How Much Does HRT Cost? 7 Providers Compared (2026)

How much does HRT cost per month, really?

Ask seven providers what HRT costs and you'll get seven different answers, because the number on the homepage rarely means the same thing twice. Sometimes it's the medication price. Sometimes it's a one-time consult fee with the medication cost tucked further down the page. Sometimes, as with Midi Health's $250 figure, it's not the medication at all — it's the visit that gets you the prescription.

The honest range, once you add up consult fees, labs, and the medication itself, runs from roughly $39/mo at the cheap end to well over $150/mo depending on formulation and provider. Winona sits at the floor because it charges nothing beyond the medication. Everyone else layers something on top — a consult, a membership, or a lab requirement — and that layer is where most of the confusion, and most of the real cost difference, actually lives.

What each major provider actually charges

Below is what each of the seven charges once the full picture — consult, medication, and any recurring fee — is accounted for.

Winona — best for the lowest entry price

Winona charges nothing for the consultation or ongoing messaging; the only line item is the product you choose, priced à la carte. Progesterone capsules start at $39/mo, estrogen tablets at $54/mo, and the combined estrogen + progesterone cream at $89/mo. The estrogen patch is the outlier at $149/mo — notably higher than Winona's own pills and cream.

What Winona actually dispenses depends on the product, which is worth knowing before you compare it against anything else. Its estrogen patch, estrogen tablets, and progesterone capsules are FDA-approved finished drugs — the patch comes in the same five strengths as the commercially manufactured estradiol transdermal system. The creams and localized treatments are the genuinely compounded items, made at the two pharmacies Winona owns. Prescribing is symptom-based rather than lab-based, which is exactly why it can skip the consult fee: there's less clinical infrastructure behind each visit. That's a fair trade for straightforward perimenopause symptoms, less so for a complicated history. One more thing worth flagging on cost specifically: Winona doesn't publish any discount for combining products, so a real protocol needing more than one item (the patch plus a separate progesterone capsule, for instance) is additive — two full prices, not one.

• Pros: zero consult fee; lowest single-product prices among all seven; no lab requirement; all 50 states
• Cons: patch pricing is high relative to Winona's own pills and creams, and double what Alloy charges for the same category of patch; a full multi-product protocol costs more than the headline price suggests; no insurance billing at all, so nothing here touches a pharmacy benefit
• Best for: women with classic perimenopause symptoms who want the cheapest legitimate starting point

Alloy — best for specialist-certified care

Alloy's model is a one-time $49.95 consult followed by $74.99/mo for the estradiol patch, with progesterone bundled in at no extra charge on the standard protocol. That bundling matters: some competitors bill estrogen and progesterone as two separate line items, which quietly adds $20–$30/mo elsewhere.

Every physician on the platform is certified by The Menopause Society, a credential Winona's prescribers don't carry. Labs are required for some protocols, adding roughly $100–$200 a year — the closest thing Alloy has to a hidden fee, and it's disclosed rather than buried. See the full Alloy review and the Alloy cost breakdown for plan-by-plan detail.

• Pros: Menopause Society–certified physicians; progesterone bundled free; transparent one-time consult
• Cons: labs add annual cost on some protocols; cash-pay only, no insurance billing
• Best for: women who want specialist-level prescribing without insurance paperwork

Midi Health — best for PPO insurance

Midi Health's self-pay pricing looks steep on paper — $250 for the initial visit, $150 for each follow-up — until you factor in insurance. Midi is in-network with most PPO plans, and patients using coverage typically land near a standard specialist copay rather than the full cash price. The Midi Health review and its cost page walk through both scenarios.

Labs, when your protocol calls for them, aren't bundled into the standard visit price — budget for that separately if your prescriber orders bloodwork. Sources also disagree on whether Midi currently accepts Medicare Advantage; confirm directly with Midi before assuming either way.

• Pros: bills most PPO insurance; board-certified menopause specialists; comprehensive lab-based care model
• Cons: self-pay price is the highest initial fee on this list; labs billed separately from the visit
• Best for: insured women with PPO coverage who want the visit itself billed like any other specialist appointment

Wisp — best for using your own pharmacy

Wisp keeps its own fee small and simple: $99 covers the consult, follow-ups, and three months of care-team access. The medication itself never touches Wisp's books — it's sent to whichever pharmacy you choose, where your existing insurance, a discount card, or straight cash pricing applies.

• Pros: low flat consult fee; prescription fills at your own pharmacy, where insurance can apply; no lab requirement disclosed upfront
• Cons: not a menopause-only platform; medication cost is a separate, variable line item you'll need to check with your pharmacy
• Best for: women whose insurance covers HRT medication at their local pharmacy but not the telehealth visit itself

Inner Balance — best for compounded cream without labs

Inner Balance's Oestra cream runs $199/mo for the first six months, then drops to $99.50/mo. There's no consult fee layered on top, and no lab work required to start. The Inner Balance review and its cost page cover the refund policy and what changes after month six.

Oestra is a compounded product — made at a 503A pharmacy from FDA-approved active ingredients, but the finished combination cream itself hasn't gone through FDA premarket review. That's a meaningfully different regulatory category from a manufactured, FDA-approved patch, and it's part of why the price and the process both look different.

• Pros: no consult fee; no labs to start; price drops significantly after month six
• Cons: first six months cost nearly double the ongoing rate; compounded product, not FDA-approved as a finished drug; cash-pay only
• Best for: women who want a cream formulation and are comfortable with compounded rather than manufactured HRT

PlushCare — best for HRT folded into primary care

PlushCare's cash-pay first visit is $129, but most in-network patients pay closer to $30. An optional $19.99/mo membership (or $149/yr) adds a SingleCare-powered discount card that can cut prescription costs by up to 80% — useful since PlushCare's own estimate puts the medication itself at $130–$240/mo before any discount or insurance applies. See the PlushCare cost breakdown for the visit-by-visit math.

PlushCare is not a menopause specialty clinic — it's a general telehealth practice that also prescribes HRT. That's a feature for women who'd rather have one provider for everything, and a limitation for anyone who wants a clinician who treats perimenopause exclusively.

• Pros: widely accepts major insurance; low copay for in-network patients; discount card can offset medication cost meaningfully
• Cons: not menopause-specialized; membership is a separate optional fee; medication price varies a lot without a discount
• Best for: women who want HRT managed by the same telehealth provider as the rest of their primary care

Evernow — best for menopause-only membership care

Evernow prices itself as a membership rather than a per-visit fee: $49/mo month-to-month, dropping to $35/mo if you commit to a year upfront. Medication is billed on top and typically adds another $20 to $100-plus a month depending on the protocol and whether insurance applies to the fill.

Video visits can be billed to insurance where accepted, and medication filled at your local pharmacy can use insurance too — only the membership fee itself is always out of pocket, though it's HSA/FSA eligible.

• Pros: menopause-only focus; membership discount for longer commitments; insurance can apply to visits and medication
• Cons: membership and medication are two separate charges that add up; total monthly cost is harder to predict upfront
• Best for: women who want a long-term menopause-only relationship and are comfortable with a membership structure

Does insurance cover HRT — and how much does that change the price?

Insurance changes the math most for Midi Health and PlushCare, both of which bill PPO plans directly. On Midi, that can take the visit from $250 self-pay down to a standard specialist copay. On PlushCare, in-network patients often land around $30 rather than the $129 cash rate.

Wisp and Evernow take a middle path: the telehealth visit or membership itself is usually cash-pay, but the medication, once it's sent to a pharmacy, can often be billed to your existing drug coverage — meaning your real out-of-pocket cost depends more on your pharmacy benefit than on the platform.

Winona, Alloy, and Inner Balance don't bill insurance at all. All three accept HSA or FSA funds, which is the closest thing to a discount available if your plan doesn't cover telehealth menopause care directly.

The hidden fees behind the "from $X/mo" price

The advertised monthly figure is rarely the whole bill. Four categories tend to hide underneath it.

• Consult fees: one-time charges like Alloy's $49.95 or Wisp's $99 that don't show up in a "$X/mo" headline but are due before you ever see medication pricing
• Labs: Alloy discloses $100–$200/yr for protocols that require them; Midi Health bills labs separately from the visit; other platforms fold lab costs into a higher base price instead of listing them separately
• Shipping and membership: Evernow and the optional PlushCare tier charge a recurring fee that exists independent of the medication itself
• Follow-up visit pricing: Midi Health's $150 follow-up and PlushCare's per-visit copay repeat every time you need a prescription adjustment, not just at signup
• Multi-product protocols: Winona's à la carte pricing means a protocol using two products (patch + progesterone, for instance) is additive, not a single line-item price

Does an HRT patch cost more than pills or cream?

Within a single provider, yes, usually. Winona's own lineup makes the comparison clean: its estrogen tablet starts at $54/mo, its body cream at $89/mo, and its patch at $149/mo — nearly triple the tablet price for the same brand.

That gap isn't universal, though. Alloy's patch runs $74.99/mo, cheaper than Winona's own patch and closer to what Winona charges for a cream — and both are FDA-approved estradiol patches, so the $74 difference isn't explained by one being a different kind of product. Formulation moves the price, but so does how each platform chooses to bill: what's bundled in, whether a consult is priced separately, and what margin sits on the medication itself. Comparing patch to patch across providers, not just format to format within one, is where the real money shows up.

What does HRT cost out of pocket with no insurance?

For the three cash-pay-only providers, the no-insurance price is simply the price: Winona from $39/mo, Alloy at $49.95 plus $74.99/mo, and Inner Balance at $199/mo tapering to $99.50/mo. There's no second number to reveal later.

For the insurance-accepting providers, the uninsured rate is the self-pay figure quoted above — Midi's $250 initial visit, PlushCare's $129 first appointment, or Wisp's $99 flat consult. Evernow's membership fee is charged the same way regardless of insurance status; only the medication line can shift.

What's the real annual cost of HRT?

Run the monthly numbers out to a year and the gaps widen. Winona's tablet works out to about $648/yr; its patch, at $149/mo, comes to about $1,788/yr. Alloy's patch, at $74.99/mo plus the one-time $49.95 consult, lands around $950 in year one and closer to $900/yr after that.

Inner Balance's cream totals about $1,791 in its first year (six months at $199, six at $99.50), then settles to roughly $1,194/yr ongoing. Evernow's membership alone runs $420–$588/yr before medication is added, which can push the all-in total anywhere from about $660 to well over $1,700/yr depending on protocol. Midi and PlushCare are harder to annualize cleanly since so much depends on your specific insurance plan, but self-pay visits alone put Midi around $700/yr and PlushCare's optional membership at about $240/yr on top of per-visit costs.

Is compounded HRT cheaper — and is that a good trade?

Sometimes, but not always — and the first thing to sort out is which products are actually compounded, because it's rarely a whole company. Inner Balance's Oestra cream is compounded, and so are Winona's creams and localized treatments: made with FDA-approved active ingredients at a licensed 503A pharmacy, but the finished mixture hasn't gone through FDA premarket review the way a manufactured drug has. Winona's patch, estrogen tablets, and progesterone capsules are the other case entirely — those are FDA-approved finished drugs it dispenses.

So the cheap-because-compounded shortcut doesn't survive contact with the actual prices. Alloy's FDA-approved patch is $74.99/mo and Winona's FDA-approved patch is $149/mo — same regulatory category, double the price. And where a real compounded-versus-approved comparison exists, Inner Balance's cream at $99.50–$199/mo against Alloy's patch, compounding still isn't the cheaper side. Compounding buys flexibility in dose and delivery format more reliably than it buys a discount, and it's worth asking which category a specific product falls into rather than assuming the answer applies to everything a provider sells.

How to lower your HRT cost without cutting corners

A few levers apply across most of these providers without changing the quality of care.

• Use FSA/HSA funds — all seven providers accept them, and it's the one savings tool that works regardless of insurance status
• Ask about a discount card if your prescription is filled at a retail pharmacy — PlushCare bundles a SingleCare-powered card, and GoodRx works independently at most pharmacies for a Wisp or PlushCare prescription
• Check PPO benefits before assuming cash pricing — Midi Health and PlushCare both bill insurance directly and the difference between self-pay and in-network can be significant
• Compare formulation, not just provider — switching from a patch to a tablet or cream within the same platform can cut the monthly bill substantially, as Winona's own pricing spread shows