HRT Online in New Hampshire: 2026 Prices, Providers and What Anthem, Harvard Pilgrim, Granite Advantage or Medicare Will Pay

Updated November 4, 2026. That day we read New Hampshire's telemedicine laws on the state legislature's site: RSA 329:1-c, 329:1-d and 310:7 for doctors, and RSA 326-B:11 for nurse practitioners. We also read Anthem's 2027 and Harvard Pilgrim's 2026 New Hampshire drug lists, the state Medicaid drug list and the health department's page on the 2027 work rules. Service prices come from each provider's own site, checked in October 2026.

Start with the line that sounds most like you, then find that provider in the table.

• Pay per product with no consult fee: Winona, about $90 a month for its combined estrogen and progesterone cream.
• One cream whose price halves: Inner Balance, about $200 a month for six months, then about $100.
• Cheapest estrogen and progesterone prescribed and shipped to you: Alloy, about $65 a month for an estradiol pill plus progesterone, after a one-time $49 consult.
• A PPO plan: Midi Health, which says it's in-network with most PPO plans. Its coverage tool shows where your plan stands.
• 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 Granite Advantage: a New Hampshire clinician who takes your Medicaid health plan, since none of these online services does.
• Your gynecologist practices in Massachusetts: office visits there follow Massachusetts rules, covered in HRT in Massachusetts.

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

No service in the table charges more for a New Hampshire address. A woman in Berlin pays the same national price as a woman in Salem. State law decides how care can start, who can prescribe, and what your plan must pay for.

You'll see three ways to pay. 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. If you already hold a prescription, a generic with a free coupon card costs least.

One name you may know is missing. Fountain's published state list leaves out New Hampshire, so it isn't in the table.

Winona: best for paying per product with no consult fee

Winona lists New Hampshire among its 37 states, plus Puerto Rico. There's no consult fee and no bloodwork. You pay for each product, and progesterone capsules alone cost about $40 a month.

For both hormones, the combined estrogen and progesterone cream costs about $90 a month. Estrogen 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. Its terms also let you ask the doctor to send a prescription to a pharmacy you choose, such as one in Concord or Keene.

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. Complaints center on automatic refills and cancelling, and Winona cost prices every product.

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

Inner Balance is run by a medical practice in Boise, Idaho, and treats patients online. It charges about $200 a month for the first six months. That covers the evaluation, clinician check-ins and Oestra, its only treatment.

Oestra is one compounded cream that holds 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 note on its pricing page says a dose change may cost extra.

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. Inner Balance cost breaks down each charge, and our Inner Balance legitimacy check looks at the practice itself.

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. Counting every fee, no other service in this table that both prescribes and ships your medicine costs 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.

Care runs through Alloy's secure portal, with a written intake and then messages with the doctor. Labs aren't required. Alloy holds 4.3 on Trustpilot from about 4,040 reviews, and Alloy cost prices every product.

Midi Health: best if your 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 says it serves all 50 states, but it has no New Hampshire page naming local insurers. Nationally, it names Aetna, Blue Cross Blue Shield, Cigna and UnitedHealthcare. Anthem is New Hampshire's Blue Cross Blue Shield company, yet Midi doesn't say Anthem plans here are in network. Its coverage tool shows whether yours is.

Without coverage, the first visit costs $250 and each follow-up costs $150. Medicare is out of network, and Midi doesn't accept Medicaid, so Granite Advantage members can't use it. 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 centers on menopause care 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. Evernow doesn't take Medicare or Medicaid.

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 New Hampshire 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 New Hampshire pharmacy

With a prescription in hand, a generic plus a free coupon card usually costs least. The coupon row uses national prices, not a quote for a Manchester, Nashua or Concord 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 about $15 to $20 with the coupon.

SingleCare is another free card. There, 30 generic estradiol tablets cost less than $5.

Patches have been harder to find this fall. The FDA says it is working with all six makers of approved estradiol patches to raise supply. In late October it said it was not aware of an imminent nationwide shortage. If your usual patch is out, ask your pharmacist about another product.

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 New Hampshire

• 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 year one, 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.
• Midi Health: your specialist copay for each in-network visit. Paying cash, a first visit and three follow-ups come to $700, before medicine.
• Evernow: about $570 for a prepaid year plus one self-pay video visit, or about $740 paying monthly. Medicine is extra.
• Your own prescriber with coupon generics: about $225 to $280 a year for tablets and progesterone. With patches, it's about $620 to $680, 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 New Hampshire, and does the first visit have to be live?

It's legal, and the first visit doesn't have to be in person or even live. New Hampshire's rules sit in three parts of its Revised Statutes: RSA 329:1-c, 329:1-d and 310:7.

RSA 329:1-c defines the doctor-patient relationship. It includes an in-person exam or an exam using telemedicine. The doctor must complete or review your history, make a diagnosis, set a treatment plan and document any prescription.

For care by telemedicine, the same section adds four duties. The doctor must verify who you are and give you their name, contact information and type of license. They must also get your oral or written consent and meet the standard of care.

RSA 329:1-d says telemedicine includes synchronous and asynchronous interactions. RSA 310:7 explains the difference. A synchronous exchange happens in real time, like a video call. An asynchronous one doesn't, like a health history a clinician reads and answers later.

A written history can start care, judged like an office visit

The bar is the one you'd meet in an exam room. RSA 329:1-d says a doctor treating you by telemedicine must use the same standard of care as in an in-person encounter. With your consent, the doctor also shares the record with your primary care clinician.

So expect a real exchange with a licensed clinician, not a form that approves itself. 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 before a prescription, choose one of those two.

A Boston, Vermont or Maine doctor needs a New Hampshire license to start care online

The license rule follows the patient. Under RSA 310:7, a clinician treating you by telehealth while you're in New Hampshire needs a New Hampshire license. RSA 329:1-d says the same for doctors.

There are two narrow openings. An out-of-state doctor may consult with your New Hampshire clinician. And under RSA 310:7, doctors and advanced practice nurses may give consultation or follow-up care by telehealth to a patient they already treated in their own state.

So a Boston gynecologist who has seen you in her office may follow up by video while you're home in Nashua or Salem. Starting new care online from New Hampshire takes a New Hampshire license. An office visit in Massachusetts follows that state's rules, covered in HRT in Massachusetts.

Doctors licensed elsewhere have a faster route to a New Hampshire license. New Hampshire joined the Interstate Medical Licensure Compact in 2016. Massachusetts hasn't joined, so a Boston doctor can't use her Massachusetts license for that fast track.

New Hampshire also belongs to the Nurse Licensure Compact. That compact covers registered and practical nurses, not nurse practitioners.

New Hampshire nurse practitioners prescribe on their own

New Hampshire lets advanced practice registered nurses, a group that includes nurse practitioners, diagnose and prescribe under their own license. RSA 326-B:11 gives them full authority to prescribe within their scope. The American Association of Nurse Practitioners lists New Hampshire among its full practice states.

Estradiol and progesterone aren't controlled drugs. A nurse practitioner licensed in New Hampshire can evaluate you online and prescribe them, under the same telehealth rules as a 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.

A 2025 state law, Senate Bill 252, lets New Hampshire doctors and nurse practitioners prescribe Schedule II to IV drugs by telemedicine. A follow-up evaluation is then required at least once a year, and federal law still applies.

To start it without an in-person exam, prescribers rely on federal telemedicine flexibilities. They run through December 31, 2026. The DEA's permanent rule went to White House review in August 2026 and isn't final yet.

New Hampshire's prescription drug monitoring program tracks Schedule II to IV fills. Your testosterone shows up there, but your estradiol and progesterone don't.

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, Harvard Pilgrim, Granite Advantage or Medicare pay for hormone replacement therapy?

Coverage usually reaches the hormones themselves, but not a telehealth membership. Visits fall in between, because Midi and Evernow bill some plans for them.

New Hampshire has a telehealth coverage law for private plans, RSA 415-J. Insurers must cover telemedicine on the same basis as an in-person visit. They can't deny a service only because it happened by telemedicine, and the total they pay must match the in-person amount.

The same law bars extra deductibles or copays for telemedicine that don't apply in person. It also counts store-and-forward care, meaning a history or photos a clinician reviews later.

State law doesn't reach every plan. Self-funded employer plans, common at large companies, follow a federal law called ERISA instead. And Winona, Alloy, Inner Balance and The HRT Club don't bill insurance at all. Our HRT insurance guide explains how to read a drug list and appeal a denial.

Anthem Blue Cross and Blue Shield

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

Anthem's 2027 New Hampshire individual drug list takes effect January 1, 2027. Generic estradiol tablets and progesterone capsules sit on tier 1, the lowest cost share. Weekly and twice-weekly estradiol patches sit on tier 1 too, with a quantity limit.

None of those lines needs prior authorization, meaning approval before you fill. Testosterone injections and gel do need it.

That list covers plans bought on the marketplace or directly from Anthem. Employer plans use other Anthem lists, so check yours in your member account or call the number on your card.

Harvard Pilgrim

Harvard Pilgrim's 2026 Core NH 4-Tier drug list puts generic estradiol tablets, weekly and twice-weekly patches, and progesterone capsules on tier 1. That tier holds generics only. Estradiol gel sits on tier 2.

None of these lines carries a prior authorization code. Harvard Pilgrim also runs a 5-tier New Hampshire list and has posted both for 2027. Your plan documents name the one you're on.

HealthCare.gov plans for 2027

New Hampshire uses HealthCare.gov for individual plans. Open enrollment for 2027 coverage runs November 1, 2026, to January 15, 2027. Pick a plan by December 15 for coverage that starts January 1.

Three insurers sell marketplace plans for 2027: Harvard Pilgrim, Anthem's Matthew Thornton Health Plan and WellSense. Ambetter leaves the market after 2026, so its members need to choose a new plan. Before you switch, compare each plan's drug list for estradiol and progesterone.

Granite Advantage, New Hampshire's Medicaid expansion

Granite Advantage covers adults aged 19 to 64 with income up to 138 percent of the federal poverty level. In 2026, that's about $22,000 a year for one adult.

Members get care through one of three Medicaid health plans: AmeriHealth Caritas New Hampshire, NH Healthy Families and WellSense Health Plan.

The state's own Medicaid drug list, used for care outside the health plans, has no section for estrogens or progesterone. It does list testosterone gels, and the forms it doesn't prefer require trying a preferred one first. Each health plan keeps its own drug list, so look for estradiol on yours.

Work rules start in 2027, under a 2025 federal law. Most members will need 80 hours a month of work, community service, a work program or school. Earning at least $580 that month also counts.

Current members face the rule at their first renewal in 2027, and renewals move to every six months. New applicants from January 1, 2027, must show they met it in December 2026.

Some people are exempt. That includes people who are pregnant or postpartum, caregivers of a child 13 or younger, and people who are medically frail.

A 2025 state law also sets monthly premiums for members with income at or above the poverty line, $60 for a household of one. They can start only after federal approval.

None of the online services above takes Granite Advantage. A New Hampshire clinician in your Medicaid health plan is the realistic route.

Medicare

Medicare drug plans, called Part D, set their own drug lists. Your plan's list shows whether estradiol and progesterone are covered, and on which tier. In 2026, your out-of-pocket spending on covered drugs stops at $2,100.

Medicare's open enrollment runs October 15 to December 7, 2026, so there's still time to compare drug lists for next year. Midi treats Medicare as out of network, so visits cost its self-pay rate. Evernow doesn't accept Medicare.

Finding a menopause doctor or specialist in New Hampshire: Manchester, Nashua, Concord, Portsmouth and the North Country

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 Lebanon, Dartmouth Health runs a Menopause and Midlife Clinic at Dartmouth Hitchcock Medical Center. It offers hormone therapy, both systemic and vaginal, along with non-hormonal medicines.

Dartmouth Health also lists menopause management among its women's health services. Those offices include Bedford, next to Manchester, as well as Concord, Nashua and Keene.

On the Seacoast, in Portsmouth, Dover or Exeter, run the directory with your own ZIP code. Look for the MSCP mark, which shows a clinician certified in menopause care.

North of the notches, distance is the hard part. From Berlin or Colebrook, the Lebanon clinic is a long drive. Online care can be a faster start, and 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 New Hampshire

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. Under New Hampshire Board of Pharmacy rules, an out-of-state pharmacy that mails prescriptions into the state must register and hold a board permit. A company that ships from several pharmacies registers each one.

Pellets are small compounded hormone implants placed under the skin every few months. Biote's provider directory has New Hampshire pages for Nashua, Merrimack, Salem, Exeter, Portsmouth and Rochester, among other towns.

Expect to pay cash for pellets, 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. In February 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.

Three estradiol patches from two makers followed on October 30, 2026, with the same statements removed.

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, The HRT Club's drugs and the coupon generics are FDA-approved. Inner Balance's Oestra cream is compounded, and Evernow is mostly approved with a few compounded items.

If you want compounded hormones on purpose, compounded HRT: where to get it covers what to check.

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

Many women in their 40s are told they're too young for hormones. The Menopause Society's 2022 position statement says benefits outweigh risks for most healthy women with bothersome symptoms. That holds under age 60, or within ten years of menopause, unless something rules hormones out, such as a past blood clot or stroke.

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 prescribe without required labs, and labs are optional at Inner Balance.

The same holds if you have no periods to track, after a hysterectomy or with a hormonal IUD. Your symptoms guide the conversation. Perimenopause labs covers what a hormone panel can tell you, and what it can't.

Before you commit, put these four questions to any prescriber who treats you in New Hampshire, on a screen or in an exam room.

• License: Do you hold a New Hampshire license? If you're my Massachusetts doctor, is this follow-up care or new care?
• 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?
• 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.