Wisp vs Sesame HRT: $99 Once vs Monthly Care
Choose the care model before you pay
Sponsored affiliate link: we may earn a commission at no extra cost to you. Provider availability and price vary by state, so confirm the exact rate before payment.
Wisp vs Sesame HRT is a choice between a $99 three-month consult and ongoing monthly care. Wisp is the lower-cost start. Sesame is stronger for provider choice, video follow-up, messaging, and labs when ordered. Sesame advertises $59 monthly, Costco lists $49, and provider profiles can display different rates. Medication is separate with both.
That's the answer. Now the part that changes it.
Sesame publishes $59 per month on its women's-health page and menopause article, $49 per month for Costco members, and different monthly prices on individual provider profiles. That means the real comparison is not one clean "$99 versus $59" headline. Your Sesame price can depend on the channel and provider available in your state.
Before we go further, here's where our money comes from. Clearly labeled Wisp and Sesame CTAs on this page may earn The HRT Index a commission at no extra cost. Ordinary Wisp and Sesame research citations remain direct editorial links. You're about to see Wisp win on first-90-day price and Sesame win on ongoing care. That's not us trying to split the difference. That's what the verified terms support.
Which provider is best for you—and when should you skip both?
Wisp is best when you want the lower verified first-90-day fee and can handle testing outside the program. Sesame is best when provider choice, video follow-up, messaging, and included basic labs are worth a continuing monthly charge. Skip both when you need insurance-billed visits, testosterone through this program, or an in-person evaluation.
| Provider | Best for you if | Not for you if |
|---|---|---|
| Wisp | You want the lowest verified first-90-day care fee, prefer an intake-led model, and can arrange any needed screening or testing elsewhere. | You want to choose your clinician, want scheduled ongoing video care, or want labs coordinated inside the program. |
| Sesame | You want to choose a provider, start by video, message between visits, and have a basic lab panel included when ordered. | You want one finite consult, you are a Medicare, Medicaid, or TRICARE beneficiary under Sesame's current terms, or recurring billing makes you nervous. |
| Neither | — | You need the visit billed to insurance, want testosterone through these menopause programs, need a physical examination, or have symptoms that require in-person evaluation. |
Wisp vs Sesame HRT: how do they compare at a glance?
Wisp publishes one $99 fee covering three months, while Sesame advertises $59 monthly, offers Costco members $49 monthly, and can show a different provider-specific rate. Wisp wins on the fixed first-90-day price; Sesame buys a broader ongoing care structure. Medication is separate with both.
| Decision point | Wisp | Sesame |
|---|---|---|
| Published care fee | $99 for consult, follow-ups, and 3 months of Care Team access | $59/month advertised; $49/month for Costco members; provider-specific rates can be higher |
| First 90 days | $99 | $177 at $59/month; $147 at the Costco rate; confirm the exact provider price before payment |
| Medication | Sent to your local pharmacy if prescribed; you pay the pharmacy | Sent to your preferred pharmacy if prescribed; you pay the pharmacy |
| Lab work | Wisp does not order the screening or testing described in its menopause pathway | Five basic panels included when ordered, with direct-pay exceptions in NY, NJ, RI, and ND |
| Choose your clinician | Not presented as a choose-your-provider marketplace | Yes |
| Visit model | Intake first; secure chat, phone, or video as needed | Initial video visit, video visits as needed, and unlimited messaging |
| Published systemic options | Estradiol patch, gel, and oral options; micronized progesterone, Provera, and other oral options | Estradiol, progesterone, combined products including Bijuva, vaginal DHEA, and named nonhormonal options |
| Federal program beneficiaries | Wisp's terms do not publish Sesame's federal-beneficiary certification; confirm eligibility before payment | Sesame's terms exclude Medicare, Medicaid, TRICARE, and other federal health care program beneficiaries |
| Renewal | The $99 page does not present an automatic menopause subscription; what happens after 3 months is not published | Recurs monthly until canceled |
| Affiliate relationship | Sponsored | Sponsored |
How to read this table: provider-stated means the company publishes it. Calculated means we did the arithmetic from a published rate. Confirm at checkout means the amount depends on your state, selected provider, or current offer and we will not guess it for you.
See Wisp's current $99 menopause consult → (Sponsored affiliate link; we may earn a commission at no extra cost.)
Check Sesame's current provider price and state availability → (Sponsored)
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.
The right online HRT provider isn't 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 can't 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 isn't the right starting point — before your first consult.
Wisp vs Sesame HRT: what's actually different?
Wisp sells a defined three-month episode of care. Sesame sells an ongoing relationship. Wisp publishes one $99 clinical fee. Sesame advertises $59 monthly, offers Costco members $49 monthly, and can show a different rate on the profile of the provider available to you. Neither program includes medication.
That difference is the whole decision.
A woman who wants one consult, a prescription decision, and three months of access is buying something different from a woman who wants to choose a provider, meet by video, message between visits, coordinate basic labs, and keep adjusting treatment month after month.
The one thing they share
Neither company includes your medication in the care fee. Wisp says, "If prescribed, you will pay for medication at your local pharmacy." Sesame says medication costs are not included in the subscription and vary by insurance and pharmacy.
So the numbers on this page compare care fees, not the total price of treatment.
Who should rule out one or both before price matters?
Four gates can settle the decision before the cost table does: federal-program eligibility, testosterone, outside testing, and whether you want one combined estradiol-progesterone capsule. Read these first and you can avoid finding a dealbreaker after checkout.
Gate 1 — Medicare, Medicaid, or TRICARE
Sesame's current terms say it does not accept Medicare, Medicaid, or other third-party insurance. The same terms require users of its cash-pay services to certify that they are not beneficiaries of a federal health care program, including Medicare, Medicaid, and TRICARE.
That makes Sesame the one ruled out by this gate.
Wisp does not bill the $99 consult to insurance either, but its published terms do not contain Sesame's federal-beneficiary certification. Confirm Wisp eligibility before payment and verify prescription coverage separately at the pharmacy.
On Medicare, Medicaid, or TRICARE? Don't force a provider that excludes you. Find an insurance-compatible starting point →
Gate 2 — Testosterone
Neither menopause program presents testosterone as an available option. Sesame states that providers in this program cannot prescribe controlled substances online. Wisp's published menopause formulary lists estrogen and progesterone options, not testosterone.
Testosterone is a Schedule III controlled substance in the United States. It requires a prescription and is subject to federal and state controlled-substance rules. FDA-approved testosterone products are approved for specific uses in men; there is no FDA-approved testosterone product for women, so prescribing it to women is off-label.
If testosterone is the treatment you want to discuss, use a clinician or telehealth practice that is licensed, registered, and set up to prescribe and monitor it lawfully in your state. Do not treat it like an over-the-counter add-on to menopause care.
Gate 3 — Testing before treatment
Wisp says its menopause diagnosis is based primarily on symptoms and period history and that routine hormone-level testing is not always required. But when screening or testing is needed, Wisp says it does not order or perform those tests; they must be arranged through an in-person clinician before treatment can begin.
Sesame includes a basic five-panel lab set when its provider orders it. That does not mean every patient needs labs, and it does not mean every hormone or specialty test is included.
This is the honest split: Wisp costs less because testing sits outside the program. Sesame charges monthly and puts a defined basic lab pathway inside it.
Gate 4 — One combined estradiol-progesterone capsule
Sesame lists Bijuva by name. Bijuva is an FDA-approved oral capsule containing estradiol and progesterone, and FDA has also approved a generic equivalent.
Wisp's own HRT guide says Wisp does not offer Bijuva or generic estradiol plus micronized progesterone in one capsule and directs readers interested in that option to an in-person provider.
So if your priority is one estradiol-progesterone capsule instead of separate prescriptions, Sesame names that option and Wisp explicitly does not offer it. The final prescription is still the clinician's decision.
How much do Wisp and Sesame cost in the first 90 days?
Wisp's published fee is $99 for the consult, follow-ups, and three months of Care Team access. Sesame's public rate is $59 monthly, or $177 over 90 days; Costco members are offered $49 monthly, or $147. Individual Sesame provider profiles can show higher rates, so your exact total belongs on the checkout screen.
The clean comparison
| Care path | Month 1 | Month 2 | Month 3 | First 90 days |
|---|---|---|---|---|
| Wisp | $99 | Included | Included | $99 |
| Sesame advertised rate | $59 | $59 | $59 | $177 |
| Sesame Costco rate | $49 | $49 | $49 | $147 |
Calculated by The HRT Index from rates published by Wisp, Sesame, and Sesame's Costco page on August 12, 2026. Care fees only. Medication is separate with both.
At the two clearly advertised Sesame rates, Wisp is cheaper by:
- $78 versus Sesame's $59 monthly rate.
- $48 versus Sesame's $49 Costco rate.
The Sesame provider-price audit nobody else assembled
Sesame lets you choose a clinician, and the provider profile can carry its own menopause-subscription price. We checked six live provider profiles on August 12, 2026 instead of pretending one rate applies to everyone.
| Sampled Sesame provider | Published menopause rate | 90-day care fee |
|---|---|---|
| Catherine Northup, APRN | $59/month | $177 |
| Shannon Brasil, NP | $64/month | $192 |
| Fabiola Anglade-Pascal, APRN | $69/month | $207 |
| Chinedu Okeke, MD | $74/month | $222 |
| Tallin Martirossian Patterson, PA | $79/month | $237 |
| Ammar Mahmood, MD | $89/month | $267 |
This is a purposeful sample, not a random survey or a platform-wide ceiling. It proves the point that matters: Sesame's public $59 rate is real, but the provider you choose or the provider available in your state may carry a different monthly price.
Which Sesame prices are current enough to use?
A past company announcement and a customer complaint are not strong enough to establish today's standard price. Current Sesame pages give the stronger evidence:
- Sesame's women's-health page advertises $59/month.
- Sesame's menopause article says the subscription is $59/month.
- Sesame's Costco page lists $49/month for the women's-health subscription.
- Current provider profiles show multiple provider-specific rates.
A complaint can describe one customer's experience. It cannot set the current price for every new customer. We removed that weak tiebreaker and replaced it with current Sesame pages.
Do not annualize Wisp from an unpublished renewal model
Sesame's annual care fee is straightforward only after you know your monthly rate. At $59 monthly, 12 months is $708. At the Costco rate, it is $588. At a higher provider rate, it is higher.
Wisp is different. Its page sells three months of access for $99 but does not publish what happens after that window. We will not multiply $99 by four and call it an annual price. Ask this before paying:
"What happens to refills, messaging, and clinical access after my three months end, and what will the next fee be?"
See the Sesame provider and price available in your state → (Sponsored)
What does each fee actually buy?
Wisp's $99 covers a menopause consult, follow-ups, and three months of Care Team access. Sesame's monthly fee covers provider choice, an initial video visit, video visits as needed, unlimited messaging, refill and treatment-adjustment support, and basic labs when ordered. Neither fee includes medication.
| What you receive | Wisp | Sesame |
|---|---|---|
| Initial clinical review | Yes | Yes, by video |
| Provider selection | Assigned through Wisp's care model | You choose from available named providers |
| Video access | Phone, secure chat, or video when needed | Initial video visit; more video visits as needed |
| Messaging | Care Team access for 3 months | Unlimited while subscribed |
| Refills and adjustments | During the published 3-month access window | Ongoing while subscribed and clinically appropriate |
| Basic labs | Not ordered by Wisp in this pathway | Five panels included if ordered, subject to state exceptions |
| Prescription transmission | Sent same day to local pharmacy if prescribed | Sent to preferred pharmacy if prescribed |
| Medication | Not included | Not included |
| After month 3 | Not published | Continues monthly until canceled |
Choosing your own clinician is Sesame's real advantage
Sesame's menopause page shows named clinicians and lets you choose among providers available in your state. If you've been dismissed before, told you were too young, or rushed through a visit, reading a clinician's profile before booking can be worth paying for.
That does not make every Sesame provider a menopause specialist, and it does not guarantee a particular prescription. Read the profile, licensure states, credentials, service price, and recent patient feedback before choosing. For the provider-level deep dive, see our Sesame HRT review.
Wisp's three-month cliff is still a genuine unknown
Wisp clearly publishes what $99 buys now. It does not clearly publish what continuing clinical access costs after month three.
That is not a reason to reject Wisp. It is a reason to ask one question before paying. If you only want a defined start, the finite window may be exactly the point. If you expect several rounds of dose or route changes, Sesame's continuing structure may be the better match. See our Wisp menopause review for the provider-specific details.
If choosing your own provider and having an open messaging channel is what you were missing, that's what Sesame's monthly fee buys. Check the current provider list and rate → (Sponsored)
What will the medication cost?
Neither provider includes medication, and no national cash-price table can tell you what your prescription will cost before the exact product, strength, quantity, pharmacy, and insurance claim are known. Compare the clinical fees first, then price the actual prescription at your pharmacy before you commit to long-term care.
Exact coupon prices and annual medication math are intentionally left out because those figures can change by ZIP code, pharmacy, dose, quantity, coupon terms, and date. A number that is accurate for one search is not a quote for the next reader.
Use this order instead:
- Ask which exact product, route, strength, and quantity the clinician is considering.
- Ask whether it is an FDA-approved product, an approved generic, or a compounded preparation.
- Check your insurance formulary and prior-authorization rules.
- Ask your chosen pharmacy for the insured price and cash price.
- Compare any discount card only after you know the exact prescription.
Wisp provides a Wisp/GoodRx discount card for local-pharmacy cash purchases. Sesame says prescribed patients receive a prescription savings card. A discount card is not insurance, cannot guarantee stock, and may not beat your plan's price.
On care fees alone, Wisp is the lower-cost start. The medication sits on both sides of the ledger, so it does not erase the $48 or $78 first-90-day difference unless the two clinicians choose materially different prescriptions.
Already know you want a straightforward consult and can handle pharmacy pricing yourself? Check Wisp's current $99 menopause eligibility → (Sponsored affiliate link; we may earn a commission at no extra cost.)
Does Wisp or Sesame include lab testing?
Sesame includes complete blood count, hemoglobin A1c, thyroid function, a lipid panel, and a comprehensive metabolic panel when its provider orders them. Wisp does not order the screening or testing described in its menopause pathway. Sesame has special lab routing in nine states, and patients pay the lab directly in four of them.
Sesame's state-by-state lab exceptions
| Where you live | How the lab order works |
|---|---|
| Most states | Quest Diagnostics; included when ordered |
| Arizona, Oklahoma, South Dakota, Wisconsin | LabCorp; included when ordered |
| Hawaii | Clinical Labs of Hawaii; included when ordered |
| New York, New Jersey, Rhode Island | Quest Diagnostics, but you pay Quest directly |
| North Dakota | Use any lab and pay the lab directly |
These routing and payment exceptions affect nine states: Arizona, Oklahoma, South Dakota, Wisconsin, Hawaii, New York, New Jersey, Rhode Island, and North Dakota.
You can upload existing lab results for a Sesame provider to review. The provider decides whether they are recent and relevant enough to use.
What the included panel is—and is not
The five included panels look at blood cells, blood sugar, thyroid function, cholesterol and triglycerides, kidney function, liver function, and electrolytes. They are not a blanket promise of every hormone test or specialist test you may want.
Routine hormone-level testing is not required to diagnose menopause in many women with a typical age, symptom, and menstrual history. Testing can still matter when the diagnosis is uncertain, symptoms are atypical, pregnancy is possible, menopause occurs unusually early, or another condition needs to be ruled out.
Sesame's lab benefit is real. It is not unlimited testing. Wisp's lower fee is also real. It moves any required testing outside the program.
What happens if you want your money back or need to cancel?
Sesame publishes the clearer menopause-specific refund policy: cancel at least three hours before the initial visit for a full refund, then cancel before the next billing cycle to stop future charges. Wisp publishes a one-time $99 menopause fee, but its general terms are stricter on refunds and the page does not explain the post-three-month pathway.
| Policy point | Wisp | Sesame |
|---|---|---|
| Before clinical review | The menopause page does not publish a separate refund promise | Full refund if canceled at least 3 hours before the initial visit |
| If no treatment can be prescribed | Wisp's general pricing page says you are charged up to $25 instead of the full consult price | No refund based solely on a provider declining a requested prescription after the visit |
| After the visit/review | Wisp's general terms say sales are final except limited circumstances or Wisp's discretion | No refund of the first month after the initial visit |
| Recurring charge | The $99 menopause page does not present the consult as auto-renewing | Continues monthly until canceled |
| Cancel-by rule | Wisp's 48-hour rule applies only if you separately enroll in a subscription product | Menopause FAQ says cancel before next cycle; Sesame's general membership terms use a 48-hour-before-renewal deadline |
| Prior paid periods | Generally nonrefundable under Wisp's terms | Prior months are nonrefundable |
The Wisp refund language needs to be read accurately
Wisp's general Terms of Service say sales of products are final except when a product is out of stock, unavailable at local pharmacies, damaged or defective, or not received, with other refunds at Wisp's discretion.
Wisp also says that if a clinician cannot prescribe any treatment, the charge is up to $25 instead of the full consult fee.
Because the menopause product page does not publish a separate refund section, save the checkout terms shown to you before payment.
Sesame gives you two deadlines worth saving
- Before the first visit: cancel at least three hours before the scheduled start for a full refund.
- Before renewal: use a 72-hour reminder so you clear Sesame's 48-hour membership deadline with a buffer.
The damaging admission that matters
Wisp's payment is smaller and not presented as recurring, but its general refund terms are strict and its post-three-month pathway is not published.
Sesame's first-visit refund rule is clearer, but the subscription keeps billing until you cancel. A friendly cancellation button does not make a recurring charge finite.
Does a defined three-month purchase feel safer than another monthly charge? Read Wisp's current checkout and eligibility terms → (Sponsored affiliate link; we may earn a commission at no extra cost.)
What does Sesame's own “Sesame vs Wisp” page get right—and wrong?
Sesame's comparison page correctly highlights provider choice, video care, price comparison in its general marketplace, and in-person options. But it is not a menopause comparison, its buttons lead to general pay-per-visit care, and its “real doctors over video, not chat” line overstates the difference. Wisp also uses licensed medical providers.
| Sesame's claim | Verdict | What the current pages show |
|---|---|---|
| Choose your own doctor or specialist | Fair | Sesame lets menopause patients choose among available providers; Wisp does not present a provider marketplace. |
| Compare prices | Fair for the marketplace; incomplete as one menopause price | Sesame advertises $59, but provider profiles can display different monthly rates. |
| In-person and video options | Fair for Sesame's broader marketplace | The menopause subscription itself is video-based; Wisp is online. |
| No insurance needed | Fair | Both are cash-pay for the clinical service. |
| “Real doctors over video, not chat” | Overstated | Wisp says board-certified medical providers review menopause intakes and may follow up by secure chat, phone, or video. |
The honest distinction is synchronous versus intake-led care, not real clinicians versus fake ones.
Sesame starts with video and keeps video plus messaging open while you subscribe. Wisp begins with an intake and uses a clinician follow-up method based on the case. That is a meaningful difference without insulting the clinicians on either side.
Which HRT medications can Wisp and Sesame prescribe?
Both programs publish estrogen and progesterone options, but Sesame publishes the broader named menu. Wisp lists estradiol patches, gels, and oral options plus micronized progesterone, Provera, and other oral options. Sesame also lists combined products, vaginal DHEA, and several nonhormonal medications. The actual prescription is always clinician-dependent.
| Category | Wisp publishes | Sesame publishes |
|---|---|---|
| Estradiol | Patch, gel, and oral options | Estradiol associated with Estrace, Climara, and Divigel |
| Progesterone/progestogen | Micronized progesterone, Provera, and other oral options | Progesterone associated with Prometrium and Crinone |
| Combined systemic products | Wisp says it does not offer Bijuva or generic estradiol-progesterone in one capsule | Prempro, Bijuva, and Mimvey |
| Vaginal DHEA | Not listed on the core consult page | Intrarosa |
| Nonhormonal options | Not clearly listed on the core consult page | Gabapentin, clonidine, ospemifene, paroxetine, sertraline, trazodone, and others |
| Medication included in care fee | No | No |
A product appearing on a menu does not guarantee that your chosen clinician will prescribe it, that your state permits the same workflow, that the pharmacy has it, or that insurance will cover it.
Systemic and local therapy are not interchangeable
Systemic therapy—such as a patch, gel, spray, or pill—circulates throughout the body and is used for symptoms such as hot flashes and night sweats. Low-dose vaginal therapy targets genitourinary symptoms such as vaginal dryness and pain with sex.
Wisp separately sells vaginal estradiol cream. That separate product is not included in the $99 systemic menopause consult. Do not assume one purchase covers both pathways.
Wisp's “bioidentical only” inconsistency
Wisp's July 2026 HRT guide says Wisp only offers bioidentical hormones for menopause therapy. The same guide and Wisp's product page list Provera, whose active drug is medroxyprogesterone acetate, a synthetic progestin.
That is a real copy inconsistency on Wisp's site. It does not make Provera illegitimate; it is an FDA-approved prescription drug. It means you should ask for the exact product rather than relying on the word “bioidentical.”
Ask:
“What exact estrogen and progestogen are you prescribing, and is each an FDA-approved product, an approved generic, or a compounded preparation?”
Bioidentical does not mean compounded
“Bioidentical” and “compounded” describe different things.
FDA has approved estradiol and progesterone products containing hormones identical to hormones produced by the body. A compounded drug is prepared by a pharmacy for an individual prescription and is not FDA-approved. FDA does not verify a compounded drug's safety, effectiveness, or quality before it is marketed.
You do not need a compounding pharmacy merely because you want an estradiol or micronized-progesterone product described as bioidentical.
Where compounded medication enters this comparison
Sesame says a provider may prescribe compounded bioidentical hormone therapy when considered appropriate. Sesame also states that compounded BHRT is outside formal FDA approval and standardization and has not been shown safer or more effective than conventional hormone therapy.
The page must keep these categories separate:
- FDA-approved branded drug or approved generic: reviewed by FDA for the approved use, manufacturing quality, safety, and effectiveness.
- Compounded preparation: not FDA-approved; FDA does not verify safety, effectiveness, or quality before marketing.
- Provider menu: evidence that a provider may consider an option, not proof of what you will receive.
Nothing here says compounded hormones are equivalent to, safer than, or more natural than FDA-approved medication.
Which care model fits you—video or messaging?
Sesame is built around an initial video visit, more video visits as needed, and unlimited messaging. Wisp is intake-led, with a licensed provider following up by secure chat, phone, or video when needed. Sesame offers the clearer ongoing relationship; Wisp removes more scheduling friction and costs less for the first three months.
Video may fit you better if your questions branch, you want to see the clinician you're choosing, you have been dismissed before and want a live conversation, or your history is hard to reduce to a form.
An intake-led model may fit you better if you know what you want to discuss, prefer writing out your history, have little privacy for a daytime video call, or scheduling is the reason you have delayed care.
That is not a trivial preference. The “better” care model is the one you will actually complete and use—provided it is clinically appropriate for your situation.
Your state or clinical circumstances may still require a video visit through Wisp. Confirm that before payment if avoiding video is a deciding factor.
Can I use insurance, Medicare, HSA, or FSA?
Neither company bills health insurance for the clinical fee. Both can send a prescription to a local pharmacy, where insurance may apply. Wisp displays HSA/FSA acceptance for the menopause consult. Sesame says most services in the subscription may be reimbursable, while its general membership terms warn that subscription fees may not be covered.
The visit and medication are separate coverage questions.
| Coverage question | Wisp | Sesame |
|---|---|---|
| Clinical fee billed to insurance | No | No |
| Medicare/Medicaid/TRICARE | Not billed; no Sesame-style federal-beneficiary exclusion found in Wisp's terms | Excluded by Sesame's terms |
| Insurance at local pharmacy | Eligible insurance may apply | Sesame's menopause FAQ says prescribed medication may be covered depending on the plan |
| Prescription discount | Wisp/GoodRx card | Prescription savings card |
| HSA/FSA | Product page says accepted | FAQ says most services may be eligible with an itemized bill; general terms are more restrictive |
Sesame's HSA/FSA conflict is real
Sesame's menopause FAQ says most subscription services may be eligible for HSA or FSA reimbursement and offers an itemized bill. Sesame's general membership terms say subscription fees are not covered under most health plans or benefit plans and may not be reimbursable.
Do not count the reimbursement until your plan administrator confirms it. Request the itemized bill either way.
What to verify before relying on insurance
- Is the exact product on the formulary?
- Does the plan require prior authorization?
- Does a deductible apply?
- Does the pharmacy have the product in stock?
- Is the claim for brand or generic?
- Is the clinical fee eligible for your HSA or FSA under your plan?
- Will a Sesame lab-state exception create a direct charge?
If you need the visit itself billed to insurance, neither Wisp nor Sesame is the answer to that requirement. Use Find My HRT Path to route by insurance and state instead of paying for the wrong model.
Is Wisp or Sesame available in my state?
Wisp's menopause page states that the consult is available in all 50 states. Sesame has providers nationwide, but the menopause clinician, provider price, appointment availability, and lab route shown to you depend on your location. Check the provider and exact monthly rate displayed for your state before entering payment.
Wisp's current primary product page plainly says available in all 50 states. Provider availability and clinical eligibility still need to be confirmed during the live intake.
Sesame's platform says licensed providers are available in all 50 states, but that does not guarantee that every menopause clinician or price is available in every state. The individual profiles list the states where each clinician practices. This is also why the monthly price can change when you choose a different provider.
The location check needs to settle four things at once:
- Is a menopause provider available in your state?
- Which providers can you choose?
- What monthly price does each profile show?
- Which lab route and direct-payment rule applies?
Check Sesame's live provider availability and rate in your state → (Sponsored)
Check Wisp's current menopause eligibility → (Sponsored affiliate link; we may earn a commission at no extra cost.)
Is Wisp legit? Is Sesame legit?
Both companies publish care through licensed clinicians and real telehealth programs. Their current Better Business Bureau records differ: Sesame is BBB-accredited with an A+ rating, while Wisp is not accredited and holds a D− rating that BBB attributes to unanswered complaints. That is a customer-service signal, not a clinical-quality score.
| BBB record checked August 12, 2026 | Sesame, Inc. | Wisp, Inc. |
|---|---|---|
| Accreditation | Accredited since December 27, 2022 | Not accredited |
| Rating | A+ | D− |
| BBB's stated issue | — | Failure to respond to 14 complaints |
BBB ratings can move and are influenced by complaint response and accreditation. They do not establish that one platform produces better medical outcomes, uses safer medication, or has better clinicians.
The useful question is narrower: what does the record tell you about billing, refunds, and support response? Read the latest complaints and company responses in the category you care about, then compare them with the written terms you are accepting.
We did not combine mixed historical Trustpilot pools or use a customer complaint to infer current pricing. Different review pools, dates, and categories should not be mashed into a pseudo-score.
What is the biggest drawback of our affiliate pick?
Sesame's biggest drawback is price variability: the company advertises $59 monthly, Costco lists $49, and sampled provider profiles show $59 to $89. Wisp's fixed $99 fee is easier to understand; Sesame earns the higher continuing cost only when you will use the ongoing care.
Here's our honest problem with the company that pays us.
Sesame advertises $59 per month, but that is not one guaranteed rate for every provider and state. Costco lists $49, while sampled provider profiles display $59 to $89 monthly.
Wisp is cleaner on this point: it prints $99 directly on the product page that sells the consult.
If seeing one fixed care fee before you begin intake is your priority, Wisp is better. The clearly labeled Wisp CTA may earn The HRT Index a commission at no extra cost; the comparison itself is based on the verified price and policy evidence above.
Sesame's price variation is connected to something real: you choose among clinicians, and provider profiles can carry different monthly rates. The exact rate still needs to be visible before payment, and you should close the tab if the number is not worth the continuing care to you.
The permission you need is simple: starting an intake is not a commitment to pay. Read the provider, price, renewal terms, and lab route. Leave if the offer does not fit.
So which one fits you?
Choose Wisp when you want the lower first-90-day fee, can arrange any needed testing elsewhere, and prefer a defined three-month care window. Choose Sesame when provider choice, video follow-up, unlimited messaging, basic labs, or a named combined product are worth a recurring monthly fee. Neither is the right path for every woman.
| If this is you | Pick | Why | What you do not get |
|---|---|---|---|
| You want the lowest verified first-90-day care fee | Wisp | $99 for 3 months | Provider choice or included labs |
| You want to choose a clinician | Sesame | Named provider profiles and state licensure | A single universal monthly rate |
| You want basic labs included when ordered | Sesame | Five defined panels | Direct lab payment is still required in NY, NJ, RI, and ND |
| You want Bijuva or its generic equivalent discussed | Sesame | Bijuva is listed; Wisp says it does not offer the combined estradiol-progesterone capsule | A prescription guarantee |
| Recurring charges make you nervous | Wisp | The menopause page presents one $99 fee | A published post-three-month pathway |
| You dislike scheduled video | Wisp may fit better | Intake-led care with phone/chat/video as needed | A guarantee that video will never be required |
| You want a live ongoing relationship | Sesame | Video visits and unlimited messaging | The lowest first-90-day fee |
| You are a Costco member | Sesame | $49 monthly offer | Guarantee that every provider/state flow uses the same offer |
| You need the visit billed to insurance | Neither | Both are cash-pay for the clinical service | In-network billing |
| You are on Medicare, Medicaid, or TRICARE | Not Sesame under current terms | Federal-program certification excludes you | Use an insurance-compatible route |
| You want testosterone through this program | Neither | Not offered in the published menopause programs | A controlled-substance prescriber and monitoring pathway |
If neither model fits, compare other online HRT providers instead of forcing a bad match.
One real patient quote, labeled honestly
Sesame's menopause page publishes this as a quote from a “Real Sesame patient”:
“She asked me about my symptoms and provided me with HRT prescriptions.”
That is a provider-selected testimonial. It illustrates the reported visit experience, not typical results, safety, or effectiveness. We cannot independently verify it, and we have a paid relationship with Sesame.
We did not find an equally specific, attributable, menopause-specific Wisp patient quote in Wisp's public materials. We are not filling that gap with an unattributed review or a testimonial about a different Wisp service.
What should you check before paying?
The final decision belongs on the exact offer screen, not in a generic provider table. Confirm the provider, price, medication pathway, lab rules, refund deadline, and what happens after the included care window. These twelve questions work for Wisp, Sesame, or any online menopause program.
Print this or screenshot it.
- Does a menopause provider serve my state?
- Is my first appointment video, messaging, phone, or a combination?
- What is the exact one-time or monthly rate before I enter payment?
- Does the fee include medication? For both programs on this page: no.
- What exact product, route, strength, and quantity is likely to be prescribed?
- What will that exact prescription cost at my pharmacy with insurance and with cash?
- Is lab work included, and does my state create a direct-payment exception?
- Is the prescription an FDA-approved product, approved generic, or compounded preparation?
- Which specific progestogen is being considered if I have a uterus and use systemic estrogen?
- What follow-up is included, through what channel, and for how long?
- What happens after Wisp's month three, or what is Sesame's cancel-by date?
- What am I charged if the clinician decides not to prescribe?
Question 12 is the one people forget. Wisp's general page says up to $25 if no treatment can be prescribed. Sesame does not refund the first month merely because the provider declines a requested medication after the visit.
When is online care not the right starting point?
Start with an in-person or established clinician when your symptoms require a physical examination, you have unexplained bleeding after menopause, you might be pregnant, or your history creates a more complex hormone-therapy decision. Telehealth can still become part of the plan after the urgent or examination-dependent issue is evaluated.
Examples include:
- Bleeding after menopause.
- Unexplained pelvic pain or symptoms requiring an examination.
- Possible pregnancy.
- A history of hormone-sensitive cancer.
- A prior blood clot, stroke, or heart attack.
- Liver disease.
- A need for imaging, biopsy, procedure, or coordinated specialist care.
FDA consumer guidance lists unusual vaginal bleeding, certain cancers, blood clots, stroke or heart attack, liver disease, and possible pregnancy among conditions that require clinician review before menopausal hormone therapy.
Postmenopausal bleeding needs evaluation rather than routing through a comparison page or leaving it sitting in an intake form.
How did we verify this comparison?
Everything on this page was produced under The HRT Index Verification Standard. We read current provider pages and terms, separated FDA-approved products from compounded preparations, checked provider-level prices and state licensing, verified lab exceptions, and calculated comparable first-90-day care fees without inventing an annual Wisp price.
We evaluate providers on five pillars, always in this order: clinical legitimacy, care quality, medication fit, price transparency, access.
What we actually verified on August 12, 2026
- Wisp's $99 menopause product page, 3-month inclusion, medication exclusion, published formulary, provider model, and all-50-state claim.
- Wisp's general no-treatment charge of up to $25, local-pharmacy insurance pathway, and Wisp/GoodRx card.
- Wisp's testing limitation for its menopause pathway.
- Wisp's current Terms of Service, including its general refund and subscription language.
- Sesame's menopause service, provider choice, video and messaging model, medication exclusion, formulary, lab panel, nine state exceptions, HSA/FSA statement, and menopause-specific refund policy.
- Sesame's $59 advertised rate, $49 Costco rate, and six current provider-profile rates.
- Sesame's federal-program terms and 48-hour membership cancellation language.
- Sesame's own general Sesame-vs-Wisp comparison page.
- FDA status of Bijuva and its generic equivalent.
- FDA statements separating approved hormone products from compounded drugs.
- DEA classification of anabolic steroids, including testosterone, as Schedule III controlled substances.
- Current BBB records for Sesame and Wisp.
What we did not do
We did not sign up, enter payment, receive a prescription, or receive treatment from either company. We did not test pharmacy stock or an insurance claim. We did not pose as a patient.
The exact Sesame provider and price available to you, the exact Wisp path after month three, and the exact dispensed product still must be confirmed in the live intake or checkout.
Primary sources
- Wisp menopause consult
- Wisp: How it works
- Wisp HRT screening and testing
- Wisp HRT medication guide
- Wisp Terms of Service
- Sesame menopause treatment
- Sesame women's health pricing
- Sesame Costco pricing
- Sesame Terms of Service
- Sesame vs Wisp
- Sesame provider profile: Catherine Northup, APRN
- Sesame provider profile: Shannon Brasil, NP
- Sesame provider profile: Fabiola Anglade-Pascal, APRN
- Sesame provider profile: Chinedu Okeke, MD
- Sesame provider profile: Tallin Martirossian Patterson, PA
- Sesame provider profile: Ammar Mahmood, MD
- FDA: Menopause and compounded bioidentical hormones
- FDA: Compounding and the FDA
- FDA: Bijuva prescribing information
- FDA: Generic estradiol-progesterone capsule approval
- FDA: Testosterone information
- DEA: Drugs of Abuse resource guide
- The Menopause Society: Hormone therapy
- FDA: Menopause medicines and conditions requiring review
- BBB: Sesame, Inc. business profile
- BBB: Wisp business profile
Frequently asked questions about Wisp vs Sesame HRT
Wisp is cheaper for the first 90 days, while Sesame includes the stronger ongoing-care infrastructure. These answers close the remaining questions about subscriptions, labs, insurance, medications, FDA status, testosterone, refunds, state access, and switching.
Is Wisp or Sesame cheaper for HRT?
Wisp has the lower verified first-90-day care fee. Wisp is $99 for the consult, follow-ups, and three months of Care Team access. Sesame is $177 for 90 days at its advertised $59 monthly rate or $147 at its Costco rate. Medication is separate with both, and provider-specific Sesame rates can be higher.
Is Sesame a subscription?
Yes. Sesame's menopause program bills monthly and continues until you cancel. The monthly price can depend on the offer and provider. Cancel at least 48 hours before the renewal processing date to follow Sesame's general membership terms conservatively.
Is Wisp's $99 menopause consult a subscription?
The current menopause page presents one $99 fee covering three months; it does not present the consult as an automatically renewing subscription. Wisp does not publish what continuing access costs after month three. Read the checkout terms and ask what happens to refills and messaging after the included window.
Why is Sesame's menopause price hard to pin down?
Sesame advertises $59 monthly, offers Costco members $49 monthly, and lets individual providers display different subscription prices. The exact monthly rate therefore depends on the channel, state, and provider you choose. Confirm it before payment.
Does Wisp's $99 include medication?
No. It covers the consultation, follow-ups, and three months of Care Team access. If a clinician prescribes medication, Wisp sends it to your local pharmacy and you pay the pharmacy. Wisp offers a discount card for eligible cash purchases.
Does Sesame's monthly price include medication?
No. Sesame includes clinical care, messaging, video visits, and basic labs when ordered, but medication is separately payable at the pharmacy. Insurance may cover an eligible prescription depending on your plan.
Does Sesame include blood work?
Sesame includes five basic panels when its provider orders them: complete blood count, hemoglobin A1c, thyroid function, lipid panel, and comprehensive metabolic panel. Patients in New York, New Jersey, Rhode Island, and North Dakota pay the lab directly under Sesame's current state exceptions.
Does Wisp require blood tests before HRT?
Not routinely. Wisp says diagnosis is primarily based on symptoms and period history and that routine hormone testing is not always needed. But when testing or screening is required, Wisp does not order it through this menopause pathway; it must be arranged with an in-person clinician first.
How do I cancel Sesame?
Cancel at least three hours before the first visit for a full refund. After the initial visit, the first month is not refundable. Cancel before the next billing cycle to stop future charges; Sesame's general membership terms specify a 48-hour-before-renewal deadline, so use a 72-hour reminder.
Will Wisp refund the $99 if I am not prescribed medication?
Wisp's general pricing page says that if no treatment can be prescribed, you are charged up to $25 instead of the full consult price. Wisp's general terms otherwise say sales are final except limited circumstances or Wisp's discretion. Save the menopause checkout terms shown before payment.
Do Wisp or Sesame take insurance?
Neither bills insurance for the clinical fee. Both can send a prescription to a local pharmacy, where insurance may apply. Sesame's terms exclude federal health care program beneficiaries from its cash-pay services; Wisp does not publish the same exclusion.
Can I use HSA or FSA funds?
Wisp's menopause page says HSA and FSA are accepted. Sesame's menopause FAQ says most subscription services may be eligible for reimbursement with an itemized bill, while its general membership terms warn that subscription fees may not be covered. Confirm with your plan administrator.
Are Wisp and Sesame available in all 50 states?
Wisp states that its menopause consult is available in all 50 states. Sesame says licensed providers are available nationwide, but the menopause clinician, provider price, and appointment availability shown to you depend on your state. Check the live provider results before payment.
Can I get testosterone from Wisp or Sesame?
Not through the menopause programs described on their current pages. Sesame explicitly says its providers cannot prescribe controlled substances online, and Wisp's published menopause formulary does not include testosterone. Testosterone is Schedule III, prescription-only, and no FDA-approved testosterone product is approved for women.
Can I get Bijuva through either provider?
Sesame lists Bijuva by name. Wisp's current HRT guide says it does not offer Bijuva or the generic estradiol-progesterone combination capsule. Listing does not guarantee that a Sesame clinician will prescribe it.
Do Wisp or Sesame prescribe compounded hormones?
Sesame says a provider may prescribe compounded BHRT when considered appropriate. Sesame also states that compounded BHRT is outside formal FDA approval and standardization and has not been shown safer or more effective. Wisp's exact dispensed product should be confirmed at prescription and pharmacy level rather than assumed from platform-wide language.
Are Wisp and Sesame medications FDA-approved?
Do not make a platform-wide claim. Both publish options associated with FDA-approved products or approved generics, but the exact dispensed product matters. Sesame also permits compounded prescriptions in some cases. Ask whether each prescription is an FDA-approved brand, an approved generic, or a compounded preparation.
Will I talk to a real person?
Yes. Sesame begins with a video visit with a provider you choose. Wisp uses licensed medical providers who review the intake and may follow up by secure chat, phone, or video. The difference is the communication model, not whether a licensed clinician exists.
What happens if the provider will not prescribe what I ask for?
A requested drug is never guaranteed. Wisp says a patient who cannot be prescribed any treatment is charged up to $25 instead of the full consult. Sesame refunds only when you cancel before the applicable deadline, not because the clinician declines a requested prescription after the visit.
What happens after Wisp's three months?
Wisp does not publish the answer on its current menopause page. Ask what happens to refills, messages, clinical adjustments, and fees after the three-month access period. Do not assume the $99 repeats quarterly or that access continues free.
Which is better for perimenopause?
The care model matters more than the label. Wisp can fit a straightforward, lower-cost start. Sesame can fit changing symptoms, diagnostic uncertainty, provider-selection needs, or repeated adjustments where ongoing video care, messaging, and lab coordination justify the monthly fee.
Can I switch from one to the other?
Yes, but do not assume the new clinician will continue the same prescription without review. Bring your medication list, pharmacy record, recent labs, treatment response, and side effects. Cancel Sesame before its renewal deadline if you are leaving the subscription.
Still not sure which HRT program is right for you?
Take our free 60-second matching quiz. The HRT Index's Find My HRT Path tool matches your symptoms, medication-route preference, whether you have a uterus, risk history, insurance situation, and state — and flags when online care isn't the right starting point.
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Educational research only — not medical advice. The HRT Index does not prescribe medication and does not replace an evaluation from a licensed clinician. Prices, provider availability, medication lists, insurance policies, and terms can change; verify current terms before paying. Clearly labeled Wisp and Sesame CTAs on this page are sponsored affiliate links; ordinary research citations remain direct editorial links. See our affiliate disclosure.