Best Online Hormone Replacement Therapy for Women in Perimenopause and Menopause
The best online hormone replacement therapy provider for you depends on a few practical questions, not on a ranking.
Start with what matters to you.
A quick fit checkInsurance pays: Midi (in-network with most major insurers, all 50 states), or Evernow for video visits with several listed insurers.
No video, fast prescription: Alloy (plan in as little as 12 hours, 24/7 messaging) or Winona (portal messaging, no phone or video visits at all).
Video visit, follow-ups included: Golden Leaf Health ($99 first visit, $49 a month with 2–3 doctor follow-ups and messaging, 33 states), or Evernow's membership with messaging.
Menopause-only practice: Golden Leaf Health, with no GLP-1, skincare or supplement lines to sell you. The large brands have all added them.
Compare
Side by side
| Golden Leaf Health | Midi Health | Alloy | Evernow | Winona | |
|---|---|---|---|---|---|
| Insurance | No. FSA/HSA accepted | In-network with most major insurers; self-pay available | No. FSA/HSA accepted | Yes for video visits (BCBS, Anthem, UnitedHealthcare, Aetna listed); membership self-pay | No. FSA/HSA accepted |
| First contact | Live video visit, $99 | Live virtual visit | Online intake, plan in as little as 12 hours | Video visit (pay-per-visit) or membership | Online intake through the patient portal |
| Who you see | A small care team: Dr. Ashley Alexis, ND; Dr. Steve Groke, MD; Mai Tran, PharmD | Physicians and nurse practitioners trained in women's health | Board-certified menopause-specialized physicians | A multidisciplinary clinician team | 30+ board-certified physicians; matched to one licensed in your state |
| Video or phone visits | Yes, every visit | Yes | Not stated; messaging-based | Yes | No phone or video; portal messaging, 24–48 hour replies |
| Follow-ups | 2–3 doctor visits plus text check-ins, included in $49/month | Follow-up visits, billed to insurance or self-pay | 24/7 messaging with your doctor | Secure messaging; optional visits | Physician check-in at 10 weeks; refills automatic |
| Published price | $99 first visit; $49/month; prescriptions and labs separate | Not published; depends on plan | Not published on the pages we read | Membership from $35/month | Not published; medication billed every 28 days |
| States | 33 | All 50 | Not stated | Not stated | 37 plus Puerto Rico |
| Also sells | Nothing beyond optional supplements at member pricing | GLP-1s, supplements, skincare, labs | Skincare, GLP-1 weight care, hair, gut products | Not stated | Not stated |
Golden Leaf Health
- Insurance
- No. FSA/HSA accepted
- First contact
- Live video visit, $99
- Who you see
- A small care team: Dr. Ashley Alexis, ND; Dr. Steve Groke, MD; Mai Tran, PharmD
- Video or phone visits
- Yes, every visit
- Follow-ups
- 2–3 doctor visits plus text check-ins, included in $49/month
- Published price
- $99 first visit; $49/month; prescriptions and labs separate
- States
- 33
- Also sells
- Nothing beyond optional supplements at member pricing
Checked October 12, 2026 on each company's public site. Companies change their offers often; if something here is out of date, email [email protected] and we'll correct it.
Decision points
What matters more than the brand
If dose changes are your main concern, HRT dose adjustments: how they work has a provider checklist, and how much hormone therapy costs separates the visit, care, prescription and lab costs.
- 1
Insurance or cash
If you have a plan Midi is in-network with, a visit may cost you a copay, and that is hard to beat on price. The trade is that insurance-billed care tends to run on the insurer's visit structure. Cash-pay practices are more predictable and usually simpler, and FSA and HSA cards work with all of them.
- 2
Video visit or questionnaire
Questionnaire-based services are fast and work well for refills and straightforward cases. For a first prescription in perimenopause, where symptoms overlap with thyroid, sleep, mood and many other things, a live conversation with a clinician may identify issues a form misses. If you've never been on hormone therapy, we'd choose a video visit, with us or anyone else.
- 3
What happens after the prescription
Hormone therapy often needs adjustment. Most women change dose or form at least once in the first months, and the difference between a good result and giving up is whether a prescriber is reachable when that happens. Ask every provider how many follow-ups are included, who provides them and what a dose change costs. Our answer is two to three visits with a doctor and messaging with the care team, inside the $49 a month.
- 4
What else they're selling
The large menopause brands have expanded into GLP-1 weight medications, skincare and supplement lines. That isn't wrong, but it changes the visit: a practice with products to sell has a reason to recommend them. Golden Leaf Health treats perimenopause and menopause and nothing else; supplements, when suggested, are optional and sold at member pricing.
Our practice
Where Golden Leaf Health fits
New to telehealth? See what happens at a first visit. Already with another clinic? See switching menopause providers.
We are the small option on this list, on purpose. Three clinicians, video visits, a first visit for $99 usually within days, and ongoing care for $49 a month that includes the follow-ups most services charge for. We prescribe FDA-approved bioidentical products and, where there's a reason, compounded prescriptions, and we tell you which and why. We don't bill insurance. We serve 33 states. If you want a named clinician who knows your history rather than a platform, that's the trade we offer; if you want insurance billing or a 12-hour questionnaire prescription, one of the others may suit you better.
First visit
$99
Video visit with a clinician.
Ongoing care
$49 a month
Follow-ups and messaging. Prescriptions and labs are separate.
Questions
Questions, answered plainly.
What is the best online hormone replacement therapy provider?
It depends on whether you want insurance billing (Midi, and Evernow for video visits), a live video visit or a questionnaire and messaging (Alloy and Winona are messaging-based), and how much follow-up is included. Golden Leaf Health is a small practice built around video visits with the same care team and follow-ups included in a $49 monthly membership, for women who want a clinician who knows them rather than a platform.
Which online HRT providers take insurance?
As of October 2026, Midi Health is in-network with most major insurers, and Evernow accepts several insurers for video visits. Alloy, Winona and Golden Leaf Health are cash-pay; all three accept FSA and HSA cards.
What are the best online providers for HRT dose adjustments?
Look for providers that include follow-up visits with a prescriber rather than charging per visit or relying on a questionnaire. Golden Leaf Health includes two to three follow-up visits with a doctor plus messaging in membership; Evernow and Alloy adjust through messaging; Winona reviews at ten weeks through its portal; Midi books follow-up visits, billed to insurance or self-pay.
Is online HRT safe?
Yes, when a licensed clinician takes a proper history, chooses the form and dose for you and follows up. Hormone therapy is prescribed on symptoms and history, which video visits handle well. What to avoid is any service that prescribes from a questionnaire alone with no way to reach a prescriber when something changes.
How much does online HRT cost?
At Golden Leaf Health, $99 for the first visit and $49 a month for ongoing care, with prescriptions and labs priced separately. The large brands range from insurance copays to monthly memberships and per-medication pricing; most don't publish a full price list, so check the current figures on each site before you decide.
Company facts from joinmidi.com, myalloy.com, evernow.com and bywinona.com, read October 12, 2026.