Sesame vs PlushCare for HRT: Which One Is Right for You?
By The HRT Index editorial team · · Editorial research, not medical advice.
Here's the short version: if you're paying cash, Sesame is usually the better first pick. If you have insurance you actually want to use, PlushCare usually wins. That's the whole decision in one line. The price tags you see first — around $59/month for Sesame, $19.99/month for PlushCare — hide the part that really changes your bill. We're going to show you that part.
| Your situation | Better first pick | Why |
|---|---|---|
| Paying cash (no insurance, or a high deductible) | Sesame | One flat monthly price; visits and basic labs included when ordered |
| Using in-network insurance | PlushCare | A copay visit can cost less than paying cash |
| You'll likely need lab work | Sesame | Basic labs included when your provider orders them (most states) |
| You only need 1–2 visits a year | Maybe PlushCare | Pay-per-visit can beat a monthly plan for light, occasional use |
| You want testosterone, injections, or pellets | Neither | Controlled-substance and injection/pellet limits apply (more below) |
| Not sure yet | Take the quiz | We'll match you by budget, state, and symptoms |
Affiliate link — we may earn a commission at no cost to you. Our verdict is based on the checks below, not the payout.
Sesame vs PlushCare for HRT — what's the real difference?
Sesame and PlushCare both connect you to a licensed provider who can prescribe menopause hormone therapy online, but they run on opposite money models. Sesame is a cash-pay plan: one flat monthly fee, no insurance, and you pick your own provider. PlushCare is an insurance-friendly membership: a low $19.99/month fee, plus a visit cost that depends on your insurance. The deciding question: are you using insurance or not?
Sesame — menopause membership model
- ✔ One flat monthly price covers video visits, unlimited messaging, and basic labs if ordered
- ✔ You choose your own clinician from their list
- ✔ Same-day visits available
- ✔ Prescription sent to your pharmacy; medication billed separately
- ✗ Does not bill health insurance — cash only
PlushCare — insurance-friendly membership
- ✔ $19.99/month door fee; first month free
- ✔ Each visit billed to insurance (often ~$30 copay) or $129 cash
- ✔ Same-day visits, 7 days a week; broad primary care
- ✔ Prescription sent to your pharmacy
- ✗ Labs and medication billed separately (discount, not free)
Two honest cautions up front:
- Sesame's price shows up as $59/month on some of its current pages and $99/month on others, including its original launch announcement. Confirm the live price at checkout before you decide — one number can flip the answer.
- Booking your first PlushCare visit automatically enrolls you in the $19.99/month membership (the first 30 days are free). Several review sites flag billing and cancellation complaints. We cover that below — and exactly how to avoid it.
How much does Sesame vs PlushCare cost for HRT?
Sesame's menopause plan runs about $59/month, which includes your visits and basic labs if ordered, with medication billed separately at your pharmacy. PlushCare costs $19.99/month plus either an insurance copay or a $129 cash visit, with medication and labs billed separately too. Which one is "cheaper" depends on how often you see a provider and whether you use insurance.
The piece almost every other page leaves out: the medication
When we checked GoodRx on June 4, 2026, generic estradiol (oral tablet) was as low as about $17/month with a coupon. Generic progesterone (Prometrium) was as low as about $11/month. So a common oral routine — generic estradiol plus generic progesterone — runs roughly $28–$50/month with a coupon. Patches, gels, creams, and brand-name versions can cost more. The medication price is the same regardless of which platform writes the prescription. PlushCare's own page quotes monthly prescription pills at $130–$240 without insurance — the real cash cost is often lower if you use a coupon.
Your real first-year cost (the math nobody shows you)
Editorial calculations using each provider's published pricing. PlushCare's first month is free, so we count 11 paid membership months. Medication is separate for both and isn't in these totals.
| Your situation | Sesame care fees / year | PlushCare care fees / year | The takeaway |
|---|---|---|---|
| Cash-pay, ongoing care (12 months) | $59 × 12 = $708 (visits + basic labs included if ordered) | $19.99 × 11 + $129 × 4 visits = $735.89 | Sesame is a touch cheaper and includes labs |
| Cash-pay, only 2 visits all year | $708 (you pay monthly all year) | $19.99 × 11 + $129 × 2 = $477.89 | PlushCare wins for light, occasional use |
| Insured, 4 visits, $30 copay | Sesame can't bill insurance = $708 cash | $19.99 × 11 + $30 × 4 = $339.89 | PlushCare clearly wins with good insurance |
| Insured, high deductible (visits not really covered) | $708, no insurance hassle | $219.89 + up to $516 in visit fees = up to $735.89 | Sesame may win when insurance doesn't lower your visit cost |
Which is better if you're paying cash?
For most cash-pay menopause shoppers, Sesame is the better pick because it bundles visits and basic labs into one flat monthly price with no insurance billing. PlushCare can still be cheaper for someone who only needs one or two visits a year and doesn't need labs, since you pay per visit instead of a monthly plan.
Sesame is better when you want:
- ✔ Ongoing support — regular check-ins, dose tweaks, messaging your provider, labs when needed
- ✔ A calm, predictable monthly number with no surprise visit charges
- ✔ Basic labs built in when your provider orders them
- ✔ Perimenopause that's actively shifting and adjusting
PlushCare can win when you:
- ✔ Just want a script and maybe one follow-up — the "prescribe it and leave me alone" type
- ✔ Only genuinely need 1–2 visits per year ($477.89 vs $708)
- ✔ Can manage refills and labs yourself
- ✔ Also want urgent care, mental health, or primary care
Most women in perimenopause and menopause land in the first group. Doses get adjusted. Symptoms shift. Labs come up. That's why Sesame is our default cash-pay pick — but now you can see exactly when it isn't.
One thing to check before you pay either provider: what's actually included. With Sesame, basic labs are included when your provider orders them (we list which ones below). With PlushCare, labs and medication are not included in the visit price — you get a discount, not free labs.
Paying out of pocket? Check Sesame's current monthly price before you book anywhere else →Which is better if you have insurance?
PlushCare is the better first check if your plan is in-network, because your visit may cost just a normal copay (often $30 or less) on top of the $19.99 membership. Sesame does not bill health insurance for its menopause plan. The exception: if your deductible is high and your plan won't actually cover the visit, PlushCare's "insurance" savings can disappear — and Sesame's flat price may win again.
The PlushCare insurance math
PlushCare accepts a lot of major plans, including Aetna, Cigna, and Humana, and says in-network patients often pay $30 or less per visit. If that's you, the math is hard to beat: about $340 a year for four visits, plus your medication. But read your own plan first — if your deductible is high and you haven't met it, "I have insurance" doesn't mean the visit is cheap. You might pay close to the full rate anyway.
Regular link — we're not paid by PlushCare.
Which is better for lab work?
Sesame has the clearer lab advantage for menopause care because its plan includes a set of basic labs when your provider orders them. PlushCare offers lab discounts but does not include labs in the visit price. One thing to know about Sesame: a handful of states have their own lab rules you should check before signing up.
Labs included with Sesame's menopause plan (when your provider orders them):
- 🩸 CBC (complete blood count — checks red and white blood cells, anemia, and clotting platelets)
- 🩸 Hemoglobin A1c (your average blood sugar over the past 2–3 months)
- 🩸 Thyroid function test (how well your thyroid is working — important, because thyroid trouble can mimic menopause)
- 🩸 Lipid panel (good and bad cholesterol, plus triglycerides)
- 🩸 Comprehensive metabolic panel (blood sugar, kidney and liver function, electrolytes)
You can also upload labs you already have — your provider decides whether those can be used instead.
State lab rules to check first (Sesame)
| If you live in… | Here's how your Sesame lab works |
|---|---|
| AZ, OK, SD, WI | Your lab order goes to LabCorp instead of Quest |
| HI | Your lab order goes to Clinical Labs of Hawaii |
| NY, NJ, RI | Your order goes to Quest, but you pay Quest directly due to state rules |
| ND | You can use any lab, but you pay the lab directly |
| Most other states | Quest Diagnostics, included in your plan |
In New York, New Jersey, Rhode Island, and North Dakota, "labs included" comes with an asterisk — you'll still pay the lab. A couple of other states may have their own rules too, so confirm yours at signup.
Can you actually get menopause HRT through Sesame or PlushCare?
Yes — both publish a clear menopause HRT process, but neither guarantees a prescription. A licensed provider reviews your symptoms and history and prescribes hormone therapy only if it's appropriate for you, then sends it to your pharmacy. A prescription is always the clinician's call.
How Sesame works
- Fill out a short symptom questionnaire
- Pick your own provider from their list
- Same-day video visit
- Provider orders labs if needed (included in plan)
- If appropriate, prescription goes to your local pharmacy
- Unlimited messaging ongoing
How PlushCare works
- Book a same-day appointment — this starts your membership
- Video visit with a board-certified doctor
- Doctor may ask for a recent mammogram before starting HRT
- If appropriate, prescription goes to your pharmacy
- Labs and medication billed separately
What to have ready for your visit (free checklist)
- Your main symptoms and how long you've had them
- Your menstrual status (still having periods, irregular, or stopped)
- Whether you've had a hysterectomy (this changes which hormones you need)
- A current medication and allergy list
- Any personal or family history of breast cancer, blood clots, stroke, heart disease, or migraine with aura
- Your most recent mammogram date
- Any HRT you've used before and how it went
- Your preferred pharmacy
- Recent lab results, if you have them
What hormones can Sesame and PlushCare actually prescribe?
Both can prescribe FDA-approved menopause hormones — estradiol, micronized progesterone, and estrogen-plus-progestin combinations — sent to your local pharmacy. Both also mention compounded "bioidentical" hormones, which are not FDA-approved. The exact prescription always depends on your provider and your medical history.
FDA-approved
Tested and reviewed by the government for safety, strength, and quality. The recommended first choice.
Compounded ("bioidentical")
Custom-mixed by a pharmacy. Not FDA-approved. The FDA says there's no evidence they're safer or more effective than approved options. ACOG recommends against routine use when FDA-approved versions exist.
| Sesame | PlushCare | |
|---|---|---|
| FDA-approved options | Estradiol (generic for Estrace, Climara, Divigel), estrogen/progestin (such as Prempro, Bijuva, Mimvey), progesterone (generic for Prometrium), DHEA vaginal inserts (Intrarosa) | Estrogen-only, estrogen + progestin, and Bijuva (an FDA-approved bioidentical) |
| Compounded BHRT? | Can be prescribed if a provider decides it's appropriate — described as outside formal FDA regulation | Listed as an option and stated as not FDA-approved or recommended |
| Non-hormonal options | Yes — gabapentin, paroxetine, clonidine, and more | Mentions non-hormonal options like paroxetine |
Both send your prescription to your local pharmacy, and medication is billed separately. On forms: PlushCare lists pills, skin patches, vaginal creams, gels, and rings. Sesame lists the named medications above and says BHRT can come as pills, patches, creams, or gels.
Who should skip both Sesame and PlushCare?
Skip both as your first stop if you need testosterone, hormone injections, pellets, emergency care, or treatment for a complex medical history. PlushCare says it does not prescribe controlled substances and does not offer injection or pellet hormone therapy. Sesame's online providers also do not prescribe controlled substances, and its menopause menu doesn't list injections or pellets.
Testosterone, injections, or pellets
Testosterone is a controlled medication — Schedule III. Neither Sesame's nor PlushCare's online providers prescribe it, and neither offers injectable hormones or implanted pellets. If that's your goal, you'll want a provider who specializes in it.
A complicated history
A personal history of breast cancer, blood clots, stroke, unexplained vaginal bleeding, or serious liver disease usually calls for hands-on, in-person care. Sesame says up front that severe or complex cases may need an in-person evaluation.
Emergency symptoms
Chest pain, trouble breathing, signs of a stroke, or heavy unexplained bleeding are emergencies. Call 911 or go to the ER — don't book a video visit.
Is Sesame or PlushCare more trustworthy for this decision?
Both are legitimate, established telehealth platforms, but they solve different problems. Sesame is more transparent for cash-pay menopause pricing and includes labs; PlushCare is stronger for insurance billing and broad primary care, but it draws more billing and cancellation complaints. Use reviews to judge service and billing — not medical results.
Our decision-friction scorecard
This measures decision friction for a cash-pay menopause shopper — not medical quality.
| What we scored | Weight | Sesame | PlushCare | Why |
|---|---|---|---|---|
| Cash-pay price clarity | 20 | 18 | 11 | Sesame's flat fee is simpler; PlushCare stacks membership + per-visit |
| Insurance usefulness | 15 | 3 | 14 | Sesame doesn't bill insurance; it's PlushCare's whole advantage |
| Lab clarity and value | 15 | 13 | 5 | Sesame includes a basic panel when ordered; PlushCare only discounts |
| Menopause-specific fit | 15 | 13 | 8 | Sesame's plan is menopause-focused; PlushCare is broad telehealth |
| Local-pharmacy flow | 10 | 9 | 9 | Both send prescriptions to your pharmacy |
| Dealbreaker honesty | 10 | 8 | 9 | Both clearly state limits (no controlled substances; no pellets) |
| Ongoing support | 10 | 8 | 8 | Both offer provider messaging |
| Cancellation clarity | 5 | 4 | 4 | Both publish policies (see next section) |
| Total | 100 | 76 | 68 | Sesame leads for cash-pay; PlushCare wins insured branch |
Sesame (checked June 5, 2026)
- ⭐ ~4.5/5 on Trustpilot (displayed on Sesame's own site)
- ✔ Reviewers often praise affordable, quick booking
- ✔ Menopause page features patients helped quickly after years of symptoms
Individual experiences; results vary and aren't typical for everyone.
PlushCare (checked June 5, 2026)
- ⭐ ~3.5/5 on Trustpilot (~3,000 reviews); ~3.1/5 on another independent site (2,000+ reviews)
- ✔ Praise clusters around individual doctors
- ⚠ Recurring flag: billing and cancellation problems — surprise charges after the free month, confusion over insurance
How to avoid PlushCare's most common complaint:
Cancel before your free 30 days end if you're not continuing, and confirm your insurance is applied before the visit, not after. Do both, and you sidestep the exact billing and cancellation problems those reviews describe.
Can you cancel Sesame or PlushCare?
Yes — both let you cancel, and the rules are clear if you know them up front. Sesame refunds your menopause plan in full if you cancel at least 3 hours before your first visit, but not after that first visit happens; you can cancel the subscription anytime before your next billing date. PlushCare lets you cancel the membership anytime, and refunds you if it can't treat you.
Sesame cancellation
- ✔ Cancel 3+ hours before your initial visit → full refund
- ✗ First visit has happened → first month is not refundable
- ✔ Cancel the subscription anytime before your next billing cycle
- ✗ Past months are not refunded
- ✔ Cancel by email or phone
PlushCare cancellation
- ✔ Cancel the $19.99 membership anytime
- ✔ First 30 days are free
- ✔ Full refund if PlushCare can't treat you
- ✗ Medication or lab costs not included in refund
- ⚠ Set a reminder to cancel before the free month ends if you don't plan to continue
What we verified — and what we couldn't
This comparison is built on each provider's own published pages, current pharmacy pricing, and independent reviews, all checked on . We're also telling you what we couldn't confirm firsthand, because honesty about the gaps is part of being trustworthy. Prices and policies change, so always confirm at checkout before you book.
| What we checked | Sesame says | PlushCare says | What we found (June 5, 2026) |
|---|---|---|---|
| Plan price | $59/mo on current pages; $99/mo in its launch post | $19.99/mo, first month free | Both numbers appear on Sesame's own pages — confirm at checkout. PlushCare's $19.99 + $129 first visit verified |
| Insurance | Doesn't bill insurance | Accepts major plans; in-network often ≤$30 | Verified on each provider's page |
| Labs | Basic panel included if ordered (state exceptions) | Not included; member discount | Verified; Sesame lists CBC, A1c, thyroid, lipid panel, and metabolic panel |
| Injections / pellets | Not listed on the menopause menu | Explicitly not offered | Verified |
| Prescriptions | Sent to your pharmacy if appropriate | Sent to your pharmacy at the doctor's discretion; may request a mammogram | Verified |
| Cancellation | Refund if canceled 3+ hrs before first visit; cancel before next billing cycle | Cancel anytime; refund if they can't treat you | Verified on each provider's page |
What we did not verify firsthand (yet):
- We did not complete a paid signup, so we haven't screen-captured each checkout flow.
- Exact insurance cost varies by your specific plan — we can't confirm your copay.
- Whether a specific provider will prescribe HRT in your specific case (that's always clinician discretion).
- Your exact out-of-pocket medication price at your pharmacy.
If any number here looks different when you check the live site, trust the live site. Last verified: June 5, 2026.
What if neither Sesame nor PlushCare fits?
If neither one fits, the next step depends on why — your insurance, your medication preference, or your need for specialty care.
You want insurance-friendly menopause care with a menopause focus
Look at a menopause-specialized telehealth clinic that bills insurance, such as Midi Health.
You want compounded hormones shipped to your door
Providers like Winona or Inner Balance (Oestra) use that model — just remember that compounded hormones are not FDA-approved, and the FDA hasn't found them safer or more effective than approved options. Go in with eyes open.
You already have a prescription and just want cheaper medication
Use a pharmacy discount tool (like GoodRx) and compare your local pharmacies — common oral generics are often under $30/month, while patches and brand-name products cost more.
You need testosterone, injections, or pellets
See a provider who specializes in it. This is controlled-substance and procedure territory, not a quick online script.
Sesame vs PlushCare HRT: frequently asked questions
- Is Sesame better than PlushCare for HRT?
- For most people paying cash, yes — Sesame's flat plan (around $59/month) includes visits and basic labs when ordered. If you have in-network insurance, PlushCare is usually cheaper. Confirm Sesame's live price first, since some pages list $99/month.
- Is PlushCare better than Sesame if I have insurance?
- Usually, yes. PlushCare accepts major plans, and in-network visits often cost a copay of $30 or less on top of the $19.99 membership. Sesame doesn't bill insurance.
- Does Sesame prescribe HRT online?
- Yes. A licensed Sesame provider can prescribe menopause hormone therapy if it's appropriate, sent to your local pharmacy. A prescription isn't guaranteed — it's always the provider's call.
- Does PlushCare prescribe HRT online?
- Yes. A board-certified PlushCare doctor can prescribe menopause hormone therapy if appropriate. Your doctor may request a recent mammogram before starting.
- How much does Sesame cost for menopause HRT?
- Sesame's menopause plan shows as $59/month on its current pages, though its launch announcement listed $99/month. Medication is separate. Confirm the live price at checkout.
- How much does PlushCare cost for HRT without insurance?
- $19.99/month membership plus a $129 initial visit without insurance. The first month of membership is free. Medication and labs are separate.
- Does Sesame or PlushCare include the medication?
- No. Both send your prescription to your local pharmacy, and you pay for the medication there. Common oral generics (estradiol plus progesterone) often run about $28–$50/month combined with a discount coupon.
- Does Sesame or PlushCare include labs?
- Sesame includes a basic lab panel when your provider orders it (with a few state exceptions). PlushCare does not include labs but offers a member discount.
- Can PlushCare or Sesame prescribe testosterone?
- No. Sesame says its providers can't prescribe controlled substances online, and PlushCare says it doesn't prescribe controlled substances. Testosterone is a Schedule III controlled substance, so you'd need a provider who specializes in it.
- Do Sesame or PlushCare offer HRT pellets or injections?
- No. Both offer pills, patches, creams, and other standard forms — but neither lists injections or pellets.
- Does Sesame take insurance?
- No. Sesame is cash-pay only. The trade-off is transparent, predictable pricing with no claims or copay surprises.
- Does PlushCare take insurance?
- Yes. PlushCare accepts many major plans, including Aetna, Cigna, and Humana.
- Can I use my own pharmacy?
- Yes, with both. Each platform sends your prescription to the local pharmacy you choose.
- Can I cancel Sesame or PlushCare?
- Yes. With Sesame, cancel a visit 3+ hours ahead for a refund, and cancel the subscription before your next billing date. With PlushCare, cancel the membership anytime — set a reminder before the free 30 days end.
- Are compounded hormones FDA-approved?
- No. Compounded hormones are not FDA-approved, and the FDA hasn't found them safer or more effective than FDA-approved hormone therapy.
- What should I do if neither provider fits?
- Take our matching quiz. We'll route you by your insurance, medication preference, state, and symptoms. Take the quiz
Still not sure which HRT program is right for you?
Get your personalized HRT match →Who wrote this, how, and why
Who: The HRT Index Editorial Team — an independent comparison resource for HRT telehealth providers.
How: We read Sesame's and PlushCare's official menopause, pricing, lab, prescription, and cancellation pages; cross-checked current generic medication prices on GoodRx; reviewed independent rating sites for billing and service patterns; and separated commercial, medical/regulatory, and our own editorial conclusions. We did not complete a paid signup, so we've flagged what still needs firsthand confirmation.
Why: Most "best HRT" pages tell you who's "best" without showing the hidden math — membership fees, lab costs, insurance fit, medication prices, and the cases where online care isn't appropriate.
What this is not: This is not medical advice, not a prescription guarantee, and not a substitute for a licensed clinician's evaluation.
Sources verified
The HRT Index is an independent comparison resource for HRT telehealth providers. This article is for education and to help you compare your options — it is not medical advice. Decisions about hormone therapy should be made with a licensed clinician who can review your symptoms, medical history, and risks. Prices and policies were verified on and can change; check each provider's site for current details. We may earn a commission from Sesame links on this page, clearly marked, which never affects our recommendations or your price. We are not affiliated with PlushCare and earn nothing from PlushCare links.