First, a quick definition. HRT (hormone replacement therapy) is prescription estrogen — and usually progesterone too — used to ease menopause symptoms like hot flashes, night sweats, broken sleep, brain fog, mood swings, and vaginal dryness. You can't buy it over the counter. A licensed clinician has to prescribe it, online or in person.
HRT prescriptions for women rose 72% since 2021, according to a November 2025 analysis from Epic Research. That's part of why so many online clinics exist now. The old “is it even safe?” fear eased a lot in early 2026, too — more on exactly what the FDA changed below.
The part most “best HRT” lists skip: Winona covers 37 states, not all 50. Hers says its menopause program isn't available everywhere either. A lot of lists still call them “nationwide.” That's not quite true. We're telling you up front because the whole point of this page is to keep you from wasting a click — or worse, handing your health history to a service that can't even treat you.
Online HRT available in all 50 states: the verified provider list
As of June 2, 2026, Midi Health, Gennev, and Sesame publicly serve all 50 states, and Inner Balance says its founding doctor is licensed in all 50 for its Oestra cream. Winona (37 states) and Hers are not all-50, so we've flagged them. We ranked these by fit for this question — nationwide access — not by who pays us the most. That's why our top pick is not our highest-paying partner.
Last checked: June 2, 2026. Prices are starting figures and change often — confirm on the provider's site before you pay.
| Provider | All 50 states? | What you actually get | Insurance / cash | Starting price (cash) | Confirm before you pay |
|---|---|---|---|---|---|
| Midi Health | ✅ Yes — verified | FDA-approved hormones (patch, pill, gel, ring, cream); menopause-trained clinicians; labs ordered locally | Bills most PPO plans; not Medicaid/Medicare; HSA/FSA | ~$0–$50 copay insured; $250 first / $150 follow-up self-pay | Your exact plan, copay, drug coverage, and whether labs are needed |
| Gennev (non-partner) | ✅ Yes — verified | Menopause-trained OB/GYNs + dietitians; Rx sent to your pharmacy; backed by Unified Women’s Healthcare | Insurance (Aetna, Anthem, UnitedHealthcare); self-pay visits ~$199–$250 | Copay if insured; ~$199–$250 self-pay | Whether your plan is in-network; medication and lab costs |
| Sesame | ✅ Yes (+DC) — provider availability varies by state | Pick your own clinician; video + messaging; Rx to your pharmacy; FDA-approved or compounded | Cash only; HSA/FSA; free Rx savings card | $59/month (includes care, labs, and medication access per Sesame) | A menopause provider is open in your state; exactly what’s included |
| Inner Balance (Oestra) | ✅ 50-state licensure claim — confirm you qualify at intake | Compounded bioidentical vaginal cream (estradiol + progesterone); no bloodwork required to start | Cash only; HSA/FSA | $199/mo first 6 months, then $99.50/mo | Your eligibility, the formula, refills, and the refund window |
| Winona | ❌ No — 37 states + Puerto Rico | Mixed model: FDA-approved patch, tablets, and progesterone capsules PLUS compounded creams; text-only (no video) | Cash only; HSA/FSA; free shipping | $89/month popular estrogen + progesterone cream (compounded); progesterone alone ~$39 | That your state is covered; whether your product is FDA-approved or compounded |
| Hers | ❌ No — not all 50 | FDA-approved medications (estradiol pill, patch, cream; progesterone); provider messaging | Cash only; some HSA/FSA | Oral $79/mo; patches $134/mo (12-month plan) | State availability; the medication route and refills |
What the labels mean: Verified= the provider's own site states all 50. 50-state licensure claim = the provider says its doctor is licensed in 50 states, but you confirm eligibility at intake. 37 states / not all 50= the provider's own materials show it doesn't serve every state.
How to check if online HRT is available in your state
Checking takes about 30 seconds: open the provider's “states we serve” page or eligibility check, enter your state, and confirm a clinician is licensed there before you pay or share your health history. Midi, Gennev, and Sesame cover all 50 states, so the answer there is almost always yes. For Winona and Hers, your state is the deciding factor.
Winona covers 37 states plus Puerto Rico — not all 50. Per Winona's own site, the states it does not serve right now are: Alabama, Alaska, Arkansas, Kansas, Louisiana, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, Utah, Vermont, and West Virginia (plus Washington, D.C.). If you live in one of those, Winona can't treat you yet — but Midi, Gennev, Sesame, and Oestra all can.
Which online HRT provider is right for you?
Pick based on the problem you actually need solved — insurance, cash price, FDA-approved medicine, mailed convenience, or speed — not on who shouts “all 50 states” the loudest. We list the downsides on purpose. A page that only tells you the good parts isn't trying to help you decide.
Midi Health — best for most insured women (our top pick)
Midi is the strongest first stop if you have PPO insurance and want a real clinician who can prescribe FDA-approved hormones. It's available in all 50 states, it's in-network with most PPO plans, and it offers hormones in whatever form fits you — patch, pill, gel, ring, or cream. Many insured women pay a normal specialist copay instead of a flat monthly cash fee.
What you get: a 30-minute video visit with a menopause-trained clinician, a personalized care plan the same day, prescriptions sent to your pharmacy, and labs ordered locally if you need them. Midi is in-network with major PPOs like Aetna, Cigna, Anthem Blue Cross Blue Shield, and UnitedHealthcare. If you're paying cash, it lists $250 for your first visit and $150 for follow-ups. More than 230,000 women use Midi for midlife care.
The honest limit: Midi cannot treat Medicaid or Medi-Cal patients at all — not even as self-pay. And it doesn't bill Medicare; Medicare patients can pay cash but can't submit claims. If you rely on Medicaid or Medicare, Midi isn't your path — use Sesame or Gennev instead.
Sesame — best flat cash price, all 50 states
Sesame is the simplest cash-pay path: $59 a month, all 50 states plus DC. Sesame says the subscription includes ongoing care from a dedicated provider, lab work, and access to medication. You pick your own clinician, meet by video, and message them as needed. Prescriptions go to your local pharmacy, and depending on the provider you choose, the medicine can be FDA-approved or compounded.
The honest limit: Sesame is a marketplace, not a single clinic. A menopause provider has to be available in yourstate, and the exact price, lab handling, and which medications are included can vary by the clinician you pick. It's a little more “check the details before you book” than a one-size program. One note if testosterone is on your mind: Sesame says its menopause providers can't prescribe controlled substances online.
Inner Balance (Oestra) — best for a mailed, all-in-one bioidentical cream
Inner Balance makes Oestra, a compounded bioidentical cream that combines estradiol and progesterone in one daily dose, shipped to your door, with no bloodwork required to start. Inner Balance says its founder, Dr. Sarah Daccarett, is licensed to practice medicine in all 50 states. Pricing is $199/month for the first six months, then $99.50/monthafter. HSA/FSA usually works; insurance doesn't.
The honest limits, stated plainly:
- It's compounded, not FDA-approved.That's a real regulatory difference (see the FDA section below). It doesn't mean it can't help you — it means the finished product hasn't been through the FDA's review.
- It's a cream you apply vaginally(no applicator yet), which isn't for everyone.
- The money-back guarantee has fine print.A refund can cover up to six months of fees — but you must request it within six months of your original order andwithin 14 days of canceling. There's a one-refund-per-customer limit. Confirm the current terms at checkout.
Winona — strong where available, but 37 states, not all 50
Winona is a popular menopause service with no-video, text-based care and free shipping — but it covers 37 states plus Puerto Rico, not all 50. Its most popular estrogen + progesterone cream runs $89/month(progesterone alone is about $39). It doesn't take insurance, but HSA/FSA works, and it has more than 100,000 patients.
Two honest things to know. First, the medication is a mix: Winona says its estrogen patch, estrogen tablets, and progesterone capsules are FDA-approved, while its estrogen and progesterone body creams are compounded — not FDA-approved, though Winona says they're made with FDA-approved ingredients. The popular $89 product is the compounded cream. If FDA-approved medicine matters to you, ask for the patch, tablet, or capsule. Second, there are no video visits — you fill out an onboarding questionnaire and message your doctor through a portal. Winona also says it does not prescribe testosterone.
Hers — fine where available, not a fit for “all 50 states”
Hers prescribes FDA-approved medications (estradiol pill, patch, and cream, plus progesterone), but it states clearly that its menopause program is not available in all 50 states. Reported pricing starts around $79/month for oral medication and $134/month for patches on a 12-month plan. One thing Hers notes: HRT is not FDA-approved specifically for treating perimenopause, though a provider may prescribe it off-label for perimenopausal symptoms at their discretion — common and legal, just worth knowing.
Where it's offered, Hers is a reasonable option with FDA-approved medicine. For this specific page, it isn't a top pick simply because it doesn't meet the all-50 promise. If you're in a supported state and like the brand, confirm availability and price at checkout. If you're not, the all-50 options above can help.
Gennev — worth comparing, even though it's not our partner
We include Gennev because an honest “all 50 states” list shouldn't hide the obvious nationwide options just because we don't earn a commission on them. We have no financial relationship with Gennev, Alloy, or Evernow.
Gennev serves all 50 states, is accepted by Aetna, Anthem, and UnitedHealthcare, and is backed by Unified Women's Healthcare — a large national women's-health network. Its menopause-trained OB/GYNs and dietitians send prescriptions to your pharmacy, and Gennev says 92% of patients report some symptom relief after their first visit. Self-pay doctor visits run in the ~$199–$250 range (confirm current pricing on its site). If you want an insurance-based, doctor-led nationwide option and you'd like to compare beyond our partners, Gennev belongs on your shortlist next to Midi.
Visit gennev.com to check coverage and pricing directly.
Is online HRT safe? What the FDA changed in 2026
Online HRT prescribed by a licensed clinician is legitimate medical care, and in early 2026 the FDA made a major change that eased a decades-old fear. On November 10, 2025, the FDA announced it would remove the “boxed warning” — its strongest label warning — about heart disease, breast cancer, and probable dementia from estrogen-containing menopause hormone products. On February 12, 2026, it approved the first six updated labels. Both announcements are on the FDA's own site.
| What the FDA did | What it means | What it does NOT mean |
|---|---|---|
| Removed heart disease, breast cancer, and probable dementia language from the boxed warning on estrogen products (first six approved Feb. 12, 2026: Prometrium, Divigel, Cenestin, Enjuvia, Estring, Bijuva) | The strongest warnings now better match current evidence | It does not mean HRT is risk-free for everyone |
| New labels emphasize timing — benefits tend to outweigh risks when HRT starts before age 60 or within 10 years of menopause | Starting earlier in the transition is generally more favorable | It does not mean HRT is right at any age or stage |
| Kept the endometrial cancer warning on systemic estrogen-only products (for women with a uterus not also taking a progestogen) | Estrogen-alone still carries that specific risk | The update did not erase every warning |
What this means for you: online HRT is mainstream medicine, not a loophole or a fad. But whether it's right for yourbody still depends on your personal and family health history. That's a conversation for the licensed clinician you sign up with — this page is a comparison resource, not medical advice.
FDA-approved vs compounded HRT: which should you choose?
If FDA-approved hormones fit your situation, they're usually the cleaner first choice, because their safety, quality, and effectiveness have been reviewed by the FDA — while compounded hormones are custom-mixed and are not FDA-approved as a finished product. Both can be appropriate. They are not the same thing, and you deserve to know which one you're paying for.
FDA-approved HRTmeans the exact product — like an estradiol patch, or micronized progesterone (Prometrium) — was reviewed by the FDA for safety, quality, and how well it works. These are also more often covered by insurance.
Compounded HRTis mixed by a compounding pharmacy to fit one person's prescription. The National Academies of Sciences, Engineering, and Medicine recommends limiting compounded bioidentical hormones to specific situations — like an allergy to an ingredient in an approved product, or a dose or form that isn't made commercially.
A quick word on “bioidentical.”The FDA does not treat “bioidentical” as a special safety category, and the Mayo Clinic points out that “bioidentical” and “natural” don't automatically mean safer — in fact, many FDA-approvedproducts are also bioidentical. Don't choose a product just because it's labeled “bioidentical.” Choose based on FDA-approved vs compounded, your symptoms, and your clinician's advice.
| Provider | Medication type |
|---|---|
| Midi | ✅ FDA-approved hormones |
| Gennev | ✅ FDA-approved hormonal (and non-hormonal) medications |
| Hers | ✅ FDA-approved medications (perimenopause use may be off-label) |
| Sesame | ⚠️ FDA-approved OR compounded, depending on the provider you choose |
| Winona | ⚠️ Mixed: FDA-approved patch, tablets, and capsules; compounded creams |
| Inner Balance (Oestra) | ❌ Compounded bioidentical cream (finished product not FDA-approved) |
Want the full deep-dive? Best compounded HRT providers online (2026).
How much does online HRT cost in all 50 states?
Online HRT runs from about $59 to $199 a monthif you're paying cash, and often just a copay if you use insurance through Midi or Gennev. The price on a homepage usually isn't the whole bill — labs, pharmacy copays, and follow-ups can add up, and a “starting at” price sometimes leaves out the medication itself.
| Provider | What you'll pay (cash) | What might not be included |
|---|---|---|
| Midi | ~$0–$50 copay insured; $250 first / $150 follow-up self-pay | Your copay, deductible, medication cost, labs |
| Gennev | Copay if insured; ~$199–$250 self-pay doctor visit | Medication, labs, plan-specific costs |
| Sesame | $59/month (care, labs, and medication access per Sesame) | Pharmacy cost for some prescriptions; provider-to-provider differences |
| Inner Balance (Oestra) | $199/mo, then $99.50/mo after 6 months | Confirm formula, refills, and refund terms |
| Winona | $89/month popular cream; progesterone ~$39; patch ~$126–$149 | State eligibility; FDA-approved vs compounded; insurance not accepted |
| Hers | Oral $79/mo; patches $134/mo (12-month plan) | State availability; refill and plan details |
Three cost traps to watch:
- “Starting at” can exclude the medicine. A low visit fee doesn't always include your prescription.
- Insurance doesn't always mean cheap. A high deductible can mean you pay full price for a while. Sometimes an FDA-approved generic with a pharmacy coupon beats your copay.
- Labs may be extra. Some providers include them, some bill separately, and some send you to a lab on your own.
One bright spot: FDA-approved generic estradiolcan be very affordable at a regular pharmacy — often roughly $10–$50 a monthwith insurance or a coupon — which is sometimes cheaper than a flat cash subscription.
See the full math in our HRT cost guide for 2026.
Do you need bloodwork for online HRT?
Not always — it depends on the provider, your age, your symptoms, your history, and what the clinician is checking. Some online clinicians prescribe based on your symptoms and medical history. Others order labs first or want recent results before adjusting your dose.
- Midimay order local labs when it's clinically appropriate.
- Sesame says lab work is included when your provider orders it (the exact lab process can differ by state).
- Gennev can order labs through your care plan.
- Inner Balance (Oestra) says no bloodwork is required to start.
- Winonabuilds a plan from your intake questionnaire; labs aren't always required.
Our honest advice: don't pick a provider just because it promises the fewest labs. Pick the one whose lab and pharmacy steps are clear before you pay, so there are no surprises.
Can online doctors prescribe estrogen, progesterone, and testosterone?
Online clinicians can prescribe estrogen and progesterone when it's appropriate and legal in your state, but testosterone is a different, more tightly regulated category — don't assume it works the same way.
Common forms prescribed online:
- Estradiol as a pill, patch, gel, or vaginal cream
- Progesterone capsules (or combined estrogen/progestogen products)
- Vaginal estrogen for dryness and related symptoms (genitourinary syndrome of menopause, or GSM)
About testosterone — read this carefully. Testosterone is sometimes used off-label in low doses for low libido in menopause. But testosterone is a Schedule III controlled substancein the U.S., and the FDA approves testosterone products mainly for men with low testosterone tied to certain medical conditions — not as a general wellness product. Prescribing it online is more limited and involves more steps. Sesame says its menopause providers can't prescribe controlled substances online, and Winona says it doesn't prescribe testosterone. Estradiol and progesterone are notcontrolled substances, so they're more straightforward online.
Who should not start HRT online?
Online HRT isn't the right first step for everyone — and the responsible move is to tell you when to seek in-person care instead of just pointing you to a “start” button.
Please get in-person or urgent care — not an online intake form — if you have:
- Unexplained vaginal bleeding
- A personal history of breast or another hormone-sensitive cancer
- A history of blood clots, stroke, or heart attack
- Active liver disease
- Chest pain, severe shortness of breath, or stroke-like symptoms right now — call 911
Online HRT also may not fit you if you:
- Rely on Medicaid or Medicare to pay for care (most of these services don't bill those programs)
- Need an in-person exam before treatment
- Want testosterone as your main therapy
- Expect guaranteed medication before a clinician reviews your case
You can find a Menopause Society Certified Practitioner near you through the Menopause Society's public directory at menopause.org.
What happens after you sign up?
Almost every online HRT path follows the same steps. The big differences are whether the provider bills insurance, mails your medicine or sends it to your pharmacy, and whether labs come first.
- Check your state. Make sure the provider serves where you live.
- Complete the intake.You'll answer questions about symptoms, history, and medications. This is not the same as being approved.
- Clinician review or visit. Midi and Gennev do a 30-minute video visit; Sesame offers a video visit (sometimes same day); Winona and Inner Balance review your questionnaire through a secure portal.
- Labs, if needed. Some plans order bloodwork before prescribing or adjusting.
- Your plan and prescription.This may be a local-pharmacy prescription (Midi, Gennev, Sesame), mailed medication (Winona, Oestra), or — if it's not right for you — no prescription and other guidance.
- Follow-up and refills. Midi gives you a care plan the same day; Winona says it delivers within a week with unlimited messaging. Confirm refill and cancellation terms up front.
What women going through this actually say
Most women searching for online HRT aren't trying to become hormone experts — they just want care that works where they live, without being dismissed. The pattern in real reporting is hard to miss.
USA TODAY reported on women who saw multiple doctors over years before getting help. One woman, Julie Andresen, said her doctor asked her whether she wanted “night sweats or… cancer,” despite no family history of breast cancer. Surveys found that 1 in 5 women wait a year before a menopause diagnosis, and that some women saw 11 doctors before getting help. That's the gap online menopause care is trying to close. And it's exactly why “can I actually get this in my state?” feels like such a loaded question — you've already been brushed off enough.
You don't need anyone's permission to want to sleep through the night again. You just need a provider who can actually treat you.
How we verified this
We checked each provider's own website for state availability, price, medication type, insurance, labs, and shipping, and we cross-checked every medical and FDA claim against authoritative sources — then ranked providers by fit for this question, not by payout.
✅ Verified June 2, 2026:
- Which states each provider says it serves — including reading Winona's live state list (37 states + Puerto Rico) and Hers's “not all 50” notice
- Starting prices listed publicly (Sesame's $59/month, Midi's $250/$150 self-pay, Oestra's $199→$99.50, Winona's $89 popular cream)
- Whether each medicine is FDA-approved, compounded, or both — including Winona's mixed model
- Insurance vs cash-pay, and HSA/FSA acceptance — including Midi's Medicaid and Medicare rules
- How labs and prescriptions are handled (local pharmacy vs mailed)
- FDA, The Menopause Society, the National Academies, the Mayo Clinic, and the DEA for every medical and regulatory claim
What still needs your own checkout:the exact menopause provider and lab handling inside the Sesame marketplace for your state; your plan-specific insurance cost; medication cost after a clinician's decision; and current promo or refund terms. Confirm these on the provider's site before you pay.
FAQ: online HRT available in all 50 states
Is online HRT available in all 50 states?
Yes — from some providers. Midi, Gennev, and Sesame serve all 50 states, and Inner Balance says its founding doctor is licensed in all 50 for its Oestra cream. Two popular names are not all-50: Hers says it’s not available in every state, and Winona covers 37 states plus Puerto Rico.
Which online HRT provider is best if I have insurance?
Midi is the strongest first option to check, because it serves all 50 states and is in-network with most PPO plans including Aetna, Cigna, Anthem, and UnitedHealthcare. You’ll still need to confirm your specific plan, copay, deductible, and whether your medication is covered. Gennev is a strong insurance-based alternative.
Which online HRT provider is best without insurance?
For cash pay, compare Sesame ($59/month, all 50 states), Winona where available ($89/month popular cream in 37 states), and Inner Balance/Oestra ($199 then $99.50/month). Sesame fits women who want video care and a local-pharmacy prescription; Winona and Oestra mail your medicine.
Is Winona available in all 50 states?
No. Winona’s own site lists 37 states plus Puerto Rico. It does not yet serve Alabama, Alaska, Arkansas, Kansas, Louisiana, Mississippi, New Mexico, North Dakota, Rhode Island, South Dakota, Utah, Vermont, West Virginia, or Washington, D.C. Confirm your state before starting.
Is Hers menopause available in all 50 states?
No. Hers states that its menopause offering is not available in all 50 states. Check availability for your state before comparing price.
Is Winona’s HRT FDA-approved or compounded?
Both, depending on the product. Winona says its estrogen patch, estrogen tablets, and progesterone capsules are FDA-approved, while its estrogen and progesterone creams are compounded and not FDA-approved, though made with FDA-approved ingredients. Its most popular product is the compounded cream, so ask for the patch, tablet, or capsule if FDA-approved medicine matters to you.
Does online HRT require bloodwork?
Sometimes. It depends on the provider, your history, and your symptoms. Sesame includes labs when a provider orders them; Inner Balance says no bloodwork is required to start; Midi may order local labs when appropriate.
Is compounded bioidentical HRT FDA-approved?
No. Compounded hormones are custom-mixed and are not FDA-approved as finished products. The Mayo Clinic and the National Academies caution that compounded bioidentical hormones are not automatically safer, and “bioidentical” is not a special FDA safety category.
Can online doctors prescribe testosterone for menopause?
Sometimes, off-label and in low doses, but testosterone is a Schedule III controlled substance, so prescribing it online is more limited and involves extra steps. Some menopause platforms don’t offer it. Estrogen and progesterone, the core of menopause HRT, are not controlled substances.
What should I verify before I pay for online HRT?
State availability, the clinician’s licensure for your state, whether the medicine is FDA-approved or compounded, insurance vs cash cost, medication cost, labs, mailed vs pharmacy pickup, the cancellation or refund policy, and whether your medical history needs in-person care.
Still deciding? Let us match you in 60 seconds
You'll get a starting point built around your state, whether you have insurance, whether you want FDA-approved or compounded medicine, and whether you'd rather pick up at a pharmacy or have it mailed. No diagnosis. No pressure. Just a clear next step toward feeling like yourself again.
Related guides
- Best Online HRT Providers for Menopause (all types)
- Online HRT Providers That Accept Insurance
- Best Compounded HRT Providers Online (2026)
- Online HRT With the Same Clinician Every Visit
- Best Online HRT Providers for Women Over 60
- HRT Cost Guide 2026
- HRT Benefits, Risks, and FDA-Approved vs. Compounded
- How We Rank Providers
Sources
Medical and regulatory:
- U.S. FDA — “FDA Approves Labeling Changes to Menopausal Hormone Therapy Products,” February 12, 2026 (boxed-warning removal; first six products): fda.gov
- HHS/FDA — boxed-warning removal announcement, November 10, 2025 (endometrial-cancer warning retained).
- The Menopause Society — Hormone Therapy patient education and position statement.
- National Academies of Sciences, Engineering, and Medicine — guidance on limiting compounded bioidentical hormone therapy.
- Mayo Clinic — “Bioidentical hormones: Are they safer?”
- DEA Diversion Control Division — Controlled Substance Schedules (testosterone, Schedule III): dea.gov
- Epic Research — “Hormone Replacement Therapy Prescriptions for Women Up 72% Since 2021,” November 24, 2025.
- USA TODAY — reporting on women's difficulty finding menopause care (Laura Trujillo).
Provider data (verified June 2, 2026):
- Midi Health — joinmidi.com (all 50 states; PPO insurance; Medicaid/Medicare rules; $250/$150 self-pay; FDA-approved hormone forms).
- Gennev — gennev.com (all 50 states; Aetna/Anthem/UnitedHealthcare; self-pay pricing).
- Sesame — sesamecare.com ($59/month menopause subscription; all 50 states + DC; no controlled substances online).
- Inner Balance — innerbalance.com (50-state licensure claim; Oestra $199→$99.50/month; compounded cream; refund policy).
- Winona — bywinona.com (37 states + Puerto Rico; FDA-approved patch/tablets/capsules and compounded creams; $89/month popular cream; no video; no testosterone).
- Hers — forhers.com (not all 50 states; FDA-approved medications; oral $79/mo; patches $134/mo).
The HRT Index is an independent comparison resource for HRT telehealth providers. This guide is for comparison and education. It is not medical advice and was not medically reviewed by a clinician. HRT decisions should be made with a licensed clinician who can evaluate your symptoms, history, and risks. If you're having a medical emergency, call 911. We re-check state coverage, pricing, insurance language, and medication details at least quarterly, and sooner after major provider or FDA updates. Found something out of date? Let us know.