How Much Does HRT Cost Per Month? Pills, Patches, Cream & 7 Providers (2026)

How much does HRT cost per month?

Ask seven providers what HRT costs and you get seven different answers. The number on a homepage rarely means the same thing twice. Sometimes it is the medication. Sometimes it is a one-time consult fee, with the medication price further down. At Midi Health, the $250 figure is not medication at all. It is the visit that gets you the prescription.

So here is the short answer for each kind of reader.

• Lowest price, no visit fee: Winona, from about $40 a month for one product.
• Cheapest FDA-approved patch: Alloy, about $100 a month plus a one-time consult.
• With PPO insurance: Midi Health, where the visit is often just a copay.
• Using your own pharmacy and drug coverage: Wisp, about $100 for three months of care.
• Menopause-only care as a membership: Evernow, from about $35 a month.

Look at the medication alone and the range is about $40 to $200 a month. The estradiol patch is the most prescribed form. It costs about $100 a month at Alloy and about $150 at Winona. Then comes whatever each platform adds: a consult, a membership or labs. That extra layer is where most of the confusion lives, and most of the real price gap.

• Medication only: about $40 to $200 a month across the seven, depending on the hormones and the form
• First visit fee: none at Winona and Inner Balance · About $50 at Alloy · About $100 at Wisp · About $130 at PlushCare · $250 at Midi Health
• Recurring fees on top: Evernow's membership · PlushCare's optional membership · PlushCare's and Midi Health's follow-up visits

Pills, patches, or cream: which form of HRT costs the most per month?

At a single provider, the patch usually costs the most and pills the least. Winona's lineup shows it clearly. Its patch costs nearly three times its estrogen tablet.

• Pills, estradiol tablets and progesterone capsules: about $40–$55 a month at Winona. At Wisp, PlushCare and Evernow, the pill is filled at your own pharmacy. There, your drug coverage or a discount card sets the price.
• Patches, estradiol through the skin: about $100 a month at Alloy, with progesterone extra. About $150 a month at Winona for the estrogen patch alone.
• Cream or gel: about $90 a month for Winona's estrogen and progesterone cream. Inner Balance's Oestra cream is about $200 a month, then about $100. Both are compounded, not FDA-approved finished drugs.
• Pellets: none of the seven offers them. Pellets are placed under the skin in an office, so they sit outside telehealth pricing.

That rule has limits. Alloy's patch costs about a third less than Winona's. Both are FDA-approved estradiol patches, so the product does not explain the gap. The billing does: what is bundled in, whether the consult is separate and the margin on the medication. So compare the same form across providers, not only forms within one.

For the medical trade-offs between forms, see HRT pills vs. patches vs. injections. For a cost-only view by form, including pellets, see HRT patch vs. pill cost. For the doses each form comes in, see the HRT dosage chart.

How much does HRT cost per month with insurance, and without?

Insurance changes the math most at Midi Health and PlushCare. Both bill PPO plans directly. A PPO is a plan that lets you see specialists without a referral. On Midi, the visit can drop from $250 to a normal specialist copay. On PlushCare, in-network patients often pay about $30 instead of about $130.

In both cases, the prescription goes to your own pharmacy. So the medication runs through your drug benefit, at whatever copay your plan sets for generic estradiol or progesterone.

Wisp and Evernow take a middle path. The visit or membership is usually cash. But the medication can often go through your drug coverage once it reaches a pharmacy. So your real cost depends more on your pharmacy benefit than on the platform.

Medicare is the exception to know about. Midi Health sees Medicare members only as self-pay patients. It cannot submit claims for them.

Without insurance, the cash price is simply the price. Winona, Alloy and Inner Balance don't bill insurance, so their prices never change. For the others, the uninsured rate is the self-pay visit fee plus what your pharmacy charges for the fill. All seven accept HSA or FSA funds, the pre-tax health accounts many employers offer. That is the closest thing to a discount if your plan skips menopause telehealth. Our HRT without insurance guide walks through each cash-pay route, and is HRT covered by insurance explains what your plan pays.

What each of the 7 providers actually charges

Here is what each one charges once the consult, the medication and any recurring fee are counted.

Winona: best for the lowest entry price

Winona charges nothing for the consultation or ongoing messaging. You pay only for the products you choose.

• Progesterone capsules: about $40 a month
• Estrogen tablets: about $55 a month
• Estrogen and progesterone cream: about $90 a month
• Estrogen patch: about $150 a month

What Winona dispenses depends on the product. The patch, the estrogen tablets and the progesterone capsules are FDA-approved finished drugs. The patch comes in the same five strengths as the standard estradiol patch. The creams are the compounded items, made at two pharmacies Winona owns.

Prescribing is based on your symptoms, not lab tests. That is part of why Winona can skip the consult fee. It is a fair trade for straightforward perimenopause symptoms, less so for a complicated history.

One cost detail matters here. Winona publishes no discount for combining products. So a plan with two products, like the patch plus progesterone, means two full prices.

• Pros: no consult fee; the lowest single-product prices of the seven; no labs required
• Cons: the patch costs more than Winona's own pills and cream. A two-product plan costs more than the headline price. No insurance billing. Not offered in every state.
• Best for: women with classic perimenopause symptoms who want the cheapest legitimate start

Alloy: best for specialist-certified care

Alloy charges a one-time consult of about $50. After that, the estradiol patch is $100 a month, shipped and billed every three months. Progesterone is its own line.

• Patch: $100 a month · Billed about $300 every 3 months
• Patch plus progesterone: about $125 a month, still below Winona's price for the same pair
• Estradiol pill: from about $40 a month, the cheaper form if it suits you
• First-order promo: 25% off the pill with code PILL25, or off the Evamist spray with code HRT25. Alloy shows no end date.

Every Alloy doctor is certified by The Menopause Society, a credential Winona's prescribers don't carry. No labs are required or arranged, so no lab fee hides under the price. See the full Alloy review and the Alloy cost breakdown for plan-by-plan detail.

• Pros: Menopause Society–certified doctors; one-time consult, no membership; no labs required
• Cons: cash only, no insurance billing; progesterone is extra; billed three months at a time
• Best for: women who want specialist-level prescribing without insurance paperwork

Midi Health: best for PPO insurance

Midi Health's self-pay prices look steep: $250 for the first visit. Each follow-up costs $150. Insurance changes that. Midi is in-network with most PPO plans, so covered patients usually pay a standard specialist copay. The Midi Health review and its cost page walk through both cases.

Labs and prescriptions are not part of the visit price. Budget for bloodwork if your prescriber orders it. Medicare is the one insurance Midi doesn't bill. Medicare members can pay out of pocket, but no claims can be filed. Midi also doesn't accept Medicaid or Medi-Cal.

• Pros: bills most PPO plans; board-certified menopause clinicians; care that can include lab testing
• Cons: the highest first-visit price on this list if you pay cash; labs billed separately
• Best for: women with PPO coverage who want the visit billed like any specialist appointment

Wisp: best for using your own pharmacy

Wisp keeps its fee small. About $100 covers the consult, follow-ups and three months of care team access. Wisp now shows it as a monthly price on its site. The medication never goes through Wisp. It goes to the pharmacy you choose, where your insurance, a discount card or the cash price applies.

• Pros: low flat fee; prescriptions fill at your own pharmacy, where insurance can apply; no labs required up front
• Cons: not a menopause-only platform; the medication cost is separate, so check it with your pharmacy
• Best for: women whose insurance covers HRT at a local pharmacy but not the telehealth visit

Inner Balance: best for compounded cream without labs

Inner Balance sells one product, the Oestra cream. There is no consult fee on top and no lab work to start.

• First six months: about $200 a month
• After that: about $100 a month
• First year: about $1,790 · About $1,195 a year after that

Oestra is compounded. A 503A pharmacy, one that mixes medicines for individual patients, makes it from FDA-approved ingredients. The finished cream has not gone through FDA review before sale. That is a different category from a manufactured, FDA-approved patch. The Inner Balance review and its cost page cover the refund policy and what changes after month six.

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

PlushCare: best for HRT inside primary care

PlushCare's first visit costs about $130 in cash. Most in-network patients pay about $30 instead. PlushCare itself estimates HRT pills at about $130 to $240 a month before insurance. See the PlushCare cost breakdown for the visit-by-visit math.

• Cash follow-up visit: about $100
• Optional membership: about $20 a month · First month free · Adds a pharmacy discount card worth up to 80% off

PlushCare is not a menopause clinic. It is a general telehealth practice that also prescribes HRT. That suits women who want one provider for everything. It is a limit if you want a clinician who focuses on menopause.

• Pros: takes most major insurance; low in-network copay; the discount card can cut medication cost a lot
• Cons: not menopause-specialized; the membership is a separate optional fee; medication prices vary a lot without a discount
• Best for: women who want HRT managed by the same telehealth provider as the rest of their care

Evernow: best for menopause-only membership care

Evernow charges a membership instead of a per-visit fee. Medication is billed on top. At Evernow's cash prices, that is about $20 a month for an estradiol pill or progesterone and about $55 for the patch. It costs less if your drug plan covers the fill. Evernow does not take Medicare or Medicaid.

• Month to month: about $50 a month
• 3-month plan: about $45 a month
• 12-month plan: about $35 a month, paid up front

Video visits can be billed to insurance where Evernow accepts it. Medication filled at your local pharmacy can use insurance too. Only the membership is always out of pocket, though HSA and FSA funds can pay it.

• Pros: menopause-only focus; lower price for longer plans; insurance can apply to visits and medication
• Cons: membership and medication are two separate charges; the monthly total is harder to predict
• Best for: women who want a long-term, menopause-only relationship and don't mind a membership

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

The advertised monthly price is rarely the whole bill. Five costs tend to hide beneath it.

• Consult fees: one-time charges, like Alloy's or Wisp's, that don't show in a monthly headline but come due first
• Labs: Midi Health bills labs apart from the visit. Winona, Alloy and Inner Balance don't require them.
• Memberships: Evernow and PlushCare's optional tier charge a monthly fee on top of medication
• Follow-up visits: Midi Health's follow-ups and PlushCare's copays repeat each time your prescription changes
• Two-product plans: at Winona, a patch plus progesterone means two full prices

What's the real annual cost of HRT?

Over a year, the gaps grow. Here is roughly what each common setup adds up to.

• Winona estrogen tablets: about $650 a year
• Winona patch: about $1,790 a year
• Alloy patch: about $1,250 in year one with the consult · About $1,200 a year after
• Alloy patch plus progesterone: about $1,525 in year one · About $1,475 a year after
• Inner Balance cream: about $1,790 in year one · About $1,195 a year after
• Evernow membership alone: about $420 to $590 a year, before medication
• Midi Health self-pay visits: about $700 a year for a first visit and three follow-ups

Evernow's all-in total depends on your prescriptions. It runs from about $660 a year on the 12-month plan with a pill to about $1,500 on the monthly plan with a patch and progesterone. PlushCare is hard to total because so much depends on your insurance. Its optional membership alone adds about $240 a year.

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

Sometimes, but not always. First, sort out which products are compounded. It is rarely a whole company. Inner Balance's Oestra cream is compounded, and so are Winona's creams. They are made from FDA-approved ingredients at a licensed pharmacy. But the finished mix has not gone through FDA review the way a manufactured drug has. Winona's patch, tablets and capsules are FDA-approved finished drugs.

So "cheap because compounded" doesn't hold up against real prices. Alloy's and Winona's patches are both FDA-approved, yet Winona's costs about half again as much. And Inner Balance's compounded cream lands in the same range as Alloy's patch, not clearly below it. Compounding buys flexibility in dose and form more reliably than it buys a discount. The compounded HRT guide goes deeper on the rules.

How to lower your HRT cost without cutting corners

A few moves work at most of these providers without changing the quality of care.

• Use HSA or FSA funds. All seven providers accept them, whatever your insurance.
• Try a discount card at a retail pharmacy. PlushCare's membership includes one. GoodRx works at most pharmacies for a Wisp or PlushCare prescription.
• Check your PPO benefits first. Midi Health and PlushCare bill insurance directly, and the gap with self-pay can be large.
• Compare forms, not only providers. Moving from a patch to a tablet or cream at the same platform can cut the bill a lot.
• Start from the cheapest legitimate route. Add only what your history needs. Our cheapest ways to get HRT ranks the options by all-in cost.