Online HRT in Michigan for Menopause: Providers, Costs & Insurance

By The HRT Index Editorial Team · Educational research — not medical advice, and not reviewed by a clinician. Published June 23, 2026 · Last verified: June 2026 · Last updated: June 23, 2026 · We recheck prices monthly and the full comparison quarterly. Jump to verification notes ↓

The HRT Index is reader-supported. We may earn a commission when you start care through some links on this page, at no extra cost to you. It never changes our recommendations or the order we list providers — current verification and your fit decide that. We include cash-pay, insurance, and in-person options, even ones that pay us nothing, because that's the only way this page earns your trust.

If you're reading this at 11pm — wiped out, not sleeping, tired of being told you're "too young" or to just "wait it out" — we see you. Here's the straight answer.

Yes, you can get online HRT in Michigan for menopause.

It's legal, and you usually won't need an in-person visit first: a Michigan-licensed clinician can evaluate you and prescribe over telehealth, as long as the visit meets Michigan's rules. Two questions sort out most of the choice: how you want to pay, and what kind of medication you want. If you want to use insurance (a PPO), Midi is the first to check. If you want cash-pay video care with lab work included, look at Sesame — after confirming a clinician is available for your ZIP code. If you want low-friction care with prices listed up front, look at Winona — but check the exact product, because some are FDA-approved and some are compounded.

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.

Your Michigan options at a glance

This is the table you'd otherwise build yourself across a dozen tabs — five providers compared on the things that actually decide your choice.

What's the best online HRT option in Michigan?

There's no single winner for everyone — and any honest page will tell you that. For most Michigan women with commercial PPO insurance, Midi Health is the strongest first check, because it bills insurance and its standard menopause care uses FDA-approved hormones. Paying cash and want a real video visit? Sesame, at $59 a month, is the leading pick. Want to skip the scheduled call? Winona is the clearest verified option in Michigan — though check which product you're getting.

Why no universal "#1"? Because the right answer flips on one or two facts about you:

• →PPO plan → Midi, so insurance does the heavy lifting.
• →Paying cash, want to see a clinician's face → Sesame.
• →Paying cash, want lowest entry for FDA-approved meds → Hers (after confirming Michigan).
• →Paying cash, just want it handled by message → Winona.
• →On Medicaid, or your history is complicated → an in-person clinician is probably your real starting point.

→ Check whether Midi takes your Michigan insurance — see your coverage before you book.

Not sure which lane is yours? → See your match with Find My HRT Path.

Can you legally get HRT online in Michigan?

Yes. A clinician who is licensed or otherwise authorized to practice in Michigan can provide telehealth care and prescribe here, as long as the visit meets Michigan's rules — patient consent, the clinician's scope of practice, proper documentation, appropriate follow-up or referral, and the same standard of care as an in-person visit. Estrogen and progesterone aren't controlled substances, so a telehealth evaluation can support prescribing them. You should still confirm the clinician's Michigan license, and remember that "legal" is not the same as "covered by your insurance."

What Michigan actually requires before you get a prescription

Under Michigan Public Health Code (MCL 333.16283–16288) and profession-specific board rules, a prescriber must build a real patient relationship before writing your prescription. In plain terms, the clinician must:

• Be licensed or authorized in Michigan under the relevant profession (physician, nurse practitioner, or physician assistant). Where you physically sit during the visit is what matters — not where the company is based.
• Take an up-to-date medical and medication history.
• Talk through the benefits and risks.
• Do an appropriate evaluation and reach a diagnosis.
• Order testing or an in-person exam when the standard of care calls for it.
• Set up follow-up or a referral path.

A bare online questionnaire, by itself, is not enough to start a brand-new patient relationship. A legitimate service has a clinician actually reviewing you — not just rubber-stamping a form. If it feels like a vending machine, slow down.

"Legal to prescribe" and "covered by insurance" are two different questions

Michigan law generally prevents an insurer from denying an otherwise-covered service just because it was delivered appropriately by telemedicine (per MCL 500.3476). That's real — but it does not mean every online provider is in your network, that your deductible is met, or that your exact medication is on your plan's list.

Put those together: a cash-pay, clinician-reviewed async service can be perfectly legal and still not be something your insurance pays for. That's not a scam — it's a different lane.

Verify any Michigan clinician in five minutes

1. Get the clinician's full name from the provider.
2. Open Michigan LARA's license-verification tool (MiPLUS) at michigan.gov/lara.
3. Confirm the license is active and check for disciplinary actions.
4. Confirm the pharmacy and the exact medication.
5. Save the provider's current price and cancellation page (prices change).

The testosterone exception

Some women use a low dose of testosterone off-label for low libido after a clinical evaluation. Be aware: testosterone is a Schedule III controlled substance. Federal telemedicine flexibilities run through December 31, 2026, which let a DEA-registered clinician prescribe Schedule II–V controlled medicines by audio-video telehealth without a prior in-person visit. The prescriber also needs to be registered with Michigan's prescription monitoring system (MAPS) and must review a MAPS report before prescribing more than a short supply. Most online menopause platforms in this guide don't prescribe controlled substances — Winona, for example, says it doesn't prescribe testosterone at all. None of this affects your ability to get estrogen and progesterone online.

→ See which Michigan care formats fit your situation — match yourself to live-video, async, or in-person before you commit.

When is online HRT not the right place to start?

Online care isn't automatically safe just because a company serves Michigan. A good telehealth clinician will send you for an in-person exam, imaging, or testing whenever your symptoms or history can't be handled safely on a screen. Knowing when not to start online is a sign of a trustworthy provider — not a weaker one.

And get an individualized clinician or specialist review — where telehealth may or may not be appropriate — if you have a complex history involving hormone-sensitive cancer, blood clots, stroke, cardiovascular disease, or significant liver disease, or symptoms outside what an online menopause provider treats.

→ Check whether online care fits my situation — our tool can return a "see someone in person first" result, and it's built to do exactly that when your answers call for it.

How do Michigan online HRT providers compare, one by one?

Below is the deeper look at each provider — who it's best for, who it isn't, what it costs, and the honest trade-off — so you can match the lane from the table above to the details.

Midi Health — best first check if you have PPO insurance

Midi is the first option to check if you have a PPO plan and want a menopause-specialist model with FDA-approved medication. Per Midi's pricing page, it's in-network with most PPO plans. It is not a universal winner, because network status, deductible, and medication coverage still depend on your plan — and it doesn't work with Medicaid, while Medicare beneficiaries can use it only as self-pay.

What we confirmed (June 2026, from Midi's own pages):

• Available in all 50 states (provider-stated), including Michigan.
• In-network with most PPO plans (provider-stated). Coverage varies; you may still owe a copay, coinsurance, or deductible.
• Self-pay: $250 first visit, $150 follow-ups — not including labs or medicine. Midi verifies your card at registration but only charges after your appointment completes.
• Its standard menopause HRT is FDA-approved (estradiol, progesterone, in patch/pill/gel/vaginal forms). Midi also runs a separate compounded "Custom Rx" line — so confirm whether your specific prescription is FDA-approved or compounded.
• First visit is 30 minutes; follow-ups are 15. Labs or imaging ordered when needed; billed separately (may go through insurance).
• Cannot treat Medicaid patients — even self-pay. Not covered by Medicare (Medicare members can self-pay, but no claims can be submitted).

The trade-off: Midi does not offer one flat all-inclusive subscription, and it doesn't remove the step of checking your insurance. If a simple flat cash price is your priority, Winona or Hers is the easier path. But because Midi runs as a real clinical practice that bills insurance, it's the one option here that can turn existing PPO benefits into lower-cost, FDA-approved specialist care — worth a few minutes of insurance legwork.

"Midi was so easy: I got a same day appointment and they took my insurance." — Victoria W.
Customer testimonial published on Midi's website. Reflects one person's experience — not a typical result — and does not establish that any treatment is safe or effective for you.

Sesame — best for cash-pay video care

Sesame is a strong starting point if you want a scheduled video visit, don't want anyone billing your insurance, and prefer your prescription sent to a local pharmacy. Its menopause subscription includes the visit and lab work; the medication is billed separately at the pharmacy. Because Sesame is a marketplace, clinician availability varies by ZIP — so confirm a menopause clinician is available for your Michigan ZIP, and check today's price, before you commit.

What we confirmed (June 2026):

• Menopause subscription is $59/month, month-to-month — confirm the current number at checkout. The subscription includes a video visit, messaging, and a lab panel (CBC, A1c, thyroid, lipids, and metabolic panel) when your provider orders it.
• Your prescription goes to your local pharmacy — medicine is a separate cost, not part of the $59.
• You choose your own provider and pick visit times.
• Cash only — no Medicare, Medicaid, or insurance — but you can submit an itemized receipt to HSA/FSA.
• Cancel anytime before your next billing cycle; past months aren't refunded. Full refund if you cancel at least 3 hours before your first visit.

The trade-off: Sesame does not make your medication free or all-inclusive. What you get instead is a low, transparent care fee, included labs, and the freedom to shop your medication's cash price at a local pharmacy. Sesame can prescribe FDA-approved medicine or compounded — if you want FDA-approved (recommended first), say so at your visit.

Winona — best for low-friction care with listed prices

Winona is the clearest Michigan-specific option here for someone who wants a simple, no-scheduled-visit process and published medication prices. Winona says it has a Michigan page staffed by Michigan-licensed physicians, requires no bloodwork, and ships from its own pharmacy. The key thing to verify is the product: Winona says its patch, tablets, and capsules are FDA-approved, while its creams are compounded — choose that on purpose.

What we confirmed (June 2026, per Winona's published pricing):

• No separate membership fee; prescribed treatments come on a subscription with automatic refills; HSA/FSA accepted; free shipping from its own pharmacy.
• Cancellation is tight: full refund only within a 24-hour window after an order processes. Once the pharmacy starts your personalized order, it generally can't be returned or refunded. Watch for the email when an order processes.
• Using an outside pharmacy adds a $50 monthly platform fee on top of your medication cost.

On the compounded question, straight talk: Winona's body creams are compounded, which means they're not FDA-approved and have not been proven safer or more effective than FDA-approved hormones. If FDA-approved status is your priority, choose Midi, Sesame, or Hers. Compounding has real, narrow uses — but it's not the option ACOG and The Menopause Society recommend first.

Hers — lowest cash entry for FDA-approved meds

Hers is a solid cash-pay choice if you want FDA-approved estradiol and micronized progesterone at the lowest entry price here — oral from $79/month and the patch from $134/month on a 12-month plan, per Hers' published rates.

What we confirmed (June 2026):

• Online intake, licensed-provider review, medicine delivery, and messaging.
• FDA-approved oral and transdermal estradiol and progesterone.
• Oral plan from $79/month; patch plan $134/month, on 12-month plans (pricing rechecked June 2026).
• Hers states it is "not available in all 50 states" — so confirm Michigan eligibility at intake.
• Cash pay. HRT for perimenopausal symptoms may be prescribed off-label — an FDA-approved medication isn't automatically FDA-approved for every use a platform markets, so ask your clinician.

The trade-off: Hers' lowest prices are tied to a 12-month plan, and its public page doesn't publicly confirm every state. That makes it a "verify-first" option rather than an automatic Michigan pick. Confirm whether the plan is billed upfront or monthly, plus the renewal and cancellation terms, at checkout.

→ Check whether Hers serves Michigan and review the plan terms — confirm your state and the commitment before you start.

Comparing Hers against the rest? → Get your best-fit path.

Inner Balance (Oestra) — a compounded vaginal-cream option

Oestra fits a specific person: someone who has decided she wants a compounded vaginal cream that combines estradiol and progesterone, ships to her door, and requires no labs or scheduled visit. It runs $199/month for the first six months, then $99.50/month, per Inner Balance's current pages.

• Best for: a woman who specifically wants a single compounded vaginal cream and accepts cash-pay care.
• Not for: anyone who wants an FDA-approved product, plans to use insurance, or wants the lowest first-90-day price.

Honest flags: Oestra is a compounded finished drug and is not FDA-approved. It's marketed for whole-body effects, which is different from an FDA-approved low-dose local vaginal estrogen — the route alone doesn't give it the same absorption, approved uses, evidence, or risk profile. And while Inner Balance advertises a 180-day money-back guarantee, the refund has timing conditions, so confirm the deadline before you rely on it.

Still weighing compounded vs FDA-approved, or cash vs insurance? → Get my personalized HRT path.

What does online HRT in Michigan cost in your first 90 days?

Published online-HRT prices aren't directly comparable, because some cover only a membership, some include a visit, and some quote a single medication. To compare honestly, you have to separate the visit, the medication, the labs, and any introductory price that jumps later.

The formula: First-90-day cost = visit or membership fees + medication + labs + shipping + any required follow-up − confirmed insurance payment. We never subtract a guessed insurance payment.

Your first-90-days cost, side by side

These are advertised-equivalent numbers, not promises about how you'll be billed, and they leave out insurance cost-sharing, medicine bought separately, taxes, and plan changes (all figures provider-stated, June 2026).

Among the published figures here, the oral options are the lowest, and a compounded program is the priciest. A low monthly fee like Sesame's is genuinely low, but the medication is billed separately — the membership isn't your all-in cost. And Midi's per-visit pricing looks high next to a flat subscription, which is exactly why it tends to make sense when your insurance does the heavy lifting.

Save this at checkout — screenshot these six things: today's charge · the renewal date · the renewal amount · what's included (visits? meds? labs?) · the cancellation deadline · refund eligibility.

Does Michigan insurance cover online HRT?

Insurance can cover a telehealth menopause visit and prescription in Michigan, but it depends on your exact clinician, plan, pharmacy, medication, deductible, and prior-authorization rules. Among the providers here, Midi is the insurance-based option (in-network with most PPO plans); Hers, Sesame, Winona, and Inner Balance are cash-pay. Treat "accepts insurance" as the start of your homework, not proof of a low copay.

PPO, Medicaid, Medicare, and HMO — the quick version

• PPO: Per Midi's pricing page, Midi is in-network with most PPO plans. Your actual out-of-pocket depends on your plan's copay, deductible, and coinsurance, so check your specific benefits.
• Medicaid: Midi can't treat Medicaid patients, even as self-pay. Michigan Medicaid's formulary does list specific hormone products, sometimes with quantity caps or prior authorization. Your own OB-GYN or a Michigan health system is usually the better route for covered care.
• Medicare: Midi visits aren't covered by Medicare, but Medicare beneficiaries can use Midi as self-pay — you just can't file claims. For covered care, your own clinician is typically the better path.
• HMO: HMOs usually require you to stay in-network and may need a referral, which most direct-to-consumer telehealth platforms don't fit. Start with your plan's in-network women's health or primary care clinician.
• HSA/FSA: Some providers say they accept HSA/FSA cards or give you an itemized receipt. Whether the expense is eligible depends on your plan administrator — it's a real way to use pre-tax money, but it's not the same as insurance covering the service.

"I'm considering a telehealth menopause visit. Is the clinician in-network on my exact plan? What's my telehealth or specialist copay? Are estradiol patches, oral estradiol, micronized progesterone, and vaginal estrogen on my formulary? Does any need prior authorization? Are labs subject to my deductible?"

Write down the answers and the date. Five minutes here can save you a surprise bill.

Want the FDA-approved, possibly-insured route? → Check Midi coverage and Michigan availability — confirm coverage before you book. On Medicaid, Medicare, or an HMO? → Get your best-fit path, which can point you to local covered care.

FDA-approved or compounded HRT — what's the difference?

FDA-approved hormone therapy has been reviewed by the FDA for safety, effectiveness, and manufacturing quality before it's sold. Compounded hormones are custom-mixed by a pharmacy and are not FDA-approved — the FDA doesn't review them before they reach you. "Bioidentical" describes the molecule, not a stamp of approval — so it doesn't mean "FDA-approved," and it doesn't mean "compounded" either.

The FDA puts it plainly: compounded drugs are not FDA-approved, and the agency doesn't verify their safety, quality, or effectiveness before they're sold. ACOG says compounded hormone therapy shouldn't be prescribed routinely when an FDA-approved option exists.

"Bioidentical" does not mean "compounded"

"Bioidentical" just means a hormone built to match the ones your body makes. Plenty of FDA-approved products are already bioidentical — like estradiol and micronized progesterone. A compounded product might contain those same hormones too. The difference isn't the ingredient — it's whether the finished medicine went through FDA approval. So if a company says its cream uses "FDA-approved ingredients," that does not mean the cream itself is FDA-approved.

Which Michigan providers use which

• FDA-approved paths: Midi's standard HRT; Hers (if Michigan-eligible); Sesame's pharmacy prescriptions (ask your clinician for FDA-approved); Winona's patches, tablets, and progesterone capsules.
• Compounded paths: Winona's body creams; Inner Balance's Oestra.

The big 2026 update you've probably heard about

On February 12, 2026, the FDA approved label changes that removed the "boxed warning" — the most prominent warning on a drug label — about heart disease, breast cancer, and probable dementia from six menopause hormone products (Prometrium, Divigel, Cenestin, Enjuvia, Estring, and Bijuva). The FDA said the decades-old warnings were misleading and overstated the risk for most women, especially those who start therapy before age 60 or within 10 years of menopause.

Can you choose a patch, pill, gel, or vaginal estrogen online in Michigan?

Yes — online providers commonly offer more than one route, and the route matters for both how the medication works and its risk profile. The big split is systemic versus local. Systemic HRT (patches, pills, gels, sprays) treats whole-body symptoms like hot flashes and night sweats. Local vaginal estrogen mainly treats vaginal and urinary symptoms, with low systemic absorption when it's an FDA-approved low-dose product.

• Patches and gels are transdermal (through the skin), which avoids first-pass metabolism in the liver. Research suggests transdermal estrogen may carry a lower risk of blood clots and stroke than oral estrogen — a reason some clinicians prefer it for certain patients. The choice is individual.
• Pills are simple and familiar, and generic oral estradiol is often the lowest-cost option.
• "Vaginal" doesn't automatically mean "local-only." An FDA-approved low-dose vaginal estrogen is local. A compounded vaginal product marketed for whole-body effects (like Oestra) is different — the route alone doesn't make it equivalent in absorption, approved uses, evidence, or risk.

Which providers offer which routes? Midi prescribes FDA-approved options across routes (patch, pill, and more). Hers offers oral and patch FDA-approved estradiol and progesterone. Winona offers pills, patches, body creams, and vaginal forms (mix of FDA-approved and compounded — confirm the product). Sesame routes a prescription to your local pharmacy, so available forms depend on what your clinician prescribes. Inner Balance (Oestra) offers one compounded vaginal cream. Confirm the exact product and its status before you fill it.

Want to go deeper? See the estradiol patch vs the pill — a full breakdown of both routes, FDA status, and which clinicians prefer each.

Do you need blood tests before starting HRT online?

Routine hormone testing often isn't required to recognize typical perimenopause in an otherwise healthy midlife woman, because hormone levels swing day to day and your symptoms and history tell the clearer story. That's the position of major medical groups, including ACOG. A clinician may still order tests when the picture is unclear, another condition needs ruling out, or your history calls for it.

Why "no labs required" isn't automatically a perk: for many women, menopause is a symptom-based diagnosis, and blood hormone levels bounce around so much they're often not that helpful. But a careful clinician still orders testing when something else needs ruling out — like a thyroid problem. The smart question for any provider: what would make you order labs or send me in person?

How does online HRT work in Michigan, step by step?

Online menopause care usually means a health-history intake, review by a Michigan-licensed clinician, a video or thorough online evaluation, and — if it's appropriate for you — a prescription sent to a local pharmacy or shipped from the provider's own pharmacy.

1. 1
   Pick a lane before you pick a brand. Insurance-first, cash-pay video, or low-friction online. Getting this right first saves you from re-doing intake somewhere else.
2. 2
   Do the intake honestly. Your history is how the clinician keeps you safe — blood clots, breast cancer, heart disease, liver issues, all of it. The intake isn't a hurdle to "get approved"; it's the safety check.
3. 3
   Know who's evaluating you. Get the clinician's name and confirm their Michigan license (that LARA tool). Some providers use live video; others use a clinician-reviewed online intake.
4. 4
   Review the actual medication. Route, strength, FDA-approved or compounded, which pharmacy, the full price, and whether a progestogen is prescribed alongside estrogen (standard if you have a uterus and take systemic estrogen).
5. 5
   Get your prescription or shipment. Sesame and Midi route to a local pharmacy; Winona and Inner Balance ship to your door.
6. 6
   Handle follow-up. Compare what's included: messaging, refills, check-ins, and what happens if a side effect shows up.

What are the honest downsides of online HRT?

Online care can improve access, but it can also fragment your records, hide the true price behind a low headline number, give you less face-to-face time, or delay the moment someone realizes you need an exam. These aren't reasons to avoid telehealth — they're things to weigh.

• The advertised price may not be the treatment price. A $59 membership or a "from $39" medication line is real, but your all-in cost includes the visit and the medication and sometimes labs.
• A no-visit model isn't a live consultation. Winona's online intake is fast and convenient — but if you want to actually talk through your history with a doctor before starting, that's not Winona's model. If a live conversation matters to you, Midi or Sesame (both video) or an in-person clinician is the better fit.
• Insurance language can mislead without your exact plan. "Accepts insurance" tells you nothing about your network, deductible, or formulary until you check.
• The online provider may not have your full record. If you have an existing OB-GYN or recent screenings, plan to share that history so care stays coordinated.
• Telehealth can't do every exam. Some symptoms need an in-person look, a swab, imaging, or a procedure. A good provider tells you when to step out of telehealth.
• Compounded is a real, different choice. A shipped compounded cream is convenient, but it's not an FDA-approved product. That's not a reason to rule it out; it's a reason to choose it on purpose, not by accident.

What if your prescription is delayed, unavailable, or you need to cancel?

Refill timing, cancellation deadlines, and what happens after a medication is prepared differ sharply by provider — and with compounded medication, your window to cancel can be short. Read these rules before you start, not after.

What if your estradiol patch or progesterone is hard to fill?

Some estrogen patches have been hard to find in 2026, so a delayed refill doesn't mean your treatment is gone for good. Call your prescriber and a few pharmacies before changing anything yourself — and let your clinician, not a website, decide on any switch.

Demand for HRT — especially estrogen patches — has jumped, and manufacturers haven't fully kept up. A Midi Health survey of nearly 8,000 women found 44% had trouble filling an estrogen-patch prescription. Availability varies by brand, strength, and pharmacy — call around before assuming your prescription is unavailable.

1. Ask whether another nearby pharmacy has your exact prescription.
2. Ask your pharmacy to order a different manufacturer's version.
3. Call your prescriber if you need a substitute or a new prescription.
4. Confirm the dose and route before accepting anything different.
5. Talk with your clinician about FDA-approved alternatives — estradiol gel, spray, a systemic vaginal ring, oral tablets, or a different patch brand.

One honest caution: some sites push compounded cream as the automatic "fix" for the shortage. Compounded medicine is one option, but it's not FDA-approved and isn't a "better" or "more natural" substitute — treat it as a conversation with your clinician, not a default.

What should you verify before you pay for online HRT?

Before you pay, you should be able to name the clinician, the exact medication, the full first-90-day cost, the renewal terms, and how follow-up and cancellation work. A provider that won't make those clear hasn't earned your card number.

How we verified this Michigan guide

We built this comparison under The HRT Index Verification Standard, using each provider's dated pricing and policy pages, Michigan's licensing and telehealth rules, and primary medical and regulatory sources — and we keep editorial conclusions separate from provider claims and from anything still unconfirmed. We don't take payment for rankings, and we don't invent scores or reviewers.

We weigh every provider on exactly five pillars, in this order: (1) Clinical legitimacy — is the clinician licensed in Michigan, is the pharmacy real, and is the regulatory language truthful? (2) Care quality — how are you evaluated, how do you reach a clinician, and what does follow-up look like? (3) Medication fit — routes offered, FDA-approved versus compounded status, local versus shipped pharmacy. (4) Price transparency — the initial price, medication, labs, follow-up, renewal, and cancellation. (5) Access — Michigan availability, insurance or cash-pay, scheduling, and fulfillment.

By The HRT Index Editorial Team. This page was built from primary provider documentation, Michigan legal and licensing sources, FDA and HHS materials, and dated price and availability checks. It is editorial research, has not been reviewed by a clinician, and is educational rather than medical advice. We do not use a named individual author or claim clinical credentials we don't have. Found something out of date? Tell us through our contact page and we'll re-verify.

Frequently asked questions about online HRT in Michigan

Online HRT is available to many Michigan women, but legality, availability, medical eligibility, insurance, and price are five separate questions. Quick answers below; details are in the sections above.

Affiliate disclosure: Some provider links above are sponsored, meaning we may earn a commission at no extra cost to you. We label those links. Commission never changes which option we recommend for your situation — and we point you to routes that earn us nothing, like seeing your own clinician, whenever they fit you better.

How we sourced this (verify current details before relying on them): provider pricing, eligibility, and policy pages for Midi (joinmidi.com), Sesame (sesamecare.com), Winona (bywinona.com and its help center), Hers (forhers.com), and Inner Balance (innerbalance.com); the U.S. FDA and HHS announcements on menopausal hormone therapy labeling (February 12, 2026) and FDA guidance on compounded drugs and menopause; The Menopause Society's statement on the 2025–2026 labeling changes; ACOG guidance on hormone-level testing in perimenopause, on hormone therapy for menopause, and on compounded bioidentical menopausal hormone therapy; Michigan Public Health Code (MCL 333.16283–16288 and related rules), insurance code (MCL 500.3476), Michigan LARA's MiPLUS license-verification tool, and Michigan's prescription monitoring system (MAPS). Last verified June 23, 2026.