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HIThe HRT Index

Best Online HRT Providers With Prescriptions Delivered (2026)

By The HRT Index Editorial Team · Published · Last verified

Editorial research — not medically reviewed by a clinician.

The HRT Index is an independent comparison resource for HRT telehealth providers. Provider links on this page marked as affiliate links may earn us a commission if you start treatment. Commissions don’t change how we score or rank providers. Non-affiliate links are labeled “editorial link.” Full disclosure →

The short answer

The best online HRT providers with prescriptions delivered in 2026 fall into three clean buckets, and which one you want depends on one question: do you want the medication at your door, or just the prescription sent somewhere?

  • Alloy Women’s Health — best for most cash-pay women who want FDA-approved estradiol delivered to their door. Estradiol patches start at $74.99/month, with micronized progesterone listed from $23/month if you still have your uterus.
  • Midi Health — best if you have PPO insurance. Live video visits with menopause specialists, in-network with most PPO plans, available in all 50 states. Prescriptions go to your pharmacy of choice, including mail-order. Self-pay is $250 for the first visit and $150 for follow-ups.
  • Winona — best for women who specifically want a compounded bioidentical cream and live in one of the 37 states Winona serves. The cream combo ships from $89/month from Winona’s own pharmacy. Note: Winona’s body creams are compounded — not FDA-approved finished products. That’s a real decision, and we explain it below.

If you already have an HRT prescription and just need cheaper refills, The HRT Cluboffers partner-pharmacy fulfillment from $99/year membership plus medication — it’s not a prescriber, just a fulfillment path.

Safety first:If you’re in a situation where HRT may not be appropriate — unexplained bleeding, breast or uterine cancer history, recent blood clot, stroke, heart attack, liver disease, or possible pregnancy — stop here. See a clinician in person first.
Not sure which path is right for you? Take the free 60-second quiz →

What we actually verified (and what we didn’t)

We checked every pricing claim, shipping window, state-availability number, and FDA-status disclosure on this page against the provider’s live website on . We update pricing monthly and policies quarterly.

What we verified on each provider’s public pagesWhat we did NOT verify (requires live testing)
Pricing, medication options, shipping/delivery languageFinal checkout totals after taxes or first-month adjustments
State availability statementsSupport-response speed via live test inquiries
Insurance acceptance languageCancellation flow timing through an actual account closure
FDA-approved vs. compounded disclosuresPatch availability by zip code
Public refill and cancellation policiesLab add-ons your specific clinician may order
HSA/FSA referencesPharmacy fill price for your specific dose and plan
FDA Feb 12, 2026 press release and updated prescribing info page

The path-fit table: start here

If you only read one section, read this one. Find your situation in the left column.

If you want…Start hereWhy
Medication shipped to your door, FDA-approvedAlloy Women's HealthEstradiol patch from $74.99/mo; progesterone from $23/mo; all 50 states
Insurance to cover the visitMidi HealthIn-network with most PPOs; menopause-specialty clinicians; all 50 states
Direct-ship compounded creamWinona$89/mo cream combo from their own 503A pharmacy; 37 states + PR
Big-brand FDA-approved pills or patchesHersOral estradiol from $79/mo (12-mo plan); patches from $134/mo
Vaginal estrogenWisp$99 menopause consult; estradiol vaginal cream from $20
Subscription with multiple delivery formatsPandia HealthPill/patch/cream/ring options; membership from $34.99/mo on annual
You already have a prescriptionThe HRT Club$99/yr Premium + medication; partner pharmacy network
TRT (testosterone for men)See our online TRT providers guideDifferent rules — testosterone is a controlled substance
Want the page to do the choosing for you? Get your matched HRT path in 60 seconds →

What are the best online HRT providers with prescriptions delivered?

Answer: The best online HRT providers with prescriptions delivered in 2026 are Alloy Women’s Health for FDA-approved direct delivery, Midi Health for PPO insurance with prescriptions routed to your pharmacy, Winona for compounded bioidentical cream shipped from their own pharmacy, and Hers for big-brand FDA-approved oral pills or patches. Evernow, Pandia Health, and Wisp fit specific situations (membership-based care, multiple delivery formats, vaginal estrogen). The HRT Club is a fulfillment-only option if you already have a prescription.

Most “best online HRT” lists treat every provider on this page as roughly the same kind of service. They’re not. The difference between “we ship medication to your door” and “we send the prescription to your CVS” is the difference between never leaving your house and still chasing pharmacies. The matrix below sorts them out.

“Prescriptions delivered” — what it actually means

Here’s the confusion no other page clears up. When a provider says “prescriptions delivered,” they could mean one of three different things, and the difference affects what you pay, how fast you get medication, and whether your local pharmacy is involved at all.

1. Medication shipped to your door.

The provider writes the prescription, their pharmacy partner fills it, and a box arrives at your house. You never go anywhere. Examples: Alloy, Winona, Pandia (for many products), Hers.

2. Prescription sent to your pharmacy.

The clinician writes the prescription electronically. Your local CVS, Walgreens, or mail-order pharmacy fills it. You still have to pick it up, or wait for the pharmacy to ship it. Examples: Midi, Gennev, PlushCare, Sesame.

3. Fulfillment-only (you already have a prescription).

A membership service partners with pharmacies to fill an existing prescription at a lower price. They don't prescribe. Example: The HRT Club.

If you want medication at your house with no pharmacy stops, you want option 1. If your insurance only covers prescriptions filled at your in-network pharmacy, option 2 is usually cheaper. If your local doctor already wrote you a script and CVS is charging too much, option 3 is the cheat code.

The HRT Index Delivery Friction Matrix

This is the table other pages don’t build. We scored eight major online HRT paths on six factors that actually predict whether you’ll have a smooth or miserable experience: online prescribing, home delivery, price visibility, FDA-approved/compounded clarity, insurance pathway, and refill resilience. One point each, six total.

ProviderTypeLowest Verified $/moFDA-Approved or CompoundedShips Medication?StatesInsurance?HSA/FSA?Delivery ScoreLast Verified
Alloy Women's HealthAsync + clinicianEstradiol patch from $74.99/mo; progesterone from $23/moFDA-approvedYes, free, to doorAll 50NoYes6/6May 26, 2026
WinonaAsync + own 503A pharmacy$39/mo progesterone; $89/mo cream combo; $149/mo patchMixed (patches/tablets/progesterone capsules FDA-approved; body creams compounded)Yes, free, ~5 business days37 + PRNoYes5/6May 26, 2026
Midi HealthLive virtual visitsSelf-pay: $250 first visit, $150 follow-ups; insurance variesFDA-approved (generic estradiol, micronized progesterone)No — Rx to your pharmacyAll 50Yes — most PPOsYes4.5/6May 26, 2026
HersAsync telehealth$79/mo oral (12-mo plan); $134/mo patch (12-mo plan)FDA-approvedYes, to doorNot all 50 — verify at signupNoHSA/FSA reimbursement varies by plan5/6May 26, 2026
EvernowAsync + membershipMembership from $35/mo (12-mo) or $49/mo monthly + medicationPrimarily FDA-approvedHybrid: ships or pharmacyMost statesSome visitsMembership eligible4.5/6May 26, 2026
Pandia HealthAsync + clinicianMembership from $34.99/mo on annual + medicationFDA-approved primarilyYes where availableVerify state at signupSome plansYes4.5/6May 26, 2026
WispAsync telehealth$99 menopause consult; estradiol vaginal cream from $20Mixed; depends on productHybrid: ships some, pharmacy othersMost statesNoYes4/6May 26, 2026
The HRT ClubFulfillment only$0 Essential; $12/mo or $99/yr Premium + medicationDepends on your RxYes (you provide Rx)Most statesNoYesNot a prescriberMay 26, 2026

Sources:Alloy.com pricing and product pages, Winona’s HRT page and state list, Midi Health pricing/insurance page, Hers menopause page, Evernow’s main and how-it-works pages, Pandia Health menopause page, Wisp menopause consult page, The HRT Club homepage and FAQ. Cross-checked against Telehealth Ally and Innerbody 2026 reviews where available, plus FDA.gov for labeling status.

Confused which row is yours? Match me to the right HRT path →

What did the FDA change about menopause HRT labels in 2026?

Answer: On February 12, 2026, the FDA approved labeling changes for six menopausal hormone therapy products that removed risk statements about cardiovascular disease, breast cancer, and probable dementia from the boxed warning. The risks themselves weren’t erased — those topics still appear in the Warnings and Precautions section of the labels, and the endometrial-cancer boxed warning remains for systemic estrogen-alone products. The FDA said the action followed a review of the evidence behind the original warning language.

This is the freshness moat most “best online HRT” pages haven’t caught up to yet. The boxed warning is the FDA’s most prominent safety warning. Removing risk language from it is a significant regulatory shift — but the change is narrower than headlines have suggested, so we want to be precise.

What the FDA actually did

On , the FDA approved labeling changes for the first six menopausal hormone therapy products:

  • Prometrium (progesterone)
  • Divigel (systemic estradiol gel)
  • Cenestin (conjugated estrogens)
  • Enjuvia (synthetic conjugated estrogens, B)
  • Estring (vaginal estradiol ring)
  • Bijuva (combined estradiol + progesterone)

The agency initiated this in November 2025 after a review of the scientific literature. The FDA has stated that 29 drug companies submitted proposed labeling changes, so more products are expected to follow.

What this changes (and what it doesn’t)

ChangedDid NOT change
Cardiovascular disease, breast cancer, and probable dementia risk statements removed from the boxed warning on these six productsThose risks still appear in the Warnings and Precautions section of the same labels
Regulatory backing strengthened for providers prescribing these specific FDA-approved productsThe FDA did not remove the boxed warning related to endometrial cancer for systemic estrogen-alone products
Compounded BHRT is unaffected — it isn’t FDA-approved as a finished product

What it means for choosing a provider

Providers that prescribe these FDA-approved products (Alloy, Midi, Pandia, Hers for the products they offer) are operating with updated regulatory backing in 2026. Your individual risk profile — your medical history, your age, what year of menopause you’re in — still drives whether HRT is right for you, and your clinician should review your specific situation against the current label language for whatever you’re prescribed.

Source: FDA press release, February 12, 2026 · FDA’s Menopausal Hormone Therapies with Updated Prescribing Information page

FDA-approved vs. compounded HRT: the decision most people don’t know they’re making

Answer: FDA-approved HRT and compounded BHRT are not the same regulatory category. FDA-approved hormone therapies have been evaluated by the FDA for safety, effectiveness, and consistent dosing. Compounded bioidentical hormone products are custom-prepared by a compounding pharmacy and are not FDA-approved as finished products. ACOG recommends FDA-approved hormone therapy over compounded BHRT when an FDA-approved option exists. Some women have valid reasons to choose compounded; most don’t realize they’re making the choice.

FDA-approved HRT — what it is

These are hormone medications the FDA has reviewed and approved as finished products. They include estradiol patches (Climara, Vivelle-Dot, and the generics), oral estradiol tablets, micronized progesterone (Prometrium), estradiol gels (Divigel, EstroGel), vaginal estradiol (Estring, Estrace cream, Yuvafem), and combination products like Bijuva.

These products went through clinical trials. The dose in your bottle is the dose on the label. They come with a package insert. They’re typically the lowest-risk, best-documented choice.

Online providers that lean FDA-approved: Alloy, Hers, Midi, Pandia, Evernow (for most of their medications).

Compounded bioidentical HRT — what it is

A compounding pharmacy (such as Winona’s in-house 503A pharmacy) prepares hormone products to a specific formulation for individual patients. The finished compounded product itself has not been reviewed or approved by the FDA for safety, effectiveness, or quality. Compounded products are not required to include a package insert.

This is what the FDA says directly: it does not have evidence that compounded hormone products are safer or more effective than FDA-approved hormone therapies.

This is what ACOG says directly: “Clinicians should counsel patients that FDA-approved menopausal hormone therapies are recommended for the management of menopausal symptoms over compounded bioidentical menopausal hormone therapy.”

Online providers that lean compounded: Winona (their body cream products specifically), and parts of services like Henry Meds depending on the product.

Why this matters when “delivered” is the selling point

Direct-ship providers are convenient. You don’t go to the pharmacy. The box just shows up. That convenience is real and worth paying for — but it can hide the FDA-approved vs. compounded question because everything is happening inside one platform.

If you want the cleanest regulatory path, you want a direct-ship provider that uses FDA-approved finished products. That’s Alloy or Hers, not Winona’s cream products.

If you want a specific compounded formulation that isn’t commercially available — a particular cream ratio, a specific dose unavailable in finished products, an allergy to an inactive ingredient — compounded BHRT through a credentialed compounding pharmacy is a legitimate option. Just know what you’re choosing.

One damaging admission:We’re not going to pretend Winona’s flagship creams are the same regulatory category as Alloy’s patch. Winona’s estrogen/progesterone body creams are compounded — they are not FDA-approved finished products.If your priority is the cleanest regulatory profile, Winona’s cream isn’t the right answer, and Alloy is. But because Winona owns its 503A pharmacy, it can offer specific cream formulations with a turnaround and price point FDA-approved alternatives don’t match — and for some women, that fit matters more than the regulatory category. (Winona also offers FDA-approved patches, oral tablets, and progesterone capsules if you want them.)
Want to filter for FDA-approved-only paths? → Set “FDA-approved only” in the match quiz

How much online HRT actually costs in the first 90 days

Answer:Online HRT pricing has four lines: consultation or membership, medication, labs (if required), and shipping. Most public prices for women’s menopause HRT fall between $35 and $200 per monthfor cash-pay paths, with insurance routes potentially lower at Midi for in-network PPO patients. Treat any “starting at” number as the floor — verify the bundled total at checkout.

Alloy Women's Health (FDA-approved, direct ship)

  • One-time consultation fee: $49.95
  • Estradiol patch: starts at $74.99/month, billed as a 3-month supply
  • Micronized progesterone: listed from $23/month if you still have your uterus (verify whether bundled in checkout)
  • Shipping: free
  • HSA/FSA accepted
  • First 90 days, public-price floor: consultation + 3-month patch supply + progesterone if needed — verify exact bundled total in checkout
Start with Alloy →

Winona (compounded cream combo)

  • Initial consultation: free
  • Estrogen + progesterone body cream: $89/month or $219 for 3 months
  • Shipping: free
  • HSA/FSA accepted
  • First 90 days, public-price floor: $219 (3-month cream supply)
Start with Winona →

Midi Health (insurance, FDA-approved)

  • With in-network PPO: visit cost depends on your plan. Midi notes deductibles may be up to $250 for new visits and $150 for follow-ups, plus possible copays and coinsurance
  • Self-pay: $250 first visit, $150 follow-ups
  • Medication: filled at your pharmacy; generic estradiol with insurance is commonly $10–$30/month, but verify with your plan
  • HSA/FSA accepted
  • Note: Midi is NOT covered by Medicare or Medicare-related plans, and Midi states it cannot treat Medicaid or Medi-Cal patients at this time
Start with Midi Health →

Hers (FDA-approved, direct ship)

  • Estradiol oral on 12-month plan: $79/month
  • Estradiol patch on 12-month plan: $134/month
  • Shorter plans cost more per month
  • HSA/FSA reimbursement eligibility varies by plan
  • Not available in all 50 states — verify at signup
Start with Hers →

The HRT Club (fulfillment, you provide Rx)

  • Essential membership: $0
  • Premium membership: $12/month or $99/year
  • Medication, shipping, and taxes paid separately to the partner pharmacy
  • Free standard shipping on orders $50+
  • Processing: 1–3 business days; shipping: 1–7 business days depending on shipping method

What can sneak up on you

  • Lab work if recommended: $60–$200, not included with most cash-pay menopause platforms
  • Shipping fees beyond standard: verify at checkout
  • Dose changes: most providers don't charge for clinician messaging or refills, but read the fine print
  • Cancellation timing: Alloy bills quarterly, so canceling mid-cycle still leaves you with the current 3-month supply; Pandia requires cancellation 30 days before the next billing period
  • Insurance medication coverage for compounded products is often limited — most insurance plans won't cover Winona's compounded creams
Want a personalized first-90-day estimate? → Get your cost match in 60 seconds

Is online HRT actually legit?

Answer: Yes — multiple online HRT providers in 2026 operate with board-certified physicians, menopause-specialty clinicians, licensed pharmacies, and prescriptions filled within state law. Legitimate online HRT is real medicine. The red flags to watch for are sites that ship hormones without any clinician review, sell from overseas without US licensing, or skip state-licensure verification.

Here’s a 30-second test you can run on any online HRT provider:

✓ Five green flags

  1. A licensed clinician reviews your intake before any prescription
  2. Visible state availability (and they verify your state at signup)
  3. A real US pharmacy (or named partner pharmacy) on the site
  4. Transparent pricing before checkout — no "free trial that auto-bills" tricks
  5. Public reviews on a third-party platform with a meaningful sample size

✗ Five red flags

  1. "No prescription needed" or "buy hormones without seeing a doctor"
  2. Shipping origin overseas — UK, Australia, Vanuatu, anywhere not the US
  3. Pricing only appears after you create an account or hand over payment info
  4. No clinician name, license, or credential visible anywhere on the site
  5. Pressure tactics ("only 3 hours to claim this price")

The providers we feature on this page publicly disclose clinician review, prescription pathways, named pharmacy partners, and state availability. That’s the baseline. The category has matured — the scams still exist, but they don’t look like Alloy or Midi.

Who shouldn’t start with online HRT (read this carefully)

We’d rather lose your click than send you somewhere wrong. Online HRT isn’t right for everyone, and a low-touch checkout flow can hide questions that should be answered by an in-person clinician first.

Talk to a clinician in person before any online HRT checkout if any of these apply:
  • Unexplained vaginal bleeding
  • History of breast cancer, uterine cancer, or other estrogen-sensitive cancer
  • History of blood clots (DVT or pulmonary embolism)
  • Recent stroke or heart attack
  • Active liver disease
  • You might be pregnant
  • You have complex medication interactions or multiple chronic conditions
  • You want testosterone replacement (different rules — testosterone is a controlled substance)

The FDA’s public menopause information lists most of these directly as situations where hormone therapy may not be appropriate. This isn’t legal cover — it’s the actual list of who should not start with a 5-minute online intake.

If a red flag applies to you, the right next step isn’t picking the cheapest direct-ship provider. It’s an in-person visit with a clinician who can take a full history. Midi Health, despite being online, is the one platform on this list structured around live video visits with menopause specialists and can sometimes serve more complex situations — but even Midi will refer you to in-person care if your history requires it.

The estradiol patch supply problem you should know about

Answer: In 2026, women are widely reporting difficulty filling estradiol patch prescriptions at retail pharmacies. Midi Health reported a survey of nearly 8,000 women in which 44% said they had difficulty filling an estrogen patch prescription this year. The FDA does not currently recognize this as a formal drug shortage, but the difficulty is real and worth factoring into how you choose a provider.

Most “best online HRT” lists don’t mention this. They should. If you’re switching from a stable prescription with your in-person doctor to an online provider, and the online provider routes you to your local CVS, you might end up calling three pharmacies trying to find your dose.

Three things to ask any online HRT provider before you sign up

1. "What happens if my pharmacy can't fill my prescription?"

A good provider will offer to transfer it, suggest a mail-order route, or have a clinician discuss alternate FDA-approved formulations with you. A bad provider will tell you to figure it out.

2. "Can I switch between home delivery and pharmacy pickup if I need to?"

Some providers (Evernow, Wisp for some products) offer this. Direct-ship providers (Alloy, Winona) don't — but their own supply lines may be more controlled than a local retail pharmacy depending on what you need.

3. "Do you offer 90-day supplies?"

Longer supplies reduce refill anxiety. Alloy ships quarterly by default. Winona offers 3-month supply options.

Don’t change your medication based on shortages. Talk to your clinician about whether an alternative formulation is appropriate if you can’t fill your current dose.

The provider deep dives

Here’s where we go provider by provider. Each one gets the same template, so you can compare apples to apples.

Best for cash-pay FDA-approved direct delivery

Alloy Women’s Health

One-line verdict: Alloy is the best online HRT provider for most women who want FDA-approved bioidentical hormones, prescribed online, shipped to their door, at one of the lowest cash prices available.

What we verified (May 26, 2026)

  • Estradiol patch starts at $74.99/month, billed as a 3-month supply
  • Micronized progesterone listed from $23/month for women who still have a uterus
  • One-time consultation fee: $49.95
  • Shipping: free
  • Available in all 50 states
  • HSA/FSA accepted
  • Care provided by menopause-focused clinicians; if a clinician holds the credential, the current credential name is MSCP (Menopause Society Certified Practitioner)
  • Uses FDA-approved bioidentical hormones — not compounded
TypeAsync (no live video visits) with clinician review
Lowest verified monthly$74.99 patch starting price; progesterone from $23
FDA-approved or compoundedFDA-approved finished products
Labs requiredNo (symptom-based intake)
StatesAll 50
InsuranceNo
HSA/FSAYes
CancellationSkip or cancel anytime from your account dashboard

What it does well

  • One of the lowest cash prices for FDA-approved estradiol patches online
  • Menopause-specialty clinical training is built into the model — rare in telehealth
  • Quarterly billing means fewer shipments to track
Damaging admission:Alloy doesn’t take insurance. If your priority is using your PPO to cover the visit, Alloy isn’t your best path — Midi Health is, because Midi is in-network with most PPO plans and your medication can be filled through your insurance at your pharmacy. But because Alloy skips the insurance layer, it can offer one of the lowest cash prices for FDA-approved HRT online, with predictable billing.

“I would describe my experience with Alloy as a pleasant straight-forward experience.”

— Alloy customer, via a public review on a third-party HRT review site. Disclosure: service-experience comment, not evidence any medication will work for you.
Start with Alloy →Not sure? Take the quiz →

Affiliate link — we may earn a commission if you start treatment.

Best for PPO insurance and live video care

Midi Health

One-line verdict: Midi is the best online HRT provider if you have PPO insurance and want a live video visit with a menopause-specialty clinician.

What we verified (May 26, 2026)

  • Available in all 50 states
  • In-network with most PPO plans
  • For visits using insurance: Midi notes you may be responsible for a deductible of up to $250 for new visits and up to $150 for follow-ups, with possible copays and coinsurance — your final cost depends on your specific plan
  • Self-pay: $250 first visit, $150 follow-ups
  • NOT covered by Medicare or Medicare-related plans. Medicare beneficiaries can self-pay but cannot submit claims for Midi visits, medications, or associated services
  • Midi states it cannot treat Medicaid or Medi-Cal patients at this time, even as self-pay
  • Prescriptions sent to your pharmacy of choice — including mail-order
  • HSA/FSA accepted
  • Clinicians are menopause-specialty trained
TypeLive virtual visits (not async)
Lowest verified monthlyVisit cost depends on insurance; $250 self-pay first visit
FDA-approved or compoundedPrimarily FDA-approved (generic estradiol, micronized progesterone, etc.)
Labs requiredClinician's discretion, not automatic
StatesAll 50
InsuranceYes — most PPOs
HSA/FSAYes
CancellationPer-visit model (no subscription to cancel)

What it does well

  • Real video visits with menopause specialists — not an async questionnaire
  • Insurance acceptance that can meaningfully reduce cost for insured PPO patients
  • Broad scope: HRT, non-hormonal hot flash treatments (Veozah/fezolinetant, SSRIs), GLP-1 weight management, bone health, mood
Damaging admission: Midi does NOT ship medication to your door — your prescription goes to your pharmacy. If you specifically want a box arriving at your house with no pharmacy trip, Alloy is the cleaner choice. But because Midi works with your existing pharmacy, you can usually use your insurance for the medication too, which often makes the total cost lower for insured patients.

“Midi was so easy: I got a same day appointment and they took my insurance.”

— Midi patient, via Midi’s public page. Disclosure: provider-published service comment, not evidence of medical efficacy.
Start with Midi →Have PPO insurance? Get matched →

Affiliate link — we may earn a commission if you start treatment.

Best for compounded bioidentical cream delivered direct

Winona

One-line verdict: Winona is the best online HRT provider if you specifically want a compounded estrogen + progesterone cream shipped from a single in-house pharmacy, and you understand the FDA-approved vs. compounded distinction.

What we verified (May 26, 2026)

  • Estrogen + progesterone body cream (most popular): $89/month or $219 for 3 months
  • Estrogen body cream alone: $89/month
  • Estradiol patch: $149/month
  • Progesterone capsules: $39/month
  • Estrogen tablets: $54/month
  • DHEA: $27 for 3-month supply
  • Initial consultation: free
  • Shipping: free, average receipt around 5 business days
  • Available in 37 states + Puerto Rico
  • HSA/FSA accepted
  • Important product-level distinction: Winona's estrogen patches, estrogen tablets, and progesterone capsules use FDA-approved hormone products. Winona's estrogen and estrogen/progesterone body creams are compounded — they are not FDA-approved finished products.
TypeAsync with their own in-house 503A compounding pharmacy
Lowest verified monthly$39 (progesterone alone)
FDA-approved or compoundedMixed by product — see distinction above
Labs requiredNo
States37 + Puerto Rico
InsuranceNo
HSA/FSAYes
CancellationPause or cancel anytime from your account

What it does well

  • Owns their pharmacy, so supply is more controlled than a partner-pharmacy model
  • Offers specific compounded cream ratios that aren’t commercially available as FDA-approved products
  • Free consultation (low commitment to evaluate fit)
  • Transparent published pricing
Damaging admission:Winona’s body creams are compounded — they are not FDA-approved finished products. If your priority is the cleanest regulatory profile, Alloyis the better choice because Alloy uses FDA-approved finished hormones. But because Winona owns its compounding pharmacy, it can offer cream formulations and ratios that aren’t commercially available as FDA-approved products, which some women specifically want. Winona also offers FDA-approved patches, oral tablets, and progesterone capsules if you’d prefer those.
Start with Winona →Compare to FDA-approved alternatives →

Affiliate link — we may earn a commission if you start treatment.

Best big-brand FDA-approved at scale

Hers

One-line verdict: Hers is the best online HRT provider if you want FDA-approved oral estradiol or estradiol patches from a publicly traded company with a polished user experience.

What we verified (May 26, 2026)

  • Oral estradiol on 12-month plan: $79/month
  • Estradiol patches on 12-month plan: $134/month
  • FDA-approved finished products for the menopause indication
  • Not available in all 50 states — verify availability at signup
  • HSA/FSA reimbursement eligibility varies by plan; Hers does not bill insurance directly for the HRT telehealth path
  • Cancellation from account dashboard
  • 12-month plan is the published headline price — shorter plans cost more per month
  • Hers notes that hormone replacement therapies are not FDA-approved specifically for perimenopause but may be prescribed off-label for perimenopausal symptoms at a provider's discretion
TypeAsync telehealth
Lowest verified monthly$79 (oral) on 12-month plan
FDA-approved or compoundedFDA-approved
Labs requiredNo (symptom-based)
StatesNot all 50 — verify
InsuranceNo
HSA/FSAReimbursement varies by plan
CancellationFrom account; 12-month commitment on the headline price

What it does well

  • Publicly traded parent company (Hims & Hers Health) with financial accountability
  • Polished mobile experience
  • Reliable supply chain backed by scale
Damaging admission:The headline $79/month is the 12-month plan — month-to-month costs more. If you don’t want a 12-month commitment, Winona has no minimum term, and Alloy bills quarterly with no annual lock-in. But because Hers operates at scale, they hold the FDA-approved oral estradiol price point lower than smaller competitors on the annual plan.
Start with Hers →Comparing Hers to Alloy? See which fits →

Affiliate link — we may earn a commission if you start treatment.

Best hybrid fulfillment with insurance flexibility

Evernow

One-line verdict: Evernow is the best online HRT provider if you want ongoing menopause-specialty support and the flexibility to choose between home delivery and your local pharmacy.

What we verified (May 26, 2026)

  • Membership pricing: starts at $35/month on Evernow's current main page; an alternate Evernow plan listing shows $49 monthly, $129 for 3 months, $348 for 12 months ($29/month) — confirm the current path at checkout
  • Medication costs are separate; exact medication prices vary by formulation
  • Prescription routing: home delivery or your pharmacy
  • Some insurance acceptance for video visits
  • HSA/FSA accepted for membership; medication coverage depends on pharmacy/plan
  • Available in most states
TypeAsync + membership + clinician access
Lowest verified monthlyMembership from $29–$49/month depending on plan; medication separate
FDA-approved or compoundedPrimarily FDA-approved
Labs requiredNo
StatesMost
InsuranceVisits sometimes; medication varies
HSA/FSAMembership yes
CancellationAnytime from account

What it does well

  • Pick your fulfillment route — ship to door or fill at your pharmacy
  • Membership model means included follow-ups
  • Founded by menopause researchers; clinical team built around the indication
Damaging admission:Evernow’s membership-plus-medication structure means the total monthly cost is often higher than Alloy or Winona for the same FDA-approved medication. If you want the lowest cash price, Alloy is usually cheaper. But Evernow’s fulfillment flexibility — home delivery OR your pharmacy with insurance — is something Alloy doesn’t offer.
Start with Evernow →Want fulfillment flexibility? Get matched →

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Best for multiple delivery formats

Pandia Health

One-line verdict: Pandia Health is the best online HRT provider if you want a choice of delivery format (pill, patch, cream, or ring) bundled with a single membership.

What we verified (May 26, 2026)

  • Membership: $69/month month-to-month, $59/month on 3-month plan, $34.99/month on annual
  • Medication cost separate from membership
  • FSA/HSA plans accepted
  • Free shipping where available
  • FDA-approved bioidentical hormone options primarily
  • Cancellation requires 30 days before next billing period; early-cancellation fee may apply
  • State availability and specific insurance plan acceptance: verify at signup
TypeAsync + clinician
Lowest verified monthly$34.99 membership on annual + medication separately
FDA-approved or compoundedFDA-approved primarily
Labs requiredVariable
StatesVerify at signup
InsuranceVerify with your plan
HSA/FSAYes
Cancellation30 days before next billing period

What it does well

  • Most delivery format choice (pill, patch, cream, ring)
  • Annual plan is one of the lower membership rates on this list
  • Founded by a board-certified physician
Damaging admission:Pandia’s cancellation requires 30 days notice and may include an early-cancellation fee, while Winona and Hers let you cancel from your account more directly. If month-to-month flexibility is your priority, Winonais cleaner. But Pandia’s annual rate plus the format variety is hard to match if you want options.
Start with Pandia →

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Best for vaginal estrogen

Wisp

One-line verdict: Wisp is the best online HRT provider if you’re focused on vaginal estradiol for genitourinary symptoms (dryness, painful sex, recurring UTIs).

What we verified (May 26, 2026)

  • Menopause consultation: $99 (includes initial consult, follow-ups, and 3 months of care team access)
  • Estradiol vaginal cream starts at $20
  • Fulfillment speed varies by product — verify at checkout
  • No insurance billed directly by Wisp
  • HSA/FSA accepted
  • Available in most states
TypeAsync telehealth
Lowest verified monthly$99 consult covers 3 months of access; estradiol vaginal cream from $20
FDA-approved or compoundedMixed by product
Labs requiredNo
StatesMost
InsuranceNo direct billing
HSA/FSAYes
CancellationPer-consult, not a subscription

What it does well

  • Strong vaginal estrogen / GSM (genitourinary syndrome of menopause) coverage
  • Low entry price ($99 consult covers 3 months)
  • Reproductive health expertise (Wisp’s original focus was broader sexual health)
Damaging admission:Wisp isn’t a comprehensive systemic HRT platform — it’s strongest for vaginal estrogen and adjacent women’s health. If you want full systemic HRT with ongoing clinician follow-up, Midi or Alloyare better matches. But for vaginal estrogen specifically at a low entry price, Wisp’s path is hard to beat.
Start with Wisp →

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Best fulfillment-only path (when you already have a prescription)

The HRT Club

One-line verdict: The HRT Club is the best fulfillment path if you already have an HRT prescription from a clinician and want a cheaper way to fill it through partner pharmacies.

This is not a prescriber.Read that twice. The HRT Club doesn’t write prescriptions. It’s a membership service that partners with pharmacies to fill prescriptions you already have at lower prices.

What we verified (May 26, 2026)

  • Essential membership: $0
  • Premium membership: $12/month or $99/year
  • Medication, shipping, and taxes are separate (paid to the partner pharmacy)
  • Processing: 1–3 business days
  • Shipping: 1–7 business days depending on shipping method
  • Free standard shipping on orders $50+
  • Requires a valid prescription
  • In April 2025, The HRT Club announced a partnership with MyMenopauseRx that expanded prescription access across 21 states and offers MyMenopauseRx care, including a $99 cash visit option
TypeFulfillment-only (not a prescriber)
Lowest verified monthly$0 Essential, $12 Premium
FDA-approved or compoundedDepends on the prescription you bring
Labs requiredNot applicable
StatesMost
InsuranceNo
HSA/FSAYes
CancellationAnytime

“The customer service has been phenomenal,” and “I am able to order my prescriptions efficiently.”

— The HRT Club customers, via their public page. Disclosure: provider-published service comments. Not evidence of medical efficacy.

Where this fits:If your in-person doctor wrote you a script and your local pharmacy is quoting more than you want to pay, The HRT Club’s partner pharmacy network may fill that same prescription for less. It’s a fulfillment hack, not a medical replacement.

Visit The HRT Club →Non-affiliate editorial link

Looking for TRT (testosterone for men)?

Testosterone is a Schedule III controlled substancein the US. Online TRT requires labs, a licensed clinician’s prescription, and ongoing monitoring — different rules from women’s menopause HRT and a different list of providers.

We cover the men’s TRT comparison on our dedicated page. For now, see a specialized TRT provider directory for the men’s comparison.

Best online HRT provider for your specific situation

This is the segmentation grid. Find yourself.

If your situation is…Best pathWhy
Cash-pay, FDA-approved, lowest priceAlloy Women's HealthPatch from $74.99/mo; progesterone from $23/mo; all 50 states
PPO insurance, live videoMidi HealthIn-network with most PPOs; menopause-specialty clinicians; all 50 states
Compounded BHRT cream, direct shipWinona$89/mo cream combo; own 503A pharmacy; 37 states + PR
FDA-approved oral pills at scaleHers$79/mo on 12-month plan; verify state at signup
Multiple delivery formatsPandia HealthPills/patches/creams/rings; annual rate from $34.99/mo
Vaginal estrogenWisp$99 consult; estradiol vaginal cream from $20
Membership with fulfillment flexibilityEvernowShip to door or fill at pharmacy; menopause-research-led clinical team
You already have a prescriptionThe HRT Club$99/yr + medication through partner pharmacy network
Breast cancer history or HRT contraindicationMidi Health (non-hormonal toolkit) or in-person clinicianVeozah/fezolinetant, SSRIs, lifestyle support; menopause-specialty clinicians
TRT (men)See a dedicated TRT providers guideDifferent rules — controlled substance, labs required
Medicaid or MedicareIn-person clinicianMost direct-pay online platforms can't accept these
You want the cheapest pharmacy fill on an existing scriptThe HRT Club, Cost Plus Drugs, or GoodRxFulfillment route — compare all three
Still not sure which row is yours? 60-second match quiz, no email required →

What real customers say

We chose the testimonials below specifically because they’re focused on service experience — not on whether HRT “worked” — and because they come from publicly verifiable sources.

“I spent almost three years being dismissed by doctors, and told to nap more. My PCP didn’t listen to my concerns, but Midi did.”

Midi patient, via Midi’s public page

“Midi was so easy: I got a same day appointment and they took my insurance.”

Midi patient, via Midi’s public page

“The customer service has been phenomenal. I am able to order my prescriptions efficiently.”

The HRT Club customer, via The HRT Club’s public page

Disclosure: These are provider-published comments about service experience. They are not evidence that any medication is safe or effective for your specific situation. Individual results vary. We don’t use testimonials to make medical claims.

How we verified and ranked these providers

Answer:We scored providers on six factors: online prescribing legitimacy, medication delivery clarity, price transparency, FDA-approved/compounded disclosure, insurance pathway, and refill resilience. We verified pricing and policies on each provider’s live website on , and we refresh pricing monthly and policies quarterly.
FactorWeightWhat we check
Online prescribing + real clinician review20%Is there a licensed clinician? What's their credential? Is the prescription state-compliant?
Medication delivery or fulfillment clarity20%Does the provider ship medication, route to pharmacy, or require existing Rx? Is this clearly disclosed?
Price transparency15%Are prices visible before checkout? What's bundled, what's separate?
FDA-approved vs. compounded disclosure15%Is the regulatory category clearly stated for each product?
Insurance or cash-pay clarity10%Is the insurance pathway honest about coverage limits?
First-fill and refill reliability10%What's the shipping window? What happens during supply disruptions?
State availability and support clarity10%Where do they actually operate? How clear is state availability?

What we don’t do

  • We don't invent author credentials or claim "medically reviewed by [Doctor]" unless a real, named, credentialed clinician reviewed the content.
  • We don't use review schema or aggregate rating schema for testimonials we haven't first-party collected.
  • We don't suppress material limitations. If a provider has a real flaw, we tell you and route you to an alternative.
  • We don't recommend providers based on affiliate commission. Evidence-based fit comes first.

Last verified: . We refresh pricing monthly (first business day of each month) and state availability, insurance, FDA labeling status, HSA/FSA acceptance, and cancellation policies quarterly. The visible “Last verified” date at the top of this page updates whenever any element changes.

Frequently asked questions

Here are the questions readers ask after they read the main comparison. Each answer is direct enough to read in isolation.

Can you get HRT prescribed online?+

Yes. Multiple licensed telehealth providers — Alloy, Midi, Hers, Winona, Evernow, Pandia, Wisp — prescribe HRT after a clinician review of your intake. The clinician must be licensed in your state. Some providers ship medication to your door; others route the prescription to your local or mail-order pharmacy.

Is online HRT covered by insurance?+

Sometimes. Midi Health is in-network with most PPO plans (Midi is not covered by Medicare or Medicare-related plans and cannot treat Medicaid patients at this time). Pandia Health accepts some plans (verify with yours). Evernow offers insurance pathways for some video visits. Subscription providers like Alloy, Winona, and Hers are cash-pay, though most allow HSA/FSA in some form.

What's the cheapest online HRT?+

Among legitimate providers, Winona starts at $39/month for compounded progesterone alone or $89/month for the compounded estrogen + progesterone cream combo. Alloy's estradiol patch starts at $74.99/month with progesterone listed from $23/month. For insured patients, Midi Health with a PPO can reduce visit costs through your plan, plus pharmacy medication (often $10–$30/month for generic estradiol with insurance, but verify with your plan).

Which online HRT is FDA-approved?+

Alloy, Hers, Pandia, Evernow, and Midi (when prescribing finished products to your pharmacy) primarily use FDA-approved bioidentical HRT. Winona’s patches, oral tablets, and progesterone capsules use FDA-approved hormone products; Winona’s body creams are compounded and are not FDA-approved finished products.

Is compounded HRT safe?+

Compounded bioidentical HRT is prepared by licensed compounding pharmacies under state pharmacy-board oversight, but the finished compounded product is not reviewed or approved by the FDA for safety, effectiveness, or quality. The FDA states it does not have evidence that compounded bioidentical hormones are safer or more effective than FDA-approved hormone therapies. ACOG recommends FDA-approved hormone therapy over compounded BHRT when an FDA-approved option exists. That doesn’t mean compounded BHRT is unsafe in absolute terms; it means the regulatory baseline is different.

Can men get HRT online?+

Yes, but testosterone is a Schedule III controlled substance in the US, so any legitimate online TRT provider requires labs and ongoing clinician oversight. The providers on this page cover women’s menopause HRT specifically. See a dedicated online TRT comparison for the men’s category.

Do you need lab work before starting HRT online?+

For menopause HRT (estrogen + progesterone), most online providers don’t require lab work — diagnosis is symptom-based per current menopause guidelines. Alloy, Hers, Winona, and Evernow all start treatment from a symptom questionnaire. Some providers include or recommend labs even for menopause HRT. For TRT, labs are required because dose titration depends on baseline and follow-up levels.

How fast does online HRT ship?+

It depends on the delivery model. For direct-ship providers: Winona states average receipt around 5 business days after clinician approval. The HRT Club processes in 1–3 business days with shipping 1–7 business days depending on method. Alloy ships quarterly — you receive a 3-month supply at a time after approval. For providers that route to your pharmacy (Midi), timing depends on your pharmacy’s processing, typically 1–3 business days for major retail pharmacies. If an estradiol patch isn’t stocked at your local pharmacy, supply can delay fulfillment further — see the estradiol patch supply section above. Verify current turnaround at the provider’s site before signing up.

What did the FDA change about HRT in February 2026?+

On February 12, 2026, the FDA approved labeling changes that removed risk statements about cardiovascular disease, breast cancer, and probable dementia from the boxed warning of six menopausal hormone therapy products: Prometrium, Divigel, Cenestin, Enjuvia, Estring, and Bijuva. Those risks still appear in the Warnings and Precautions section of the labels. The FDA did not remove the boxed warning related to endometrial cancer for systemic estrogen-alone products. Compounded BHRT was not affected because it isn’t FDA-approved as a finished product.

Is online HRT a good idea if I have a complex medical history?+

Not always. If you have unexplained bleeding, certain cancers, blood clots, a recent stroke or heart attack, liver disease, or other complex risks, start with an in-person clinician who can evaluate you fully — not a 5-minute online intake. The FDA’s public menopause information lists most of these as situations where hormone therapy may not be appropriate. Midi Health, despite being online, is the platform on this list most equipped to handle complex cases because of its live video model with menopause specialists — but even Midi will refer you in-person if your history requires it.

For more on HRT cost, benefits, and candidacy, see our full HRT cost breakdown and HRT benefits and risks guide.

Your next step

If you’re cash-pay and want FDA-approved hormones shipped to your door, Alloy is probably your answer. If you have PPO insurance and want a real video visit with a menopause specialist, Midi is your answer. If you want compounded cream direct from a 503A pharmacy and you understand the regulatory tradeoff, Winona is your answer. If you already have a prescription, The HRT Club plus a pharmacy price comparison is your fastest path.

If none of those feels obvious, take the quiz. It’s 60 seconds, six questions, no email required to see your match.

Take our free 60-second matching quiz →

Related guides on The HRT Index:

Methodology, sources, and disclosures

The HRT Index is an independent comparison resource for HRT telehealth providers. We don’t accept payment to change rankings. When we earn a commission on a provider link, we disclose it above the fold on this page. Affiliate relationships, when in place, are layered on top of evidence-based recommendations — never in place of them.

Author: The HRT Index Editorial Team. Last verified: . Refresh cadence: Pricing monthly; states, insurance, FDA labeling status, HSA/FSA acceptance, and cancellation policies quarterly; immediately if a major change occurs.

Primary sources verified for this page

  • Alloy Women's Health pricing and product pages (myalloy.com/solutions, myalloy.com/solutions/estradiol-patch)
  • Winona pricing pages, product pages, HRT page, and state-availability page (bywinona.com)
  • Midi Health pricing/insurance page (joinmidi.com/pricing-insurance) and Midi help-center billing articles
  • Hers menopause page (forhers.com/menopause)
  • Evernow main page and how-it-works page (evernow.com)
  • Pandia Health menopause page (pandiahealth.com/menopause)
  • Wisp menopause consult page and shop (hellowisp.com)
  • The HRT Club homepage and FAQ (thehrtclub.com)
  • FDA press release: "FDA Approves Labeling Changes to Menopausal Hormone Therapy Products," February 12, 2026
  • FDA: "Menopausal Hormone Therapies with Updated Prescribing Information," updated February 12, 2026
  • FDA: consumer-facing menopause information (fda.gov)
  • ACOG Clinical Consensus: "Compounded Bioidentical Menopausal Hormone Therapy"
  • Midi Health published survey data on the 2026 estradiol patch supply issue (joinmidi.com/post/estrogen-patch-shortage-data)
  • The Menopause Society on the MSCP (Menopause Society Certified Practitioner) credential
  • DEA Diversion Control Division on controlled substance scheduling
  • Cross-checks with Telehealth Ally (verified March 2026), Innerbody, and Policy Lab 2026 coverage

Medical disclaimer: This page is for educational comparison only and is not medical advice. HRT is not appropriate for everyone. A licensed clinician should determine whether hormone therapy is appropriate for your medical history.

We re-verify pricing every quarter. If you see something we should correct or update, email us at corrections@thehrtindex.com. Corrections are logged at our corrections page.

See our editorial standards, methodology, and affiliate disclosure for the full policy.

The HRT Index — an independent comparison resource for HRT telehealth providers.