Stella Menopause Alternatives: 10 Options Compared — and How to Tell Which One Fits You

The best Stella menopause alternative depends on the gate that stopped you. For state or commercial-insurance access, Midi Health is the widest national option. For Medicare or Medicaid, check Elektra Health in a state and plan it serves. If Stella’s $200 self-pay visit was the problem, MyMenopauseRx charges $150 and Alloy’s consult is $49 before medication.

That’s the short version. Here’s the part most pages skip.

Many women searching for Stella menopause alternatives are not leaving after bad care. They never got through the front door. They filled out the form and hit a wall — a state, a plan, an age limit, Medicare, testosterone, delivery, or price. Stella publishes those limits across different pages, and each one has a different answer.

And there is an eleventh option down there that nobody is selling you. For a lot of women, it is the cheapest one on the list.

Best for / not for you if

This page is for you if you looked at Stella and got stopped by your state, insurance, age, Medicare or Medicaid, testosterone, the $200 visit fee, or the fact that medication is filled through your own pharmacy instead of arriving in a subscription box.

This page is not for you if you are looking for non-hormonal alternatives to hormone therapy — options such as fezolinetant, gabapentin, or certain antidepressants. That is a different decision, covered in our non-hormonal menopause options guide.

Stella may still be the right answer if your plan and state clear its checker, you want a scheduled visit with a menopause-focused clinician, you want prescriptions sent to your own pharmacy, and you would use the app and coaching included after the first visit.

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.

Where our money comes from, before you read the table. Links to Sesame and Winona may earn us a commission and are labeled. Midi, Stella, Elektra, MyMenopauseRx, Gennev, Evernow, Alloy, Wisp, and Hers do not pay us for a click from this page. Affiliate relationships did not determine the recommendations. See our affiliate disclosure.

Which Stella gate stopped you?

Stella’s public U.S. pages describe several different limits. We pulled the decision-relevant ones into one place, then matched each limit to the provider model that actually clears it. Find the row that stopped you. The last column is your shortest path.

What stopped you	What Stella currently publishes	Best next check
Your state or commercial-insurance network	Stella advertises clinicians and in-network care broadly, but its live checker determines whether your state and plan can use the service.	Midi for all-state access and most PPO plans; Evernow or Gennev as additional national checks.
Your age	Stella says its service is designed for women ages 35 to 70.	Midi, MyMenopauseRx, Gennev, Elektra, Evernow, Alloy, Wisp, or Sesame; none of their cited public pages lists the same 35–70 ceiling.
Medicare or Medicaid	Stella’s U.S. Terms say Vira Health is not enrolled with Medicare or Medicaid.	Elektra, but only in the states and plans it currently lists.
Your commercial plan	Stella’s clinical pages advertise in-network care; its current Terms still say Vira Health does not accept commercial insurance.	Get Stella’s answer in writing first. Then compare Midi, MyMenopauseRx, Gennev, Evernow, or Elektra.
You want testosterone	Stella U.S. says “Not yet” and offers a waitlist.	Midi has the widest clearly documented pathway; MyMenopauseRx publishes a select-state route but its live pages conflict on the exact states; Elektra says some clinicians prescribe it for New York residents.
You want compounded hormones	Stella says it prescribes FDA-regulated medications rather than compounded products.	Read the compounded-versus-FDA-approved section before considering a mixed-formulary provider such as Winona.
You want medication delivered	Stella sends prescriptions to the pharmacy you choose.	Alloy, Hers, or Winona ship medication; Evernow offers local-pharmacy or delivery paths.
The $200 self-pay visit	Stella lists $200 initially and $90 for follow-ups, with no membership fee.	Alloy has a $49 consult before medication; Wisp is $99 for a three-month care episode; MyMenopauseRx and Evernow are $150 per visit; Sesame lists $59/month.
You wanted the standalone Stella app	The U.S. App Store listing says the app is available through partners such as employers, health insurers, and communities, while also displaying in-app purchase prices.	Check your employer and insurer benefits before paying another service for app-based support.

Source: Sources checked August 14, 2026:* Stella U.S. insurance, Stella U.S. FAQs, Stella U.S. Terms, and the U.S. App Store listing.

Here is what that table really says: you are not necessarily looking for “better.” You are looking for the provider that clears your specific gate without creating a worse one.

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

Get my personalized starting-point plan →

Are you sure you were looking at the right Stella?

Answer: The U.S. clinic, U.K. clinic, and partner-distributed Stella app are not interchangeable. The U.S. clinic lists $200 for an initial visit and does not currently offer testosterone; the U.K. service lists £85 for an initial appointment and does prescribe it. The app’s U.S. listing says access is partner-distributed.

We are starting here because it is the fastest fact on this page that might make the problem disappear.

Stella product or market	Current public price or access model	Testosterone?	Can a U.S. consumer sign up directly?
Stella U.S. virtual clinic	$200 initial visit; $90 follow-up; no membership fee	Not currently	Yes, subject to state and coverage eligibility
Stella U.K. clinic	£85 initial appointment; £45 repeat appointment; £10 prescription fee; medication separate	Yes, when clinically appropriate	No — U.K. service
Stella app	U.S. listing says partner-distributed; the listing also displays in-app purchase prices	Not a prescribing clinic	Generally through an employer, insurer, or other partner
Other regional Stella services	Region-specific	Varies	Region-specific

If the price you saw had a pound sign, you were on the wrong Stella for U.S. care. Nothing shady has to be happening for £85 and $200 to coexist. They are different services with different formularies and access rules under one brand.

Check your employer’s benefits portal and your insurer’s app before you pay anybody. The Stella app may already be included through a benefit. That same rule applies elsewhere: employer-distributed menopause benefits can be easy to miss because they never appear in a retail-provider comparison.

One honest caveat on the app: the App Store says it is partner-distributed and also shows in-app purchase prices. Both statements are currently live. We cannot tell from that listing which users can actually buy those plans, so we do not add an app fee to any cost comparison.

Sources: Stella U.S., Stella U.K., and Stella on the U.S. App Store.

Why do women actually look for Stella menopause alternatives?

Answer: The most useful explanation is not “Stella is bad.” It is that Stella has a narrower front door than several competitors. Its published age band, plan and state checks, federal-program exclusion, testosterone waitlist, pharmacy model, and visit fee each create a different reason to compare alternatives.

The state and network mess

Stella’s public pages use different scopes: broad national clinician language, insurance availability in many states, named carrier relationships, and a live eligibility checker that controls what a particular person can book. Those statements are not automatically contradictory. A clinician can be licensed in a state while the service is out of network for your exact plan there.

The age band

Stella says the U.S. service is designed for women ages 35 to 70. If you are outside that band, do not assume another provider fixes it. Check the next provider’s criteria before you start intake. Winona, for example, publishes an even narrower 35-to-59 band.

Medicare and Medicaid

Stella’s current Terms say Vira Health is not enrolled with federal or state healthcare programs such as Medicare and Medicaid. That is not a soft “maybe.” It is a reason to check Elektra’s current plan-and-state list or move to an in-person clinician who bills your coverage.

Testosterone

Stella U.S. answers with “Not yet.” The U.K. service does prescribe testosterone, which is why this detail is so easy to get wrong.

No medication in the box

Stella writes a prescription and sends it to the pharmacy you choose. You pay the pharmacy through your own pharmacy benefit or cash price. If you expected a monthly package, that can feel like something is missing. It is not. It is a different business model — and it is often the cheaper one.

Before you switch: is Stella actually the problem?

Answer: Stella has no membership fee, so there is no platform subscription to escape. If your problem was a coverage estimate, one clinician fit, or one unexpected bill, switching companies may add a new intake fee without fixing the underlying issue. Leave only when you have identified the gate that another provider actually clears.

This is the section we would want someone to write for us.

Stella’s current pricing structure is unusual in menopause telehealth: you pay for visits, while medication is handled at your pharmacy. That means:

• There is no Stella membership renewal to cancel.
• An active prescription and its remaining refills stay at the pharmacy as written. They still expire and run out under normal prescription rules.
• You can compare another clinic without first stopping a Stella subscription.

Before you compare ten companies, put your problem into one of these buckets.

“The bill surprised me.” That is often a coverage-verification problem. It can follow you to the next clinic if you do not verify the billing entity, network status, deductible, coinsurance, and pharmacy benefit first.

“I did not click with my clinician.” Ask Stella whether you can see another clinician before you pay a second company’s intake fee. We did not find a public promise that reassignment is free, so get the answer before assuming.

“I hit an actual wall.” Wrong state. Wrong age. Medicare or Medicaid. Testosterone. Delivery. Price. This is when a different provider model can solve something concrete.

If you are in the first two buckets, contact Stella before you switch. We would rather lose the affiliate click than send you through a second intake that fixes nothing.

What does Stella cost, and what is included?

Answer: Stella currently lists a $200 initial virtual visit and $90 follow-ups, with no membership fee. Its site says the app is included for 12 months after the first visit, along with coaching and care coordination. Medication and any pharmacy cost are separate because the prescription goes to your chosen pharmacy.

Here is what Stella publishes:

• Initial virtual visit — $200
• Follow-up visit — $90
• Average insured copay — $45, explicitly described as an average, not a quote
• Membership fee — none
• Stella app — 12 months included after the first visit
• Medication — separate at your pharmacy
• HSA/FSA — eligible
• Out-of-network paperwork — superbill available

The $45 number is the easiest one to misuse. It is a provider-published average. It does not predict your bill. A person with an unmet deductible may owe far more than the average even when the clinician is in network.

For a Stella-only cost breakdown, see Stella menopause cost.

Primary source: Stella’s current insurance and pricing page.

Does Stella take insurance?

Answer: Stella’s current clinical pages advertise in-network care and an average $45 copay. Its U.S. Terms, last updated August 14, 2025, still say Vira Health does not accept commercial insurance. Those public documents do not clearly explain the difference. Get the billing entity, network status, and expected cost in writing before paying.

Current document	What it says
Stella insurance, FAQ, and begin pages	Advertise in-network clinical care, named insurers, an average $45 copay, and superbills for out-of-network reimbursement
Stella U.S. Terms, Section 7	Says Vira Health does not accept commercial insurance and is not enrolled with Medicare or Medicaid
What the public pages do not explain clearly	Whether different affiliated clinical entities, contracts, or operating models account for the wording difference

The correct editorial move is not to accuse Stella of deception and not to pretend the documents agree. They do not.

The Terms also describe Vira Health as a technology platform while care may be delivered through separate medical groups. That structure can matter for billing, but the public pages we reviewed do not give enough detail to tell a reader which entity will appear on a claim.

What to do before paying:

“Will my plan be billed for this visit? Which medical group and tax ID will submit the claim, is that entity in network for my exact plan in my state, and what is my expected out-of-pocket cost?”

Save the answer. This is not a Stella-only protection. It is the best insurance question on this page.

Sources: Stella insurance and Stella U.S. Terms.

No affiliate link belongs in this section, and there is not one.

What states is Stella available in?

Answer: Stella does not publish one clean state list that resolves every reader’s access. Its site uses national clinician language, insurance language, and a live eligibility checker. Those measure different things. Run the public checker using the state where you will physically be during the appointment and your exact insurance plan.

A “state count” can mean four different things:

1. States where at least one clinician holds a license.
2. States where the service offers a particular visit type.
3. States where a named insurer contracts with the clinical entity.
4. States where your exact plan clears the live checker today.

Those numbers do not have to match. Publishing a single Stella state count would give false certainty.

Credit where it is due: Stella lets a reader test coverage before creating a full care relationship. That is more useful than a vague “available nationwide” claim.

Licensing also follows where you are physically located during the telehealth visit. If you are traveling, splitting time between states, or moving, use the state where you will actually sit for the appointment.

Which Stella menopause alternatives clear each gate?

Answer: No single alternative clears every Stella gate. Midi has the broadest published all-state commercial-insurance model; Elektra is the federal-program route in listed states and plans; MyMenopauseRx and Evernow charge $150 per self-pay visit; Wisp is $99 for three months of care access; and Alloy’s consult is $49 before medication.

A $200 appointment and a $79 monthly medication plan are not the same kind of number. The table separates the door price, the recurring charge, and whether medication is included.

Provider	Current public door price	Insurance for clinical visits?	Medication model	What recurs	Material limit
Stella	$200 initial; $90 follow-up	Marketing says in network; Terms still say Vira does not accept commercial insurance	Your pharmacy	Visits only	Ages 35–70; no Medicare/Medicaid; no U.S. testosterone
Midi Health	$250 initial; $150 continued-care visit	Most PPO plans nationwide; coverage varies	Your pharmacy; compounded testosterone handled by pharmacy where prescribed	Visits only	Cannot treat Medicaid/Medi-Cal patients, even self-pay; no Medicare claims
Elektra Health	$249 initial; $149 follow-up	Select commercial, Medicare, and Medicaid plans in listed states	Your pharmacy	Visits; optional coaching if not covered	Clinical footprint and payer list are state-specific
MyMenopauseRx	$150 per visit	Lists Aetna, BCBS, Cigna, Humana, UHC, TRICARE, and Sana	Your pharmacy	Visits only	Available in 39 states plus D.C.; testosterone pages conflict on the exact prescribing states
Gennev	$250 initial; $199 OB-GYN follow-up	Lists Aetna, Anthem, and UnitedHealthcare pathways	Your pharmacy	Visits only	Higher self-pay follow-up than several alternatives
Evernow	$150 pay-per-visit; membership options also available	Major commercial plans; no Medicare/Medicaid	Local pharmacy or delivery, depending on medication	Visits or membership, depending on path	Pay-per-visit access lasts 90 days; membership is separate
Alloy	$49 one-time consult	No	Ships medication	Medication subscription	Medication is extra; patch page currently shows $100
Wisp	$99	No	Your local pharmacy	New care episode after three months if needed	Public page includes three months, not a full year
Sesame (affiliate)	$59/month	No — cash-pay model	Your pharmacy	Monthly membership	Medication excluded; controlled substances cannot be prescribed online through Sesame
Hers	Oral from $79/month; patch from $134/month on 12-month plans	No	Ships medication	Subscription	Read cancellation terms and the pending FTC case disclosure below
Winona (affiliate)	Patch from $149; progesterone capsules from $39	No	Ships medication	Every 28 days for a 30-day supply	Ages 35–59; 37 states plus Puerto Rico; mixed FDA-approved and compounded catalog

That is eleven rows because Stella is the baseline and ten alternatives are compared.

Provider-stated versus verified: every amount above was rechecked on a live provider-controlled page on August 14, 2026. “Insurance accepted” does not mean your plan will pay, and no average copay is treated as a quote.

Primary pricing sources: Midi, Elektra, MyMenopauseRx, Gennev, Evernow, Alloy, Wisp, Sesame, Hers, and Winona.

Two rows fit and you cannot tell which gate matters more? Use Find My HRT Path to compare your state, insurance model, medication route, uterus status, and risk flags before you start another intake.

Show me the path that fits my situation →

What if your state or commercial plan was the blocker?

Answer: Midi is the widest national insurance-first alternative in this comparison. It operates in all 50 states, says it is in network with most PPO plans, charges $250 for an initial self-pay visit and $150 for continued care, and has no mandatory membership. Coverage, deductibles, coinsurance, prescriptions, and labs remain plan-specific.

Midi’s front door is wider than Stella’s for many commercially insured women. Its current pricing page says it is accepted by insurance nationwide and in network with most PPO plans.

Here is what we do not like about it

Midi’s first self-pay visit costs $250. That is $50 more than the Stella visit you just walked away from. If your only problem was Stella’s $200 price, Midi is the wrong cash-pay answer. MyMenopauseRx and Evernow charge $150 per visit, and Wisp charges $99 for a three-month care episode.

But because Midi skips a mandatory membership, sends ordinary prescriptions to your pharmacy, and can bill many PPO plans nationally, nothing automatically recurs except care you book. For the right insured reader, the expensive sticker can turn into the cheaper path.

Two hard stops are stated plainly on Midi’s own pricing page:

• Midi cannot treat Medicaid or Medi-Cal patients, even as self-pay.
• Midi does not bill Medicare or Medicare-related plans. Medicare beneficiaries may use self-pay, but claims cannot be submitted for Midi care.

Midi is also the widest published testosterone route in this roster, covered later.

Does that sound like your situation? Check your exact state and plan before assuming either the self-pay fee or an average copay.

Check Midi coverage in my state → (direct provider link — no commission)

Source: Midi pricing and insurance.

What if you have Medicare or Medicaid?

Answer: Elektra is the only provider in this comparison that explicitly lists both Medicare and Medicaid plans. That does not mean national federal-program access. Its current payer list is state-specific: Medicare appears in several states, while Medicaid appears through named plans in New York, Pennsylvania, New Jersey, and Illinois.

Elektra’s current FAQ lists these federal-program routes:

• New York: Medicare and Medicaid among a broader payer list
• Connecticut: Medicare
• Massachusetts: Medicare
• Florida: Medicare
• Pennsylvania: Medicare and Medicaid
• New Jersey: Medicare and Medicaid
• Illinois: Aetna Better Health of Illinois, identified as Aetna Medicaid

Its cash-pay price is $249 initially and $149 for follow-ups. Coaching is $99 per session when it is not covered. Elektra says it does not prescribe compounded or non-FDA-approved medications.

The catch is real: “Elektra accepts Medicare and Medicaid” is incomplete unless the sentence also names the state and plan. Do not get attached to the answer until the insurer and state both clear.

If you are a Medicare or Medicaid beneficiary, check Elektra’s current payer list before looking at cash-pay subscriptions.

Check Elektra insurance and availability → (editorial link — no commission)

If Elektra does not serve your state or plan, an in-person gynecologist, primary-care clinician, or practitioner found through The Menopause Society’s directory may be the better use of coverage. Paying cash online while an accessible local clinician can bill your plan is a bad trade.

What if Stella’s $200 visit was the blocker?

Answer: Five current public prices come in below Stella’s $200 initial self-pay visit: Alloy’s $49 consult before medication, Sesame at $59/month, Wisp at $99 for three months of care access, and MyMenopauseRx or Evernow at $150 per visit. Those prices buy different things, so the cheapest number is not automatically the cheapest care.

Option	Current public charge	What it buys	What remains separate
Alloy	$49 one-time consult	Intake, prescribing review, and ongoing messaging while the prescription is active	Medication; patch page currently displays $100
Sesame (affiliate)	$59/month	Video visits as needed, unlimited messaging, and basic lab work if necessary	Medication at your pharmacy
Wisp	$99	Consult, follow-ups, and three months of care-team access	Medication; care after the three-month episode
MyMenopauseRx	$150 per visit	Same-clinician selection, messaging, care coordination, local-pharmacy prescriptions	Medication; labs if ordered
Evernow	$150 per visit	Video visit and 90 days of portal/prescription access	Medication; optional membership

MyMenopauseRx: the cleanest lower-price visit model

MyMenopauseRx now publishes $150 per virtual visit — not the $99 figure still repeated on older comparison pages. It lists seven insurance families and 39 states plus Washington, D.C. The practice was founded by Dr. Barbra Hanna, a board-certified OB-GYN and Menopause Society Certified Practitioner. Its site also says patients can select the same specialist, message the care team, and use a local pharmacy.

That is still $50 below Stella’s first self-pay visit and $100 below Midi’s. It is no longer the cheapest door on the page.

See MyMenopauseRx’s current price and state list → (editorial link — no commission)

Wisp: the lowest fixed care episode

Wisp’s menopause page lists $99 for the consult, follow-ups, and three months of care-team access. If prescribed, medication is paid for at a local pharmacy. The public page does not promise a full year of care or list included menopause lab work, so do not turn $99 into an annual total.

Alloy: the cheapest consult, not the cheapest complete plan

Alloy’s $49 is a one-time consult fee. Medication is extra. Its estradiol-patch page currently displays $100 and says a three-month supply is delivered. The $49 number is therefore a door price, not a treatment total.

Sesame: the lowest recurring care fee

Sesame’s current menopause page displays $59/month. It includes video visits as needed, unlimited messaging, and basic lab work if necessary; medication goes to the patient’s pharmacy and is not included. Sesame is cash-pay and says controlled substances cannot be prescribed online through its platform.

Evernow: the flexible middle

Evernow lists $150 self-pay per video visit and a separate membership model. Its FAQ says pay-per-visit care includes a 90-day access window, and medication can go to a local pharmacy or be delivered depending on the prescription.

What if you want medication delivered to your door?

Answer: Stella deliberately separates clinical care from medication fulfillment. Alloy, Hers, and Winona ship medication, while Evernow offers local-pharmacy or delivery paths. Delivery is convenient, but it usually replaces a visit-only model with recurring medication billing, narrower cancellation timing, or less freedom to price-shop at another pharmacy.

First, a defense of the model you are trying to leave.

When a prescription goes to your own pharmacy:

• your pharmacy benefit can apply;
• you can compare insurance and discount-card prices;
• the pharmacy relationship is not tied to a telehealth subscription;
• unused refills remain available under the prescription’s normal terms even if you stop booking the clinic.

When medication is bundled, you trade some of that flexibility for convenience. Sometimes that is exactly the right trade. Make it on purpose.

Alloy

Alloy ships three-month medication supplies and charges the separate $49 consult fee. Its estradiol-patch page currently displays $100. Confirm the full prescribed regimen at checkout because progesterone or another product may be separate.

Winona

Winona ships to 37 states plus Puerto Rico and publishes an age range of 35 to 59. Its treatment catalog is mixed: the estradiol patch is presented as an FDA-approved finished product, while several creams and DHEA products are compounded. The provider bills a 30-day supply every 28 days, not once per calendar month.

Hers

Hers advertises oral menopause medications from $79/month and patches from $134/month on 12-month plans. Those are advertised monthly equivalents tied to a longer plan, not proof that every order is charged one month at a time.

Two things to know before any bundled plan

First, cancellation timing. Hers’ current terms say to cancel at least two days before the renewal processing date. Our safer house practice for any subscription is to cancel earlier than the published minimum, do it in writing, and save the confirmation. Winona says a 30-day supply is processed every 28 days and gives a 24-hour order-cancellation window before an order becomes nonrefundable.

Second, the Hers enforcement disclosure. On July 29, 2026, the Federal Trade Commission, joined by Utah and California through Los Angeles County Counsel, filed a federal complaint against Hims & Hers. The complaint alleges deceptive immediate charging, cancellation friction, and sharing sensitive health information with advertising platforms. These are allegations in a pending case, not findings by a court. The FTC says the matter will be decided by the court.

We removed the Hers affiliate link from this page. If Hers is your answer, go to the provider directly.

Sources: Hers pricing, Hims & Hers terms, FTC complaint announcement, Winona products, and Winona FAQ.

There is no provider CTA in this section. That is deliberate.

What if you want testosterone?

Answer: Stella U.S. does not currently prescribe testosterone. Midi publishes the widest clearly documented pathway in this comparison across 25 jurisdictions. MyMenopauseRx publishes select-state testosterone visits, but its live pages conflict on the exact state set; Elektra says some New York clinicians prescribe it. Testosterone is Schedule III and requires a prescription, video follow-up, and state-specific controlled-substance compliance.

The dead ends first:

• Stella U.S. says “Not yet.”
• Sesame says providers cannot prescribe controlled substances online through its platform.
• Alloy, Wisp, Hers, and Winona do not list testosterone in the menopause offerings reviewed here.
• Winona’s DHEA is not testosterone and should never be presented as equivalent.

Midi’s current published program covers Arizona, California, Colorado, Washington, D.C., Delaware, Florida, Iowa, Illinois, Indiana, Kansas, Massachusetts, Maryland, Maine, North Carolina, New Jersey, New Mexico, Nevada, New York, Ohio, Oregon, Pennsylvania, Texas, Utah, Virginia, and Washington.

Midi says the pathway includes an initial evaluation, lab review, and a second visit before prescribing when appropriate. It describes the medication as compounded testosterone because there is no FDA-approved testosterone product specifically indicated for women in the United States.

MyMenopauseRx: a real route with conflicting public documentation

MyMenopauseRx is no longer a clean dead end for testosterone, but its public documentation does not support one definitive state count. Its FAQ says testosterone is prescribed for patients located in Illinois. Multiple clinician pages list testosterone gel or cream appointments in Arizona, Florida, Illinois, Mississippi, Nebraska, New Hampshire, Ohio, Oregon, Pennsylvania, Texas, Washington, and Wisconsin. Its general treatment page still says its virtual specialists cannot prescribe controlled substances and instead coordinate with a local primary-care clinician. Its refill guide says testosterone prescribing is available where state law allows and requires a video visit plus periodic lab review.

That conflict changes the recommendation: verify the exact clinician, state, visit type, and prescription pathway before paying. The service publishes a real testosterone workflow, but its current pages do not agree enough for us to claim a fixed national footprint.

Elektra: a narrower New York route

Elektra’s current FAQ says some clinicians can prescribe testosterone to patients residing in New York. That leaves Midi as the widest clearly documented route here, not the only one.

Two practical consequences:

1. The medication may be a separate cash transaction. A compounding pharmacy can arrange payment and delivery directly even when the clinical visit is billed to insurance.
2. Compounded testosterone is not FDA-approved. The FDA does not pre-verify a compounded finished drug for safety, effectiveness, or quality before marketing.

The controlled-substance point is not fine print. The DEA lists testosterone as Schedule III. State law, clinician licensing, identity verification, prescription limits, and follow-up requirements can narrow access further.

If testosterone is why you are leaving Stella, check the state list before paying for a general menopause intake.

Check Midi’s testosterone availability → (direct provider link — no commission)

Sources: Midi testosterone program, MyMenopauseRx FAQ, MyMenopauseRx clinician page, MyMenopauseRx treatment page, MyMenopauseRx refill guide, Elektra FAQ, and DEA drug scheduling.

What if you want compounded or “bioidentical” hormones?

Answer: Stella says it prescribes FDA-regulated medications rather than compounded products. An FDA-approved finished drug and a compounded finished drug are not interchangeable regulatory categories. Compounded drugs can meet real patient needs, but the FDA does not approve them or verify their safety, effectiveness, or quality before they are marketed.

Start with something small that matters a lot.

“FDA-regulated” is not the same phrase as “FDA-approved.” Stella uses both kinds of regulatory language across its public materials, so the only safe way to classify a medication is by the exact finished product the clinician prescribes.

Phrase	What it means
FDA-approved drug	The FDA approved that specific finished drug under an application after reviewing evidence, manufacturing controls, and labeling.
FDA-regulated	The FDA has oversight of the category, facility, process, or market. The phrase alone does not prove that the finished drug is approved.
Commercially available	A product is sold through ordinary distribution. Commercial availability alone does not prove approval.
Compounded	A pharmacy or outsourcing facility prepares a patient-specific or batch product under compounding law. The finished compounded drug is not FDA-approved.
“Bioidentical”	A description of molecular structure, not an FDA approval category. Both approved and compounded products may be marketed with this word.

The label alone is not enough. Use the FDA database test.

A manufacturer name, package insert, or National Drug Code does not prove FDA approval. The FDA says the NDC Directory includes approved, unapproved, repackaged, relabeled, and compounded products, and that an NDC number does not denote approval.

The correct check:

1. Get the exact finished product name, strength, dosage form, manufacturer or labeler, and NDC.
2. Search Drugs@FDA or the Orange Book.
3. If the product is prepared and labeled by a compounding pharmacy, treat the finished product as compounded even when a similar ingredient appears in an approved drug.
4. Ask why the compounded route is needed for your situation and which pharmacy will prepare it.

None of this means compounding has no legitimate place. The FDA gives examples such as an allergy to an inactive ingredient, an unavailable dosage form, or a shortage. It means nobody should sell a compounded finished drug as FDA-approved, therapeutically equivalent, safer, more natural, or proven to match an approved product without evidence that applies to that exact finished product.

Winona is the clearest mixed-formulary example on this page: it publishes an estradiol patch and oral products alongside compounded creams and DHEA. Evaluate the exact product, not the provider logo.

Sources: FDA compounding Q&A, FDA National Drug Code Directory, and The Menopause Society’s hormone-therapy position statement.

No CTA belongs in this section. Choosing a compounded route should be a clinical decision, not a click.

What will the published fees look like over a year?

Answer: There is no honest single “year-one cost” across these models. Four self-pay visits total $470 at Stella, $600 at MyMenopauseRx or Evernow, $696 at Elektra, $700 at Midi, and $847 at Gennev. Bundled plans include medication, while visit-only totals do not, so they must stay in separate columns.

The table below is reproducible arithmetic, not a treatment recommendation or a promise about visit frequency.

Provider or model	Reproducible scenario	Published-fee total	Medication included?	What can still change
Stella	1 initial + 3 follow-ups	$470	No	Insurance, pharmacy cost, actual follow-up cadence
MyMenopauseRx	4 visits × $150	$600	No	Insurance, medication, labs, actual cadence
Evernow pay-per-visit	4 visits × $150	$600	No	Insurance, medication, optional membership
Elektra	$249 + 3 × $149	$696	No	Insurance, medication, coaching, cadence
Midi	$250 + 3 × $150	$700	No	Insurance, medication, labs, cadence
Gennev	$250 + 3 × $199	$847	No	Insurance, medication, cadence
Wisp	One three-month care episode	$99	No	Additional care after month 3, medication
Sesame	$59 × 12 months	$708	No	Medication, price at checkout, months retained
Alloy patch example	$49 consult + $100 × 12 monthly equivalents	$1,249	Yes, patch only	Exact billing schedule and any added medication
Hers oral example	$79 × 12 monthly equivalents	$948	Yes	Exact plan and billing schedule
Hers patch example	$134 × 12 monthly equivalents	$1,608	Yes	Exact plan and billing schedule
Winona patch example	$149 × 365 ÷ 28	about $1,943	Yes	Product, pauses, shipment timing
Winona patch + progesterone capsules	($149 + $39) × 365 ÷ 28	about $2,451	Yes	This is an arithmetic combination, not one packaged product

Two things jump out.

Insurance can flip the table. A high self-pay price can become the lowest out-of-pocket path when the clinician is in network and the deductible is satisfied. An advertised average copay is still not a quote.

Bundled plans are not automatically “overpriced.” Their totals include medication and fulfillment. The visit-only rows do not. A fair personal comparison adds your expected pharmacy price, labs, deductible, and actual follow-up schedule.

The Winona number is the easiest one to miss. A 30-day supply processes every 28 days, which produces roughly 13.04 billing cycles in a 365-day year. The $149 patch therefore annualizes to about $1,943, not $1,788.

Put your own copay and visit count into the decision instead of borrowing someone else’s average. Find My HRT Path will show which provider model fits before you spend time on intake.

Compare the model that fits my budget →

Is your own clinician and pharmacy the cheapest eleventh option?

Answer: The medication itself can be far cheaper than a bundled telehealth plan. Current discount-price pages show generic oral estradiol around $7 to $9 for 30 tablets and generic micronized progesterone around $12 to $16 for 30 capsules. The hard part is often access to a clinician who will evaluate and prescribe appropriately.

Nobody earns a commission when you choose this route.

A current cash-price snapshot checked in August 2026:

• Generic estradiol 1 mg, 30 tablets: from about $7.44 on a current cash-price guide
• Generic micronized progesterone 100 mg, 30 capsules: from about $11.77, with discount estimates commonly around $15 to $16

That puts one simple oral estradiol-plus-progesterone cash-price example around $19 to $25 per month before insurance, depending on pharmacy, coupon, stock, prescribed regimen, and location. This is not a recommended dose or a total cost of care. It is proof that the service model can cost more than the generic medicine.

The reason many women do not take this path is not the pill price. It is finding a clinician who will listen, assess contraindications, select the route and regimen, and remain available for follow-up.

If you already have that clinician, do not assume you need a menopause subscription. Ask the clinician to send the prescription to your chosen pharmacy, then compare your insurance price with a reputable cash discount.

If you have been dismissed before, bring the pre-pay and continuity questions from this page to the clinician you already have, or use Find My HRT Path to compare another starting point.

Price sources: Drugs.com estradiol price guide, Drugs.com generic progesterone pricing, and GoodRx menopause treatment pricing. Prices move and should be rechecked at the pharmacy.

What does the evidence show about these companies?

Answer: We found no published head-to-head trial showing that one provider on this page produces better outcomes than another. Stella’s widely repeated 75% figure traces to a preliminary, self-reported analysis of 76 app users who completed multiple check-ins. Service design, access, medication fit, and transparent terms are more verifiable than cross-company outcome claims.

On Stella, the 75% figure appears in the App Store and company materials. Vira Health describes the basis as a preliminary study of 76 Stella app users who completed multiple symptom check-ins. That is an app analysis, not a randomized comparison of the U.S. clinic against Midi, Elektra, or another provider.

The U.S. App Store listing showed 4.6 out of 5 from 21 ratings on August 14, 2026. Twenty-one ratings can describe those users’ experiences. It cannot establish comparative clinical superiority.

The same standard applies to affiliate partners. In February 2026, the National Advertising Division reported that Midi permanently discontinued a challenged “91% relief within two months” claim during an inquiry. NAD did not review the claim on its merits. We therefore do not repeat it.

Alloy currently publishes a “95% feel relief in two weeks or less” statement on its patch page. The visible product page does not show enough methodology for us to use that figure as comparative evidence, so it is excluded from the recommendation.

What can be verified consistently is the five-part framework behind this page: clinical legitimacy, care quality, medication fit, price transparency, and access. That is The HRT Index Verification Standard. There is no numeric score because a number would hide the exact tradeoffs the reader needs to see.

Sources: Stella App Store listing, BBB National Programs’ Midi decision summary, and Alloy’s patch page.

No CTA here. This section exists to make the rest of the page believable.

What should you verify before paying an online menopause provider?

Answer: Confirm the billing medical group, state availability on the appointment date, exact fee and cadence, medication inclusion, finished-drug FDA status, lab costs, cancellation deadline, prescription ownership, and between-visit support. A trustworthy provider can also tell you which costs and treatment choices remain unknown until a clinician evaluates you.

The four costs people confuse

1. Visit fee: the clinician’s charge, which may be billable to insurance.
2. Platform or membership fee: generally separate from a clinical claim; HSA/FSA or employer benefits may sometimes help.
3. Medication benefit: what the pharmacy plan or cash discount pays toward the drug.
4. Lab benefit: what the medical plan pays if testing is ordered.

One being covered tells you nothing reliable about the other three.

The insurance question

“Which medical group and tax ID will bill my plan, is that entity in network for my exact plan in my state, and what are my expected copay, deductible, and coinsurance for the first visit and follow-ups?”

The continuity question

“Can I keep the same clinician for follow-ups and refills, and what happens if that clinician leaves or is unavailable?”

The escalation question

“If I have side effects, unexpected bleeding, or a refill problem, what is the response time, and which situations do you direct to urgent or in-person care?”

The medication question

“What exact finished product would be prescribed, is that finished product FDA-approved or compounded, which pharmacy fills it, and what will I pay before insurance?”

The full pre-pay checklist

• Medical-group name and prescriber type
• State availability where you will physically be
• Age and program eligibility
• Live video versus asynchronous intake
• Initial fee, follow-up fee, membership fee, and billing cadence
• Whether medication is included
• Exact drug, strength, route, and finished-product status
• Local pharmacy versus shipped fulfillment
• Whether labs are included, optional, or separately billed
• Cancellation deadline in days
• Refund window after an order starts processing
• What happens to refills if you stop the service
• Whether any displayed cost is a quote, average, monthly equivalent, or checkout-only amount

How do you switch without losing your prescription?

Answer: Stella sends prescriptions to your chosen pharmacy, so an active prescription does not disappear simply because you stop booking Stella visits. Request your records first, count remaining medication and refills, confirm the new clinic before leaving the old one, and do not stop or change hormone therapy without your prescriber’s guidance.

Leaving Stella is structurally simpler than leaving a medication subscription because there is no Stella membership renewal to cancel. That does not make medication continuity automatic.

Use this sequence:

1. Request your records. Get visit notes, medication list, allergies, relevant test results, and the exact drug, dose, route, schedule, and pharmacy.

2. Count medication and refills. Write down how much is left, the next refill date, and when the prescription expires. That is the real switching deadline.

3. Confirm the new clinic before you stop the old relationship. Verify state access, age, transfer-of-care rules, and whether the new clinician will consider continuing the current prescription or require a fresh evaluation.

4. Do not cancel a bundled service before the replacement plan is confirmed. Overlap deliberately when safe and permitted. A gap caused by subscription timing is still a gap.

5. Do not change treatment based on a comparison page. Route, dose, progesterone need, contraindications, and interactions are clinical decisions. We compare provider models. We do not choose a regimen for your body.

When is online menopause care not the right starting point?

Answer: Online care should not delay evaluation of postmenopausal bleeding, unexplained abnormal bleeding, a new breast lump, severe or sudden symptoms, or a history that needs coordinated specialist input. Telehealth can be part of care, but a comparison page or asynchronous intake cannot replace examination, imaging, urgent assessment, or cancer workup.

Go to an in-person or urgent-care pathway first when appropriate for:

• Any bleeding after menopause or unexplained abnormal genital bleeding. ACOG says postmenopausal bleeding warrants prompt evaluation.
• A new breast lump or unexplained breast change.
• Chest pain, sudden shortness of breath, one-sided weakness, severe new headache, or other emergency symptoms.
• A personal history of breast or endometrial cancer, blood clots, stroke, or heart attack when treatment decisions need coordination with an established clinician or specialist.
• Symptoms that may have another cause, including new palpitations, marked mood change, or severe fatigue that has not been assessed.
• A screening or examination gap that the prospective clinician says must be addressed before prescribing.

A history of cancer, clotting, or cardiovascular disease does not reduce to one universal internet rule. The Menopause Society notes that some treatments may still be considered in selected situations after individualized evaluation. That is exactly why a checkout funnel is not the first decision for these readers.

Find My HRT Path is designed to flag when online care is not the right starting point and route the reader away from a provider link.

Sources: ACOG guidance on postmenopausal bleeding and The Menopause Society’s hormone-therapy position statement.

Who did we leave out, and why?

Answer: We left compounded-primary programs out of the headline recommendations for a reader coming from Stella’s non-compounded model, and we left broad primary-care memberships out when they did not publish a menopause-specific national price and access path. Being absent from the winner table is not a claim that a service is illegitimate.

• Inner Balance / Oestra: compounded-primary. It may fit a reader intentionally seeking that route, but it does not belong as the default replacement for a reader who chose Stella’s non-compounded model.
• One Medical: potentially useful for existing members in supported markets, but it is not presented as a single nationwide menopause-telehealth product with one public menopause price.
• Employer-only menopause platforms: valuable when already included as a benefit, but not directly purchasable substitutes for every reader.
• Unverified comparison-hub recommendations: omitted when we could not trace price, state access, medication status, and cancellation terms to a current provider-controlled source.

The rule is simple: a provider does not enter the decision table because another roundup named it. It enters when the facts needed to choose it can be checked.

What did The HRT Index actually verify?

Answer: On August 14, 2026, we rechecked the live provider pages for Stella and all ten alternatives, including public price, insurance wording, state or age limits, medication fulfillment, recurring billing, cancellation terms, and testosterone or compounding status. We separated what the provider states from what the public evidence can independently establish.

Verified firsthand on current public pages

• Stella’s $200 initial and $90 follow-up fees
• Stella’s average $45 copay language and no-membership model
• Stella’s 35-to-70 age band
• Stella U.S.’s testosterone waitlist
• The conflict between Stella’s insurance marketing and its current Terms
• The Stella app’s partner-distribution language and 21-rating count
• Midi’s $250/$150 self-pay fees, PPO language, and Medicaid/Medicare limits
• Elektra’s state-specific Medicare and Medicaid payer list
• MyMenopauseRx’s corrected $150 self-pay fee, 39-state-plus-D.C. list, and conflicting testosterone documentation
• Gennev’s corrected $250 initial / $199 follow-up self-pay fees
• Evernow’s $150 pay-per-visit path and separate membership model
• Sesame’s current $59/month menopause page
• Wisp’s $99 three-month care episode
• Alloy’s $49 consult and current $100 patch page
• Hers’ $79 oral and $134 patch monthly equivalents on 12-month plans
• Winona’s age range, state list, product prices, and 28-day billing
• Midi’s 25-jurisdiction testosterone pathway
• Elektra’s New York testosterone statement
• FDA and DEA regulatory distinctions used in this article

What remains individual or checkout-dependent

• Whether Stella, Midi, Elektra, MyMenopauseRx, Gennev, or Evernow is in network for your exact plan
• Your deductible, copay, coinsurance, lab benefit, and pharmacy price
• The exact prescribed regimen and whether multiple medications are needed
• Checkout discounts, plan length, taxes, or shipping changes
• Whether a clinician determines that a medication is appropriate
• Appointment availability on the date you need care

How we work

The HRT Index Verification Standard means we read every published price, separate FDA-approved from compounded products, verify state availability and insurance wording, and recheck on a fixed schedule — top providers monthly and the full roster quarterly.

The five pillars are always evaluated in this order: clinical legitimacy, care quality, medication fit, price transparency, access.

We do not publish invented scores. A score would hide the exact gate this page is built to expose.

Provider-published service experiences

We do not use testimonials as evidence that treatment works.

• Stella publishes the service comment: “Your online clinic and Stella care co-ordinators are A+ at helping women access HRT.” Stella uses patient material across markets, so this is not treated as a U.S.-clinic outcome.
• Midi publishes a comment attributed to Victoria W.: “Midi was so easy: I got a same day appointment and they took my insurance.”

These comments describe two individual service experiences. They do not establish typical results, safety, or comparative clinical effectiveness.

This page is editorial research. It is not medically reviewed by a clinician. See our medical review policy. Nothing here is medical advice.

Related Stella and menopause provider guides

Keep comparing the exact gate, care model, cost, and prescription path before you switch:

• Read the full Stella menopause review
• Check Stella menopause cost and insurance
• Compare Hers and Stella
• Compare Evernow and Stella
• Compare Gennev and Stella
• Compare Midi and Stella
• Review the best online HRT providers
• Find your best-fit HRT path

What else do women ask about Stella menopause alternatives?

Answer: The remaining questions are mostly about Stella’s state access, insurance contradiction, relative price, testosterone, medication delivery, app access, switching, compounded drugs, and routine lab testing. The answers below stay short, preserve the conditions that change the result, and point back to the detailed evidence above when the nuance matters.

Does Stella take insurance?

Stella’s clinical pages advertise in-network care and an average $45 copay. Its current U.S. Terms still say Vira Health does not accept commercial insurance. Ask which medical group and tax ID will bill your exact plan, then get the expected out-of-pocket cost in writing.

What states is Stella available in?

Stella does not publish one clean list that resolves clinician licensing, service availability, insurer contracts, and a reader’s exact plan. Use its live checker with the state where you will physically be for the visit.

Is Stella cheaper than Midi?

On published self-pay prices, yes. Stella charges $200 initially and $90 for follow-ups; Midi charges $250 and $150. Midi can be cheaper when it is in network and Stella is not, but only your plan can confirm that.

Is MyMenopauseRx still $99?

No. Its current public page lists $150 per virtual visit. It also lists seven insurance families and 39 states plus Washington, D.C.

Does Stella prescribe testosterone?

Not currently in the United States. Stella U.S. offers a waitlist. Midi publishes the widest clearly documented pathway in this comparison across 25 jurisdictions. MyMenopauseRx publishes select-state testosterone visits, but its live pages conflict on the exact state set; Elektra says some clinicians prescribe it for New York residents. Testosterone is Schedule III and requires a prescription, video follow-up, and state-specific compliance.

Does Stella send medication to your home?

Stella sends the prescription to a pharmacy you choose. Alloy, Hers, and Winona ship medication; Evernow offers both local-pharmacy and delivery paths depending on the prescription.

Can I use Stella with Medicare or Medicaid?

Stella’s current Terms say Vira Health is not enrolled with Medicare or Medicaid. Elektra lists both programs in certain states and plans; it is not a national blanket acceptance.

Is the Stella app free?

The app is included for 12 months after a U.S. Stella initial visit. Its U.S. App Store listing also says it is distributed through partners and displays in-app purchase prices. Check your employer or insurer benefit first.

Why is Stella cheaper in the U.K.?

It is a different regional service. The U.K. clinic lists £85 for an initial appointment and can prescribe testosterone; the U.S. clinic lists $200 and currently does not offer testosterone.

Do I need to cancel anything to leave Stella?

There is no Stella membership renewal to cancel. You should still request records, track active refills, and arrange replacement care before the prescription expires or medication runs out.

Are compounded hormones FDA-approved?

No. The FDA does not approve compounded drugs and does not verify their safety, effectiveness, or quality before marketing. A similar ingredient in an approved product does not make the compounded finished drug approved or equivalent.

Does an NDC prove FDA approval?

No. The FDA says the NDC Directory includes approved and unapproved products and that assignment of an NDC number does not denote approval. Verify the exact product in Drugs@FDA or the Orange Book.

Do I need hormone lab work before menopause treatment?

Routine hormone testing is often unnecessary for a typical menopause diagnosis based on age, symptoms, menstrual history, and medical history. The Menopause Society notes that no laboratory test or biomarker definitively determines the perimenopause stage. Testing may still be appropriate for early or premature menopause, diagnostic uncertainty, other suspected conditions, medication monitoring, or a clinician-specific reason.

Which Stella alternative is cheapest?

The lowest public consult fee is Alloy at $49, but medication is separate. Wisp is $99 for a three-month care episode. MyMenopauseRx and Evernow are $150 per visit. Sesame lists $59/month. The cheapest complete path depends on medication, insurance, visit frequency, and how long you keep a subscription.

Which Stella alternative should you check next?

Answer: Start with the gate that actually stopped you, not the provider with the loudest marketing or lowest isolated number. Check that provider’s current state access, exact insurance status, full first-year cost, medication model, and any controlled-substance or compounding limits before intake. When two gates overlap, use the matching tool instead of guessing.

If two rows apply at once, a general comparison cannot safely choose for you.

Still not sure which HRT program is right for you? Take our free matching quiz — it takes about 90 seconds.

Find My HRT Path →

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The HRT Index is an independent decision resource for online menopause and HRT care. Educational only — not medical advice. Last verified August 2026.