HRT Online in Nevada: 2026 Prices, Providers and What Anthem, Nevada Medicaid or Medicare Will Pay

Updated October 27, 2026. That day we read Nevada's telehealth statute, NRS 629.515, its telehealth coverage law, NRS 689A.0463, and its prescription monitoring rule, NRS 639.23507. We also read Anthem's 2026 Nevada drug list and Nevada Medicaid's managed care and drug list notices. Service prices come from each provider's own site, checked in October 2026.

Find the line below that fits you, then look up that provider in the table.

• Cheapest estrogen and progesterone prescribed and shipped to you: Alloy, about $65 a month for an estradiol pill plus progesterone, billed every three months, after a one-time $49 consult.
• Pay per product with no consult fee: Winona, about $90 a month for its combined estrogen and progesterone cream, or about $95 for tablets plus a progesterone capsule.
• A fee that halves: Inner Balance, about $100 a month from the seventh month.
• A PPO plan: Midi Health, which says it's in-network with most PPO plans.
• A low-cost membership with messaging: Evernow, about $35 a month on a prepaid year, with medicine extra.
• You already have a prescriber: coupon generics, or The HRT Club.
• On Nevada Medicaid: a Nevada clinician who takes your Medicaid health plan, since none of these online services does.

What does HRT cost in Nevada, and which online services prescribe here?

Each service below charges one national price. A woman in Elko pays what a woman in Henderson pays. Nevada decides how care may start, who may prescribe, and what your coverage must pay.

You can pay in one of three ways. Some services bundle the clinician and the medicine into one bill. Others charge only for care, through a membership or your insurance, and send the prescription to a pharmacy. Once you have a prescription, a generic with a free coupon card is the cheapest option.

One name you may know is missing. Fountain doesn't list Nevada among the states it serves, so it isn't in the table.

Winona: best for paying per product with no consult fee

Winona lists Nevada among its 37 states, plus Puerto Rico. There's no consult fee and no bloodwork, and you pay for each product. Progesterone capsules alone cost about $40 a month, and estrogen tablets about $55.

For both hormones, the combined estrogen and progesterone cream costs about $90 a month. Tablets with a progesterone capsule come to about $95. The estradiol patch costs the most, at about $150 before progesterone.

The patch, tablets and capsules are FDA-approved. The creams are compounded, meaning mixed to order, in two pharmacies Winona owns. Under its terms, you can also ask the doctor to send your prescription to a pharmacy you choose.

Care runs by written intake and doctor messaging, with no video visit and no testosterone. Winona holds 4.6 on Trustpilot from about 8,600 reviews, and complaints center on automatic refills and cancelling. Winona cost prices every product.

Inner Balance: best for one cream whose price halves after six months

Inner Balance charges about $200 a month for the first six months. That covers the evaluation and Oestra, its only treatment. Oestra is one compounded cream with both estradiol and progesterone. You apply it to the vaginal tissue, and it acts throughout the body.

From month seven, the fee falls to about $100. The cream ships every three months and is billed monthly. Labs are optional, and a footnote on its pricing page says a dose change may cost extra.

The practice behind it, Inner Balance Health PLLC, is based in Boise, Idaho. It holds 2.2 on Trustpilot from 38 reviews, and most complaints involve cancelling. Its refund guarantee has two deadlines, which our review lays out.

Alloy: best for the cheapest estrogen and progesterone prescribed and shipped

Alloy treats menopause in all 50 states and DC. You pay a one-time $49 consult, then a price for each product, with no membership. Alloy says its consult doctors are certified by The Menopause Society, the main US medical society for menopause care.

The estradiol pill costs about $40 a month, and progesterone starts near $25. No other service in this table that both prescribes and ships your medicine charges less for that pair. The estradiol patch costs about $100 a month.

Everything ships as a three-month supply, billed once a quarter. For the pill with progesterone, each charge comes to about $190. Code PILL25 takes 25 percent off a first order of the pill.

One Nevada detail shows up on Alloy's product list. It says compounded medications aren't available in Nevada. That covers its compounded weight-care medicines and a compounded tretinoin face cream, not its FDA-approved estradiol and progesterone.

Care runs by message, with no video and no required labs. Alloy holds 4.3 on Trustpilot from about 4,040 reviews. Alloy cost prices every product.

Midi Health: best if your Nevada plan is a PPO

A PPO, or preferred provider organization, is a plan that lets you see specialists without a referral. Midi Health says it's in-network with most PPO plans. In network, you pay your specialist copay, a set fee per visit, plus any deductible you still owe.

Midi names Blue Cross Blue Shield and UnitedHealthcare among the carriers it works with. It doesn't name Anthem or Health Plan of Nevada. Anthem is Nevada's Blue Cross Blue Shield company. Midi's coverage tool shows whether your own plan is in network.

Without coverage, the first visit costs $250 and each follow-up costs $150. Medicare is out of network, and Midi doesn't accept Medicaid. Visits happen by video, and labs and medicine are billed on their own.

Midi holds 4.1 on Trustpilot from about 1,700 reviews. Midi Health and insurance goes plan by plan, and Winona vs Midi Health weighs cash against insurance.

Evernow: best for messaging a clinician between visits

Evernow treats only menopause and says it serves all 50 states plus DC. Membership costs $49 month to month, or $129 for three months. A year paid upfront costs $420, which works out to about $35 a month.

Membership covers round-the-clock messaging with a clinician, prescriptions and refills. Video visits cost extra. Evernow bills Aetna, Anthem, Blue Cross Blue Shield and UnitedHealthcare plans for them, or charges $150 without coverage. Medicine is billed separately.

Its estradiol patches and vaginal estradiol cream are FDA-approved. On the 3- or 12-month plan, the cream is free if you qualify. Some items, such as a facial estriol cream, are compounded.

Its Trustpilot profile is small and unclaimed. It shows 2.0 from 15 reviews, too few to judge either way.

The HRT Club: best if a clinician already writes your prescription

The HRT Club is not a clinic. It's a mail-order pharmacy membership with a free directory of prescribers. The basic tier costs nothing, and membership costs $12 a month or $99 a year.

Members pay $15 for 30 capsules of generic progesterone, against $135 for guests. Shipping costs $10 an order, and annual members ship free on orders of $50 or more.

It suits you if a Nevada clinician already prescribes for you and you pay cash. The catches are no refunds, an annual plan you can't end early, and no Trustpilot reviews so far.

Generic estradiol and progesterone at a Nevada pharmacy

If you already have a prescription, a generic plus a free coupon card usually costs least. The coupon row uses national prices, not a quote for a Las Vegas, Reno or Carson City ZIP code.

GoodRx lists a month of generic estradiol patches, eight twice-weekly patches, at about $35. Thirty capsules of micronized progesterone, the body-identical form of the hormone, cost as little as about $15 with the coupon. SingleCare is another free card, and there 30 estradiol tablets cost about $5.

Online services leave this door open. Winona's and Alloy's terms let you send your prescription to a pharmacy you pick. With insurance, compare the coupon price with your copay and pay whichever is lower.

Our HRT savings guide shows how the discount cards work. To compare every low-cost route, see the cheapest HRT options.

What a year of HRT costs in Nevada

• Winona: about $1,070 a year for the combined cream, or about $1,115 for tablets with a progesterone capsule. The patch with a capsule runs about $2,260.
• Inner Balance: about $1,790 in the first year, then about $1,195 a year.
• Alloy, pill and progesterone: about $805 in year one with the consult, then about $755, paid in four quarterly charges. The patch with progesterone runs about $1,525 in year one, then about $1,475.
• Evernow: about $570 for a prepaid year plus one self-pay visit, or about $740 paying monthly. Medicine is extra.
• Midi Health: your specialist copay for each in-network visit. Paying cash, a first visit and three follow-ups come to $700, before medicine.
• Your own prescriber with coupon generics: about $240 a year for tablets and progesterone. With patches, it's about $635, counting 13 four-week patch boxes. Add visit fees, plus $99 a year if you fill through The HRT Club.

Is it legal to get HRT online in Nevada, and does the first visit need video?

Yes, it's legal, and video isn't required by statute. Nevada's telehealth law, NRS 629.515, lets a provider establish a relationship with a patient by telehealth when it's clinically appropriate.

Nevada defines telehealth broadly. It covers live video and asynchronous store-and-forward care, meaning health information sent for a clinician to review later. It also covers audio-only care, by phone or recorded message. Fax and email don't count.

The same law sets a limit. Telehealth never widens what a clinician may do, and care must still meet the standard expected in an office. A distant clinician treating you in Nevada falls under Nevada law and its courts.

In practice, Winona, Alloy and Inner Balance start with a written health history. A clinician reviews it and follows up by secure message.

Midi holds its visits by video, and Evernow adds paid video visits to its messaging. If you'd rather talk face to face first, choose a video service.

Your clinician needs a Nevada license

What counts is where you are during the visit. NRS 629.515 requires a clinician treating a patient in Nevada to hold a valid Nevada license, even when the company sits in another state.

Doctors have two shortcuts. Nevada joined the Interstate Medical Licensure Compact in 2015, giving doctors licensed in other member states a faster path to a Nevada license. The medical board can also issue a special purpose license for telehealth to board-certified doctors licensed elsewhere.

Nurses have no compact shortcut. Nevada hasn't joined the Nurse Licensure Compact, and a 2025 bill to join died without a hearing. That compact covers registered nurses anyway, not nurse practitioners.

Nevada nurse practitioners prescribe on their own

In Nevada, a nurse practitioner is licensed as an advanced practice registered nurse, or APRN. A 2013 law, AB 170, took effect on July 1 that year. It dropped the written collaborative agreement with a physician.

One limit remains, and it doesn't touch hormone therapy. To prescribe Schedule II drugs, the strictest class of prescription drugs, an APRN needs two years or 2,000 hours of clinical experience, or a physician's protocol.

Estradiol and progesterone aren't controlled drugs at all. A Nevada APRN can evaluate you by telehealth and prescribe them with no supervising doctor.

Testosterone has extra rules

Testosterone is a Schedule III drug, a federal class of controlled medicines with stricter handling. The prescriber needs a DEA registration. Nevada adds its own controlled substance registration, issued by the Nevada State Board of Pharmacy.

To start it without an in-person exam, prescribers rely on federal telemedicine flexibilities. They run through December 31, 2026. The DEA sent its permanent telemedicine rule to the White House for review in August 2026, and its terms aren't public yet.

Nevada adds a database check. Under NRS 639.23507, a prescriber must check the state's Prescription Monitoring Program before a first prescription for a Schedule II, III or IV drug. They must check again at least every 90 days while treatment continues.

Midi lists a testosterone cream in its online store, from $100 per 90 days. Winona and Evernow don't list testosterone. No testosterone product is FDA-approved for women. A 2019 global consensus statement supports it only for low sexual desire after menopause.

Will Anthem, Nevada Medicaid or Medicare pay for hormone replacement therapy in Nevada?

Coverage usually reaches the hormones themselves, but never a telehealth subscription. Visits fall in between, because Midi and Evernow bill some plans for them.

Nevada's telehealth coverage law, NRS 689A.0463, and its sister sections for group plans and HMOs require plans to cover telehealth as they cover in-person care. A plan can't demand an earlier in-person visit. It can't require prior approval for a telehealth visit unless the same visit in person would need it.

Equal pay rates are another matter. The law requires them only in narrower cases, such as mental health counseling. For a menopause visit, your plan sets the rate.

These rules don't reach every plan. Self-funded employer plans, common at large companies, follow a federal law called ERISA instead. Nevada's Division of Insurance estimated about 1.2 million Nevadans were in self-funded plans in 2023.

Winona, Alloy and Inner Balance don't bill any insurer, and no plan covers Evernow's membership. HSA and FSA cards, the tax-free health accounts many employers offer, work at all four. Winona and insurance covers that route for a Winona order.

Our HRT insurance guide explains how to read a drug list and appeal a denial.

Anthem Blue Cross and Blue Shield in Nevada

Every plan publishes a formulary, its list of covered drugs sorted into price tiers. The lower the tier, the less you pay.

Anthem's 2026 Nevada drug list for individual plans, current as of October 1, puts generic estradiol tablets on tier 1. That's the lowest-cost tier. Progesterone capsules are tier 1 too.

Weekly and twice-weekly estradiol patches are also tier 1, with a quantity limit. A quantity limit caps how much you can fill at once. Vaginal estradiol cream sits on tier 2, also with a quantity limit.

Testosterone gel is tier 2 and needs prior authorization, meaning approval from the plan before you fill. Testosterone cypionate injections are tier 1, also with prior authorization.

Employer plans from Anthem use other lists, such as its Essential and National drug lists, so tiers can differ. Check yours in your member account or call the number on your card.

For visits, Evernow names Anthem among the plans it bills. Midi names Blue Cross Blue Shield but not Anthem by name.

Nevada Health Link

Nevada runs its own marketplace, Nevada Health Link, so you don't shop on HealthCare.gov. For 2026 it offered 140 plans from eight insurers.

Those insurers were Anthem, CareSource, Health Plan of Nevada, Hometown Health, Imperial, Molina, Select Health and SilverSummit, sold as Ambetter.

2026 also brought Nevada's first Battle Born State Plans. State law requires these plans to be sold statewide and to meet targets that hold down premium growth. Anthem's Community Care Health Plan of Nevada, SilverSummit and Health Plan of Nevada offer them.

Open enrollment for 2027 opens November 1, 2026. If you buy your own plan, compare each drug list for estradiol and progesterone before you switch.

Nevada Medicaid

Nevada expanded Medicaid in 2014. Adults 19 to 64 qualify with income up to 138 percent of the federal poverty level. In 2026, that's about $1,835 a month for one person.

Since January 1, 2026, managed care covers the whole state, not just Clark and Washoe counties. Five health plans take part: Anthem, CareSource, Health Plan of Nevada, Molina and SilverSummit.

Your choice depends on where you live. Rural members can pick CareSource or SilverSummit. Urban Washoe adds Anthem and Molina, and urban Clark County adds Health Plan of Nevada too.

All plans now use one state preferred drug list, also from January 2026. Since July 1, 2026, a non-preferred drug is rejected at the pharmacy unless your prescriber gets an exception approved first.

Nevada Medicaid pays for telehealth as it pays for in-person care. Audio-only visits are covered when medically necessary.

A work rule is coming. From January 1, 2027, many expansion adults must show 80 hours a month of work, school, job training or community service, or earnings of at least $580 a month.

Current members face the rule at their regular renewal in 2027. New applicants may need to meet it the month before coverage starts. Exemptions include people who are medically frail, among others.

None of the online services above takes Nevada Medicaid. A Nevada clinician who accepts your Medicaid health plan is the realistic route.

Medicare

Most Part D drug plans list generic estradiol and progesterone. Your 2026 out-of-pocket spending on covered drugs stops at $2,100.

Midi treats Medicare as out of network, so visits cost its self-pay rate. Evernow doesn't accept Medicare.

Finding a menopause doctor or menopause specialist in Las Vegas, Reno or rural Nevada

The Menopause Society's practitioner directory, at portal.menopause.org, is the usual first stop. It lists members and Menopause Society Certified Practitioners, known as MSCPs.

In Las Vegas or Henderson, run that directory with your own ZIP code. Look for the MSCP mark, which shows a clinician certified in menopause care.

In Reno, Renown Women's Health lists menopause and perimenopause care among its general gynecology services. Its women's health physicians also teach at the University of Nevada, Reno School of Medicine.

Outside the two metro areas, distance is the hard part. The 2026 March of Dimes report counts about half of Nevada's 17 counties as maternity care deserts, with no obstetric clinician and no hospital obstetric unit.

If the nearest specialist means a long drive or a long wait, online care can be a faster start. A local visit still adds what a screen can't, such as a hands-on pelvic exam.

To size up a local clinician, see our guide to finding perimenopause care. HRT near me helps you weigh an online clinician against the closest office, and finding an HRT doctor covers what to ask.

Bioidentical hormones, compounded creams and pellets in Nevada

Bioidentical describes the shape of a hormone, not how it's made. The molecule matches the estradiol or progesterone your ovaries produce. Most estradiol patches and micronized progesterone capsules meet that test, and they're FDA-approved too.

Compounded hormones are mixed by a pharmacy for one patient and never go through FDA approval. In Nevada, the State Board of Pharmacy licenses pharmacies and oversees compounding.

Under NRS 639.2328, a pharmacy outside Nevada needs a license from the board before it dispenses prescriptions to patients here. That covers mail-order pharmacies used by online services.

Pellets are small compounded hormone implants placed under the skin every few months. Biote's provider directory has Nevada pages for Las Vegas, Henderson and Reno, with more than a dozen listings in Las Vegas alone.

We found no Nevada clinic that posts its pellet prices online. Expect to pay cash, and ask for a written quote that covers the pellets, insertion and labs. Read our hormone pellets guide before you book.

At the FDA's request, the National Academies reviewed compounded bioidentical hormones in 2020. They found little evidence of safety or benefit. ACOG and The Menopause Society both prefer an FDA-approved product whenever one exists.

Approved products are getting new safety labels. On February 12, 2026, the FDA approved revised labels for a first group of six hormone products. Statements on heart disease, breast cancer and probable dementia came out of the boxed warning, a label's most prominent caution.

That first group included Prometrium, a brand of micronized progesterone, and Divigel, an estradiol gel. No estradiol patch was in it.

In the table, Winona is mixed. Its patch, tablets and capsules are FDA-approved, while its creams are compounded.

Alloy's hormone protocol, Midi's default treatments, Evernow's patches and vaginal cream, The HRT Club's drugs and the coupon generics are FDA-approved. Inner Balance's Oestra is compounded, a systemic cream applied vaginally. If you want compounded hormones on purpose, compounded HRT: where to get it covers what to check.

Starting HRT in your 40s in Nevada: labs, age and the questions to ask

Many women in their 40s hear that they're too young for hormones. The Menopause Society's 2022 position statement says benefits outweigh risks for most healthy women with symptoms. That holds under age 60, or within ten years of menopause.

Perimenopause comes before the last period, so it falls inside that window. Hormone levels swing too much in these years for a blood test to confirm it. Winona and Alloy both prescribe without required labs.

Wondering whether to test anyway? Perimenopause labs covers what a hormone panel can tell you, and what it can't.

Before you commit, ask any Nevada prescriber these four questions, online or in person.

• Training: Have you trained in menopause care, or earned The Menopause Society's certification?
• First choice: Do you begin with FDA-approved estradiol and micronized progesterone, and turn to compounded hormones only if those don't suit me?
• License: Do you hold a Nevada license? If you're an APRN, which national certification do you hold?
• Format: Beyond my written history, how will you assess me: by message, a phone call or a video visit?

Once you start, our HRT dosage guide walks through how the dose gets adjusted.