Hormone Replacement Therapy Near Me: Which of the Four Options You're Actually Looking At
Choose the right HRT door before you pay
Compare local care, menopause specialists, pellet clinics, and licensed online options using your state, symptoms, insurance, and need for hands-on care.
Searching for hormone replacement therapy near me usually means one of four doors: your current clinician, a menopause specialist, a local hormone or pellet clinic, or a telehealth clinician licensed where you are. For most insured women, start local; if the 42-day average new-patient OB/GYN wait is unworkable, compare licensed online care.
By The HRT Index Editorial Team · Last verified August 2026
Editorial research — not medical advice, and not reviewed by a clinician. We earn a commission if you choose some of the providers on this page. Every paid link is labeled, and the free or non-affiliate routes stay in the comparison when they are the better answer.
What changes the answer:
- The wait is too long. New-patient OB/GYN appointments averaged about 42 days across 15 major U.S. metros in the 2025 AMN Healthcare survey. Family medicine averaged 23.5 days. Those are broad specialty averages, not menopause-specific guarantees.
- You're on Medicare or Medicaid. Online access narrows sharply. Elektra publishes participation in both programs, but only in listed states and plans. Midi permits Medicare self-pay without claim submission and does not accept Medicaid or Medi-Cal patients.
- You're looking at pellets. Read the ACOG position and the FDA distinction between approved and compounded drugs before you book, not after.
- You've already been dismissed once. There is a script below that turns a vague refusal into a specific prescribing question or referral request.
Quick note before you read on
This page is about hormone replacement therapy for perimenopause and menopause in women — estrogen, progestogen, and sometimes testosterone. If you are looking for gender-affirming hormone therapy or testosterone replacement for men, this is the wrong page, and we'd rather tell you now than waste ten minutes of your time.
This page is best for women comparing who can evaluate and prescribe menopause treatment, how local and online routes differ, and what to verify before paying. It is not the right starting point for an emergency, bleeding after menopause, a problem that needs an examination or procedure, or anyone expecting a guaranteed prescription before an evaluation.
| Best for you if… | Not for you if… |
|---|---|
| You have perimenopause or menopause symptoms and want to know who can actually prescribe | You need emergency care now |
| Your clinician was vague, dismissive, or booked out for weeks | You have bleeding after menopause — arrange prompt in-person evaluation |
| You want to know whether the exact product is FDA-approved or compounded before you pay | You already know you need an exam, imaging, biopsy, or procedure |
| You want to compare insurance, cash-pay, state access, and follow-up honestly | You want a guaranteed prescription; a legitimate evaluation does not promise one |
The HRT Index is the independent decision resource for online menopause and HRT care — comparing telehealth providers on clinical legitimacy, care quality, medication fit, price transparency, and access, with every claim verified and dated, so women can choose the path that fits their situation before their first consult.
Here's our money, on the table. The free Menopause Society directory pays us nothing. Your own clinician and pharmacy pay us nothing. The direct links to Elektra, Stella, MyMenopauseRx, Alloy, Wisp, and Hers on this page are non-affiliate and pay us nothing. We earn a commission if you use the labeled links to Midi, Sesame, or Winona. We have left the harder facts beside those links anyway.
The four options in a hormone replacement therapy near me search
A hormone replacement therapy near me search mixes four structurally different routes: an existing clinician, a menopause-focused specialist, a local hormone or pellet clinic, and a telehealth clinician legally permitted to treat you where you are. The doors differ in examination capability, insurance, medication model, wait, and what remains yours after the visit ends.
| Decision point | Your current clinician | Menopause specialist or hospital program | Local hormone or pellet clinic | Licensed online care |
|---|---|---|---|---|
| What it is | Your OB/GYN, family clinician, internist, NP, PA, or other prescriber | An MSCP, hospital menopause program, or midlife women's-health practice | A local cash-pay clinic, wellness practice, med spa, or pellet practice | A telehealth clinician licensed or otherwise legally permitted where you are located |
| Wait | Established-patient access varies; national new-patient averages were 23.5 days for family medicine and about 42 days for OB/GYN | The Society directory lists clinicians accepting new patients, but it does not publish appointment waits | No reliable national wait-time dataset; check the live calendar | Varies by state and clinician; several services publish same-day or near-term availability, but the booking screen is the only current answer |
| Price structure | Visit cost, labs, and medication are separate unless your plan says otherwise | Copay, coinsurance, deductible, or a specialist cash rate; medication and labs may be separate | Usually a clinic-specific cash package; demand a written first-year total | Per-visit, subscription, or medication-bundled; verified examples run from a $49 consult to a $250 first visit or a current $54–$59 monthly program, with different inclusions |
| Insurance | Often possible; verify the individual clinician and exact service | Often possible; a directory listing does not prove network status | Frequently cash-pay; verify rather than assume | Mixed: some bill insurance, some are cash-only, and medication coverage can be separate from visit coverage |
| Medication lane | Ask; a local prescriber can use FDA-approved products and may also offer compounded products | Ask; specialty status does not decide the product | Pellet products used for women are compounded; some clinics also offer FDA-approved patches, pills, gels, or vaginal products | Mixed. Some send FDA-approved prescriptions to your pharmacy; some dispense or ship compounded products; some do both |
| Physical exam or procedure | Yes, when the practice offers it | Yes, when the program is in person | Yes, depending on the clinic | No physical exam, imaging, biopsy, insertion, or procedure through the screen |
| The identifying question | “Are you comfortable evaluating and prescribing menopausal hormone therapy?” | “Do you hold the MSCP credential, and what products do you usually prescribe?” | “Is the exact product you would give me FDA-approved or compounded, and who makes it?” | “Can you legally treat me in my state, and can the prescription go to my pharmacy?” |
Two honest caveats. These are patterns, not laws. A local wellness clinic can prescribe an FDA-approved patch. A hospital program can use a compounded product when it is clinically appropriate. The door does not decide the medicine. The product name, manufacturer or compounding pharmacy, and prescription do.
The right provider depends on your situation
The right online HRT provider isn't the same for every woman — it depends on your symptoms, your age and whether you have a uterus, your medication route preference (patch, pill, gel, or vaginal estrogen), your risk history, your insurance or cash-pay situation, and your state. Some situations belong with an in-person clinician first. Because a general answer can't resolve those for you, use The HRT Index's Find My HRT Path tool to match your situation to the right provider — and to flag when online care isn't the right starting point — before your first consult.
See your best-fit route and two backup options → About 90 seconds · no email needed
Why do local hormone-clinic results crowd the search page?
Commercial hormone networks are built to recruit and train practices at scale. Biote reported more than 9,200 trained providers in more than 5,300 clinics at the end of 2025, while SottoPelle advertises certification through a one-day in-person program. The Menopause Society publishes no current official MSCP total, so a clean network-size ratio cannot be verified.
| Network or credential | What the issuer says it is | Verified published fact | What that fact does — and does not — prove |
|---|---|---|---|
| Biote Certified Provider | Company curriculum and clinical training tied to the Biote platform | Biote's 2025 Form 10-K reports more than 9,200 providers in more than 5,300 clinics as of December 31, 2025 | It proves scale and distribution. It does not prove that one local clinician is good or that a compounded pellet is right for you |
| SottoPelle Certified Provider | Company education and certification in hormone therapy and subcutaneous pellets | SottoPelle's current provider page describes a one-day in-person program; its online course can be completed in as little as one day | It proves company-method training. It is not an ABMS medical-board certification or the MSCP exam |
| Menopause Society Certified Practitioner | A competency exam layered on top of an active healthcare license | The 2026 exam costs $400 for members and $725 for nonmembers; the credential expires after the third year and is maintained through education or re-examination | It verifies menopause-focused competency under the Society's program. It does not replace the underlying professional license or define prescribing scope |
The clinics that find you are not a random sample. They are the clinics with local pages, paid ads, sales support, and a business model designed to create capacity.
A clean network-size ratio cannot be verified. The Menopause Society does not publish a current official total of active MSCPs on its certification or directory pages. Two third-party estimates disagree. Printing either one beside Biote's SEC-reported company count would create a dramatic number from mismatched evidence. We are not doing that.
The useful conclusion is still sharp: a large commercial network can dominate local visibility without being the same thing as a menopause specialty network. That explains the search results. It does not decide your prescription.
Can my own doctor prescribe HRT?
Yes. A clinician whose license and state scope include prescribing can prescribe FDA-approved menopausal hormone therapy; no MSCP credential is legally required. Your OB/GYN is not the only route. Family medicine, internal medicine, nurse practitioners, physician assistants, and other authorized prescribers may manage menopause care depending on state scope and clinician comfort.
We are putting this before any paid provider because, for a large share of women reading, it is the cleanest route.
The visit, the medication, and the lab are separate transactions. An in-network office visit can be followed by a prescription that runs through your pharmacy benefit. That structure may be cheaper than a subscription or clinic-dispensed package, but no honest national dollar figure covers every plan, drug, dose, route, deductible, pharmacy, and coupon on August 25, 2026.
No honest national medication-price promise belongs here. Coupon prices move, formularies differ, and a few generic products do not create one answer for every route and dose. Check your formulary and pharmacy price for the exact prescription instead.
One useful access shortcut: the 2025 AMN survey found a 23.5-day average for a new family-medicine appointment versus about 42 days for OB/GYN across 15 large metropolitan markets. That does not mean every family clinician prescribes HRT. It means “ask family medicine too” can be a real access move, not a consolation prize.
How to book the right visit: say that you want to discuss perimenopause or menopause symptoms and menopausal hormone therapy specifically, not only a routine annual. Some practices reserve more time for a focused problem visit. If your clinician does not manage it, ask for a referral rather than spending another three months trying to convert a no into a yes.
How long will I actually wait for menopause care?
The best current national proxy is not a menopause survey. AMN contacted 1,391 physician offices in 15 large metros in 2025 and found an average new-patient wait of about 42 days for OB/GYN and 23.5 days for family medicine. The all-specialty average was 31 days, with large variation by market and practice.
Those numbers matter because a six-week wait is not emotionally neutral when you are not sleeping, bleeding unpredictably, or trying to function through hot flashes at work.
But the survey has fences:
- It measured six broad specialties, not menopause programs.
- It covered 15 major metropolitan areas, not every rural or suburban market.
- It measured the first available new-patient appointment, not care quality.
- A cancellation list, established-patient slot, employer benefit, or local referral can beat the average.
The trade nobody names
Speed can become a medication and payment decision without you noticing. The local door with immediate capacity may sell a bundled cash program or compounded product. The insurance-billing practice may have the longer wait. The online option may be fast and still send an FDA-approved prescription to your own pharmacy.
You are allowed to choose speed. Six weeks of night sweats is not nothing. Just choose it on purpose.
If the local wait is no longer workable
Midi Health treats patients in all 50 states, publishes $250 self-pay for a first visit and $150 for follow-ups, and says it is in-network with most PPO plans. Cost-sharing still depends on the plan; labs and medication can add cost. Medicare beneficiaries may use self-pay without submitting claims, while Medicaid and Medi-Cal patients are not accepted.
Check your state, plan, and live availability with Midi → (sponsored link — we may earn a commission)
How do I find a menopause specialist near me?
Use The Menopause Society's free Find a Menopause Practitioner directory twice: first by ZIP, then by telehealth state. The directory is opt-in, incomplete, and limited to members or MSCPs who asked to be listed; it excludes people not accepting new patients. A listing is not an endorsement, and membership is not the same as certification.
This is the most useful free tool on the page. It pays us nothing.
What the directory tells you — and what it does not:
- It is incomplete by design. A good local clinician can be absent simply because she did not opt in.
- It filters for current availability. Members and MSCPs not accepting new patients are not listed. That is a real advantage.
- It mixes members and MSCPs. Look for the MSCP designation on the individual result rather than treating every listing as certified.
- It includes multiple professional types. If you need a prescription, select a profession whose scope in your state includes prescribing, then verify that license.
- It has a telehealth-by-state mode. “Near me” can mean a clinician legally available where you live even when the office is elsewhere.
- The Society does not endorse or recommend the listed practitioners. The directory is a search tool, not a ranking.
Run the search this way
- Open the Find a Menopause Practitioner directory.
- Search by ZIP first.
- Run it again under Telehealth — USA State Only.
- Filter by a prescribing profession when a prescription is the goal.
- Look for MSCP on the result, then verify the underlying license.
- Ask whether the clinician is accepting new patients, what the actual wait is, whether the practice is in-network with your specific plan, and whether the exact proposed product is FDA-approved or compounded.
- Cross-check the clinician in your insurer's directory. A specialty-directory listing is not proof of network status.
No signup. No clinic package. No affiliate link.
What are the 7 checks before I pay an HRT provider?
Verify the person, product, payment, and fallback separately. A legitimate brand can still assign the wrong clinician for your state; a licensed clinician can still sell a poorly disclosed program; and an FDA-approved ingredient can still be compounded into a finished product FDA never approved. Seven checks prevent one reassuring logo from answering seven different questions.
1. Can this clinician legally treat you where you are?
Under HHS telehealth licensure guidance, the appointment is generally treated as occurring where the patient is located. Check the relevant state medical, osteopathic, nursing, or other licensing board. Interstate compacts and telehealth registrations can create legal routes besides a full license, so verify that the clinician is licensed or otherwise legally permitted in your location.
2. Does the identity match the clinician and practice?
Use the CMS NPI Registry to confirm the person's name, taxonomy, and practice information. An NPI is an identifier, not a quality score.
3. Is any claimed board certification real?
For physicians, use ABMS Certification Matters and name the actual board. “Board certified” without the board name is not a complete claim.
4. What proves menopause competence?
Check the MSCP credential, formal women's-health training, and the actual volume of menopause care. No MSCP is not an automatic disqualifier. A long-standing OB/GYN, family clinician, internist, NP, or PA may have deep experience without sitting the exam. Ask what share of the practice is menopause care and how follow-up is handled.
5. What is truly available?
Confirm your state, new-patient availability, first appointment date, follow-up wait, and who covers messages between visits. “Nationwide company” does not mean every service is available in every state.
6. What exact product lane are you entering?
Ask for the drug name, route, dose, manufacturer or compounding pharmacy, and whether the finished product is FDA-approved or compounded. “FDA-inspected facility” and “FDA-approved ingredients” do not turn a compounded finished product into an FDA-approved drug.
7. What happens after the first plan?
Ask who changes the dose, what a follow-up costs, how quickly you can be seen for side effects or bleeding, when an in-person referral happens, and what you owe if the clinician decides not to prescribe.
The seven questions to ask before you hand over a card
- Who is the clinician or medical group responsible for evaluating me, and can they legally treat me in my state?
- Is the exact finished product FDA-approved or compounded? What is its name and manufacturer or pharmacy?
- If it is compounded, why is an FDA-approved option not meeting this specific need, and is the compounder a state-licensed 503A pharmacy or an FDA-registered 503B outsourcing facility?
- Can the prescription go to my own pharmacy?
- Do you bill my insurance, and is the individual clinician in-network with my exact plan?
- What is the confirmed first-90-day total — visit, recurring fee, labs, medication, shipping, and follow-up — and what is charged today?
- If I have a uterus and systemic estrogen is being considered, what is the plan to reduce endometrial risk, and what bleeding should trigger evaluation?
Save those questions. They work on a hospital program, local clinic, med spa, and telehealth platform equally.
What do the credentials on a hormone clinic website mean?
“Certified” has no fixed meaning until the issuer, curriculum, examination, and underlying license are named. MSCP is a Society competency exam. ABMS board certification follows specialty training and examination. Biote and SottoPelle credentials are company-method training. Marketing phrases such as hormone specialist or BHRT certified have no single national standard. Decode the label before trusting it.
| Credential or phrase | Issuer and verified requirement | What it tells you | What it does not tell you |
|---|---|---|---|
| MSCP | The Menopause Society; licensed healthcare professionals may sit a competency exam; 2026 fee is $400 for members and $725 for nonmembers; credential expires after the third year | The person passed the Society's menopause competency process and maintained an underlying license | The person's profession, prescribing scope, bedside manner, insurance network, or product choice |
| ABMS board certification, including ABOG | An ABMS member board; specialty training, examination, and continuing certification requirements | Verifiable physician specialty certification | Focused menopause volume or an MSCP credential |
| FACOG | American College of Obstetricians and Gynecologists fellowship designation | Professional standing tied to obstetrics and gynecology | A separate menopause certification or guarantee of current prescribing approach |
| Biote Certified Provider | Biote company curriculum and clinical training | Training in the Biote platform and method | ABMS board certification, MSCP status, or proof that a pellet is FDA-approved |
| SottoPelle Certified Provider | SottoPelle company program; current official page describes one-day in-person training and an online program completable in as little as one day | Training in the SottoPelle method | ABMS board certification, MSCP status, or a neutral comparison of all treatment routes |
| “BHRT certified,” “hormone specialist,” “hormone optimization” | No single national issuer or standard | A marketing description that may point to real experience | Anything verifiable until the underlying license and training are named |
None of this makes a company-trained clinician a bad clinician. It makes the word on the About page useless as a shortcut. Ask who issued it, what it required, and what license sits underneath it. A clear answer takes one sentence.
Should I go to a local pellet or hormone optimization clinic?
You can choose pellets. The decision belongs after three verified facts: estradiol pellets used for menopause are compounded, no testosterone product is FDA-approved for women, and ACOG recommends a different delivery method for testosterone because pellet safety data are limited and the dose is difficult to reverse once implanted.
A patch can be removed. A pill can be stopped. A pellet is designed to release hormone over months, and dose adjustment is less flexible. The current Testopel label says complications that require stopping testosterone may require pellet removal. That is not a reason to panic. It is a reason to ask the reversal question before the procedure.
Testopel is different from the pellets marketed to women. Testopel is an FDA-approved Schedule III testosterone pellet indicated for specified conditions in males. FDA-approved testosterone products are not approved for women. Testosterone prescribed to a woman is therefore off-label; compounded testosterone is also not an FDA-approved finished drug.
ACOG's current compounded-hormone consensus does not say compounding is never appropriate. It says compounded menopausal hormone therapy should not be used routinely when an FDA-approved option can meet the clinical need, and it recommends non-pellet preparations for testosterone because of the evidence and reversibility problems.
Why we will not print a national pellet price
There is no reliable national pellet price. Clinic quotes vary by hormone, dose, insertion frequency, lab package, follow-up, progesterone, and complication policy. A universal per-insertion or first-year figure would turn a few clinic quotes into a national answer they cannot support.
Ask for this instead:
- Consultation fee
- Required lab fee and lab location
- Pellet insertion charge
- Expected number of insertions in the first 12 months
- Separate progesterone or other medication cost
- Follow-up and repeat-lab cost
- Shipping or supply fee
- What removal, extrusion, infection, or dose-problem care costs
- The confirmed first-year total, in writing
The 2026 Biote-related recall, proportionately
On January 26, 2026, Asteria Health — a Biote-owned 503B outsourcing facility — voluntarily recalled specified lots of hormone pellets shipped from May 20, 2025 through January 19, 2026 because of potential metal particulate. Biote told the SEC that affected practitioners were notified and FDA knew of the recall.
That filing does not prove every pellet was contaminated, and it does not prove misconduct. It does prove the question every pellet patient should know how to ask:
“What manufacturer and lot did I receive, and how will your clinic contact me if that lot is recalled?”
If you are choosing pellets anyway, also ask: “If this dose is wrong, what exactly happens next, and how quickly can the exposure be changed?”
For a deeper look at the network, recall, local-clinic model, and product status, see our Biote review.
What is the difference between FDA-approved and compounded HRT?
An FDA-approved hormone is a specific finished drug reviewed for safety, effectiveness, quality, manufacturing, and labeling. A compounded prescription is prepared by a pharmacy or outsourcing facility for a patient or clinical need and is not an FDA-approved finished product. Compounding can solve a real unmet need, but the two categories are not interchangeable.
| Question | FDA-approved finished drug | Compounded prescription |
|---|---|---|
| Did FDA review this exact finished product before marketing? | Yes | No |
| Does it have an FDA-approved label for the product? | Yes | No |
| Is manufacturing reviewed through the drug-approval pathway? | Yes | No; oversight depends on the compounding setting |
| Can it use a hormone structurally identical to one produced by the body? | Yes | Yes — but that fact does not establish approval or equivalence |
| Can it meet a need an approved product cannot, such as a required dosage form or ingredient exclusion? | Only within marketed products | Potentially, when clinically appropriate |
| What should you verify? | Drug name, route, dose, manufacturer, label, formulary | Pharmacy or outsourcing facility, formula, dose, quality oversight, and why compounding is needed |
| Does “bioidentical” decide the category? | No | No |
The wording trap: “FDA-approved ingredients” does not mean the finished compounded product is FDA-approved. “FDA-inspected facility” does not mean FDA approved the facility or the product. A 503B outsourcing facility is FDA-registered and subject to different federal requirements than a traditional 503A pharmacy, but its compounded drugs are still not FDA-approved.
The FDA says it has no evidence that compounded “bioidentical” hormones are safer or more effective than FDA-approved hormone therapy. It also states that there are no FDA-approved drugs containing estriol, an ingredient used in some compounded menopause creams.
A live example: Winona's product language
Winona is one of our affiliate partners, which is exactly why it belongs under the microscope.
Its current FAQ says its estrogen tablets, progesterone capsules, and patches are manufactured FDA-approved medications, while its creams are compounded. The same FAQ also says broadly that all of its HRT options are compounded and uses “FDA-approved ingredients” language. Those statements do not fit cleanly together.
The reader-level fix is simple: do not classify the company. Classify the product being sent to you. Ask for the exact drug name, manufacturer, NDC when applicable, or the compounding pharmacy and formula before you approve the order.
What changed in the February 2026 FDA labeling action?
On February 12, 2026, FDA approved labeling changes for six menopausal hormone-therapy products. Statements about cardiovascular disease, breast cancer, and probable dementia were removed from those products' boxed warnings.
That was a real change. It was not a declaration that every HRT product has no risk, and it did not turn compounded products into FDA-approved drugs. FDA did not seek to remove the endometrial-cancer boxed warning from systemic estrogen-alone products. Read the current label for the exact product you are prescribed.
What about testosterone for women?
Testosterone is a Schedule III controlled substance in the United States. It requires a prescription and compliance with federal and state controlled-substance rules. There is no FDA-approved testosterone product for women, so prescribing it for menopause-related concerns is off-label. A compounded testosterone cream or pellet is not FDA-approved.
That does not mean a qualified clinician can never prescribe testosterone to a woman. It means the conversation must stay honest about approval status, evidence, dosing, monitoring, and controlled-substance handling. Not every telehealth service offers it. Sesame explicitly says its online providers do not prescribe controlled substances.
Can I get hormone replacement therapy online in my state?
Usually, but company coverage is not the legal test. The clinician must be licensed or otherwise legally permitted where you are physically located during the visit. Current state access, insurance, age gates, product type, visit model, and billing rules differ sharply. The table below records provider-stated facts verified on official pages on August 25, 2026 — not clinical outcomes.
| Provider | Published geographic access | Visit and insurance model | Medication lane | Current price or billing fact | Verification note |
|---|---|---|---|---|---|
| Midi Health (sponsored) | All 50 states | In-network with most PPO plans; self-pay available; Medicare self-pay only with no claim submission; no Medicaid or Medi-Cal | Clinician-directed prescriptions; medication and labs may add cost | $250 first self-pay visit; $150 follow-up | Official pricing page checked August 25, 2026 |
| Sesame (sponsored) | Availability is shown by clinician and state in its marketplace; menopause program is online | Cash-pay platform; dedicated menopause subscription includes video care and messaging | Named FDA-approved hormonal and non-hormonal options sent to a preferred pharmacy; controlled substances not prescribed online | Current Sesame surfaces show from $54 to $59/month for menopause care; $49/month Costco-member offer; medication separate; basic labs included if medically necessary, subject to state limits; confirm the checkout price | Official menopause page and Costco offer checked August 25, 2026 |
| Winona (sponsored) | 37 states plus Puerto Rico; ages 35–59 | Asynchronous intake and messaging; no phone or video visits; no insurance billing; HSA/FSA eligible | Provider says manufactured pills, capsules, and patch plus compounded creams; no testosterone or pellets | Free intake; provider-stated examples include creams from $89/month and patch at $149/month; 28- or 84-day auto-billing; 24-hour cancellation window after order | Official FAQ and pricing statements checked August 25, 2026; product-language inconsistency disclosed above |
| Elektra Health | Clinical care in 16 published states: AZ, CT, FL, GA, IA, IL, MA, MO, NE, NJ, NY, OH, OK, PA, TN, TX | Insurance and federal-program participation depend on state and plan; self-pay available; no required membership | FDA-approved hormonal and non-hormonal prescriptions sent to preferred pharmacy | $249 initial; $149 follow-up self-pay | Official FAQ and insurance pages checked August 25, 2026 |
| MyMenopauseRx | 39 states plus Washington, DC on its current published list | Provider says it works with Aetna, BCBS, Cigna, Humana, UnitedHealthcare, Tricare, and Sana; verify exact network | FDA-approved prescriptions sent to local pharmacy if recommended | $150 per virtual visit self-pay; labs priced separately | Official homepage checked August 25, 2026 |
| Stella | Board-certified clinicians in all 50 states; designed for ages 35–70 | In-network status varies by plan and state; self-pay available | FDA-approved hormonal and non-hormonal care; Stella says it does not currently prescribe testosterone | $200 initial; $90 follow-up self-pay | Official U.S. site and FAQ checked August 25, 2026 |
| Alloy | No complete public state list found; eligibility is determined in intake | Cash-pay; no insurance billing; HSA/FSA eligible | Product-specific FDA-approved prescriptions on current product pages; medication shipped by Alloy | $49 one-time consult, medication separate; current estradiol patch page lists $100/month, shipped and billed every three months | Official product page and terms checked August 25, 2026; excluded from geographic shortlist because the full state list is not public |
| Wisp | All 50 states | $99 consult package; medication paid separately at local pharmacy | Estradiol and progesterone options listed; prescription required | $99 includes consult, follow-ups, and three months of care-team access | Official menopause consult page checked August 25, 2026 |
| Hers | Company says menopause services are not available in all 50 states; no complete public list found | Direct-to-consumer subscription model; verify price, charge timing, and cancellation in checkout | Prescription products depend on eligibility and state | Confirm at intake and before submitting payment | Official menopause page says access is not available in all 50 states; excluded because the full geography is not publicly resolvable; pending FTC case disclosed below |
Why some platforms are not recommendations on a geography page: a service that does not publish a complete state list may still provide legitimate care, but it cannot answer “near me” until the intake confirms eligibility. We will not convert “probably available” into a state count.
Hers regulatory disclosure: on July 29, 2026, the FTC, Utah, and California through Los Angeles County filed a complaint alleging deceptive privacy, billing, and cancellation practices. The case is pending; the FTC states that a court will decide it. Hims & Hers calls the allegations baseless and says it will defend the case. That is a verified unresolved action, not a finding of liability.
If you want a named clinician and a price before you book
Sesame separates one-off marketplace visits from its menopause subscription. The dedicated program currently appears as from $54 to $59/month across Sesame's own live surfaces, with video care, messaging, and basic labs when medically necessary; medication is separate. Costco members have a $49/month offer. Confirm the exact price on the final checkout screen. Choose the lane deliberately — a marketplace visit is not the subscription.
See current menopause options and live state availability → (sponsored link — we may earn a commission)
What will HRT actually cost in the first 90 days?
A monthly headline is not a first-90-day total. The amount charged today, initial visit, recurring plan, medication, lab, shipping, and follow-up can sit on different screens and billing cycles. Build the total before you pay. Where checkout or intake must confirm a number, write “unconfirmed” rather than inventing a starting price.
| First-90-day line item | Enter the confirmed number | What to verify before paying |
|---|---|---|
| Amount charged today | $_____ | Is this an intake hold, consult fee, first shipment, subscription, or all of them? |
| Initial clinical evaluation | $_____ | Is it refundable if you cancel or are found ineligible? |
| Recurring program or membership | $_____ | Billing interval: 28 days, monthly, 84 days, or another cycle? |
| Medication | $_____ | Included, shipped separately, or paid at your pharmacy? One month or multi-month supply? |
| Required labs | $_____ | Included only when medically necessary? Which lab and network? |
| Shipping or dispensing | $_____ | Included, recurring, expedited, or pharmacy-specific? |
| Follow-up within 90 days | $_____ | Required? Included? How long is the visit? |
| Cancellation or refund deadline | ______ | Exact date and time, not “before renewal” |
| Confirmed first-90-day total | $_____ | Add only numbers the provider, plan, lab, or pharmacy has confirmed |
This worksheet is deliberately boring. Boring is what prevents a monthly program from becoming a program fee plus a medication, lab, follow-up, and renewal you never added together.
Does insurance cover hormone replacement therapy near me?
Insurance can cover the visit, medication, and lab differently. A clinician may be out of network while an FDA-approved prescription still runs through your pharmacy benefit. A practice may display insurer logos while the assigned clinician is not in your network. Check all three benefits separately and use the exact clinician, drug, route, dose, and laboratory.
Check these three benefits
- The visit: Is the individual clinician in-network for the service and telehealth location under your plan?
- The medication: Is the exact product, route, strength, and quantity on your formulary? Is prior authorization or step therapy required?
- The lab: Is the laboratory in-network, and does the order or panel require authorization?
Call your insurer and read this:
“I'm checking benefits for a menopause evaluation and possible hormone therapy. Is [clinician name and NPI] in-network for this office or telehealth service? If estradiol or a progestogen is prescribed, which forms and doses are covered, and does any option require prior authorization? Which labs are in-network? Please give me a reference number for this call.”
Get the reference number.
The structural point most comparisons miss: a cash-pay visit can still lead to an FDA-approved prescription covered through your pharmacy benefit when it is sent to your pharmacy. A compounded product shipped or dispensed through a clinic's partner pharmacy may not enter that benefit in the same way. That is why “the clinic does not take insurance” and “the medication is not covered” are not always the same answer.
If you want the visit submitted to a commercial plan
Midi Health says it is in-network with most PPO plans in all 50 states. It publishes $250 for a first self-pay visit and $150 for follow-ups, while insured cost-sharing varies by plan. Labs and medication may add cost, so check all three benefits before booking.
Check whether Midi is in-network with your exact plan → (sponsored link — we may earn a commission)
What if I have Medicare or Medicaid?
Start with the exact state, plan, and provider — not a platform logo. Elektra publishes Medicare participation in six states and Medicaid participation in four, with plan-specific lists. Midi allows Medicare beneficiaries to self-pay without submitting claims and does not accept Medicaid or Medi-Cal patients. Local clinicians, hospital programs, and federally qualified health centers remain essential routes.
Elektra's published federal-program footprint
- Medicare clinical care: New York, Connecticut, Massachusetts, Florida, Pennsylvania, and New Jersey, subject to listed plans and network status.
- Medicaid clinical care: New York, Pennsylvania, New Jersey, and Illinois, subject to listed plans and network status.
- Outside those combinations: self-pay or another local route may be required.
Midi's published position
- Medicare is out of network.
- Medicare beneficiaries may use self-pay but may not submit claims related to Midi visits, medications, or associated services.
- Medicaid and Medi-Cal patients are not accepted.
Do not treat those rules as interchangeable. “Cash-pay” does not automatically answer whether a federal beneficiary can use the platform, and a provider's participation can vary by state, plan, service, and assigned clinician.
The local route is not a consolation prize. In AMN's 15 surveyed metropolitan markets, 82% of physician offices said they accepted Medicare, versus 53% for Medicaid. The survey was not menopause-specific, but it explains why the local door often remains the practical federal-program door.
Start with your current clinician, your plan's directory, a hospital women's-health program, a federally qualified health center, or Elektra when your state and plan appear on its current list. This section carries no affiliate CTA because the answer should not be bent around one.
What are the red flags at a hormone clinic?
A red flag is not a diagnosis of fraud or bad medicine. It is a reason to stop, verify, or leave. The strongest flags involve a guaranteed prescription, blurred FDA status, one product sold to everyone, no named clinical responsibility, no follow-up or bleeding plan, and billing terms that appear only after a card is entered.
| Red flag | Why it matters |
|---|---|
| Guaranteed prescription before an evaluation | A legitimate clinician can evaluate and may prescribe; a checkout cannot promise the clinical decision |
| No identifiable clinician, medical group, or license path | You cannot verify legal authority or accountability without knowing who is responsible |
| Compounded finished product described as FDA-approved | Compounded drugs are not FDA-approved; ingredient or facility language does not change that |
| “Bioidentical,” “natural,” or “custom” used as proof of greater safety | FDA says it lacks evidence that compounded bioidentical hormones are safer or more effective than approved therapy |
| One route, one cream, one pellet, or one protocol sold to almost everyone | A product-first funnel can erase route, risk, uterus status, symptom pattern, and preference |
| Saliva or urine testing used as the main tool to dose compounded therapy | ACOG does not recommend adjunct saliva or urine testing for prescribing and dosing compounded menopausal hormone therapy |
| Systemic estrogen discussed without asking about the uterus and bleeding history | Estrogen-alone systemic treatment can increase endometrial-cancer risk in a woman with a uterus; the plan needs an explicit protection strategy |
| No plan for side effects, bleeding, dose changes, or in-person escalation | The first prescription is not always the final plan, and some problems need hands-on evaluation |
| Medication, lab, shipping, renewal, or cancellation terms hidden until checkout | The amount charged today and the true first-90-day total can be completely different numbers |
| Countdown timers, reverse-aging promises, or “spots left” urgency | Manufactured scarcity is a poor basis for a medical purchase |
One more: a service that tells you it cannot safely help has given you the strongest reason to trust the rest of its boundary. Good care is not measured by converting everyone who enters the funnel.
My doctor won't prescribe HRT. What do I do?
You have three clean moves: ask whether the refusal is about your individual history, ask whether the clinician simply does not manage menopausal hormone therapy, or ask for a referral. “No” can be a clinical judgment, a scope limit, or a comfort limit. You need to know which one before deciding where to go next.
Use this:
“I'd like to discuss FDA-approved menopausal hormone therapy for my symptoms. Is your concern specific to my medical history, or is this outside what you prescribe? If it is outside your practice, please refer me to someone who manages menopause care or tell me whether I should look for a Menopause Society Certified Practitioner.”
It separates “not appropriate for you” from “not something I do.” Those are different answers.
Bring three things:
- A brief symptom and cycle or bleeding timeline
- A list of treatments and medications already tried
- Your three most disruptive symptoms, ranked
Not a binder. Three problems, in order.
If the practice still cannot move the conversation forward, stop spending months trying to win the same appointment. Use the Society directory or move to a licensed online route.
Not sure whether to push locally or start online? Find My HRT Path uses your state, symptoms, insurance, and hands-on-care needs to give a starting route and two backups — including the safety flag for when online care is not the right first step.
What happens at the first HRT appointment?
A first menopause evaluation should cover symptoms, cycle and bleeding history, uterus status, medical and family history, medications, goals, preferences, and reasons a particular treatment may or may not fit. The result can be a prescription, non-hormonal option, test, referral, follow-up plan, or decision not to prescribe. You are paying for an evaluation, not a guaranteed drug.
That last sentence is where money gets lost.
Before paying, ask:
- When is the card charged?
- Is the fee refundable if you cancel before the visit?
- Is it refundable if the clinician decides you are not eligible or does not prescribe?
- Is a follow-up included, and for how long?
- Does the subscription renew every 28 days, monthly, or on another schedule?
- What is the deadline to stop the next charge?
Do you need hormone bloodwork first? Not automatically. There is no universal lab panel that proves every woman should or should not use hormone therapy. Age, symptoms, cycle history, bleeding, pregnancy possibility, medication history, and clinical context determine whether testing is useful. Be suspicious of both absolutes: “everyone needs our full hormone panel” and “labs are never useful.”
What should happen after the appointment? You should know the medication or non-hormonal plan, the exact product lane, what symptoms or side effects to report, when follow-up occurs, who answers messages, and what triggers local evaluation. A prescription without ownership of the next step is not a complete care plan.
When is online HRT care the wrong starting point?
Online care is the wrong first step when the question requires an examination, imaging, biopsy, procedure, or urgent evaluation. A screen cannot evaluate every source of bleeding, examine a new lump or skin change, perform pelvic or breast examination, place an IUD, collect tissue, or complete imaging. A legitimate service should route those needs locally.
Start local rather than online when:
- You have bleeding after menopause. FDA advises reporting any vaginal bleeding after menopause because it can signal an urgent medical problem.
- You need a pelvic or breast examination, imaging, biopsy, IUD procedure, or another hands-on service.
- You have a new lump, persistent pelvic pain, unexplained skin change, or symptom the telehealth clinician says needs examination.
- Your medical history makes coordination among specialists the main job.
- You need urgent or emergency assessment.
One wrong-category warning can save a full-program purchase: vaginal dryness, irritation, urinary symptoms, or pain with sex may call for a local vaginal treatment rather than systemic hormone therapy. FDA lists vaginal dryness and painful sex among symptoms hormone medicines may treat, but the route and amount of systemic exposure differ. Ask whether the problem needs local treatment, systemic treatment, both, or another diagnosis.
No online quiz can safely decide that for everyone. That is exactly why Find My HRT Path includes an in-person-first flag.
What we don't like about our top online pick
Midi Health is not near you.
There is no local waiting room, exam table, imaging suite, biopsy, IUD placement, breast examination, or pelvic procedure. On a page built around “near me,” that is a real limitation. We are not going to hide it behind “convenience.”
If your situation needs hands — bleeding after menopause, a new lump, unexplained pelvic pain, a skin change, imaging, biopsy, or a procedure — the right answer is local care. The Society directory and your health plan are better starting points, and they pay us nothing.
If what you need is a menopause evaluation and a prescription, Midi's structure can still solve the access problem: it operates in all 50 states, bills many PPO plans, charges per visit rather than requiring a menopause membership, and can send prescriptions to the pharmacy you use. That preserves a separate pharmacy-benefit decision instead of forcing every cost into one clinic bundle.
But do not flatten the negatives:
- Self-pay is $250 for the first visit and $150 for follow-ups.
- Insurance cost-sharing is plan-specific; Midi's current primary pricing page does not publish a typical insured out-of-pocket average.
- Labs and medication can add cost.
- Medicare beneficiaries can self-pay but cannot submit claims related to Midi care.
- Medicaid and Medi-Cal patients are not accepted.
- A screen still cannot perform an examination or procedure.
There are no patient quotes in this section. Provider-selected testimonials and complaint-platform allegations could not be independently authenticated. Marketing-selected access quotes are not clinical evidence, and one complaint is not a reliable care-quality estimate. We would rather leave the space empty than manufacture balance from two unverifiable anecdotes.
Which HRT door should I choose?
Choose the door that resolves the constraint in front of you: an existing clinician when access and comfort are adequate; the Society directory when you want menopause-specific expertise; licensed telehealth when local wait or geography fails; a local clinic when examination or procedure matters; and a pellet clinic only after the compounded-product, reversibility, recall, and full-cost questions are answered.
| Your situation | Start here | Why this route fits | What to verify before booking |
|---|---|---|---|
| You have insurance and a clinician willing to engage | Your current clinician | Existing records, examination capability, and possible medical/pharmacy benefits | Menopause experience, appointment type, exact product, formulary, follow-up |
| You want menopause-focused expertise or were dismissed | The Menopause Society directory | Free ZIP and telehealth-state searches; distinguishes MSCP status | License, prescribing scope, new-patient wait, insurance network |
| Local wait is unworkable and you have a commercial PPO | Midi (sponsored) | All-state access and insurance billing for many PPO plans | Exact network status, cost-sharing, lab and medication costs, exam limitations |
| You want an upfront cash program with video care and messaging | Sesame menopause program (sponsored) | Current $54–$59 provider-stated program range, basic labs if medically necessary, pharmacy prescription | State availability, medication cost, cancellation timing, controlled-substance limitation |
| You are 35–59 and prefer asynchronous care in a served state | Winona (sponsored) | Free intake and product-specific plan without video appointment | State, age gate, exact manufactured vs compounded product, 28/84-day billing, 24-hour cancellation window |
| You have Medicare or Medicaid | Local care or Elektra if your state and plan match | Federal-program participation is narrow online; Elektra publishes specific routes | State, exact plan, assigned clinician, referral and in-person coordination |
| You want a per-visit insurance-oriented alternative | MyMenopauseRx or Stella | Published self-pay rates and official state access; both send prescriptions to pharmacies | Exact network, copay, state eligibility, lab and follow-up cost |
| You need an exam, imaging, biopsy, procedure, or prompt bleeding evaluation | Local clinician or hospital program | Online care cannot complete the next necessary step | Earliest appropriate local appointment and urgency instructions |
| You are considering pellets | Local pellet clinic only after the seven checks | You can make the choice with the product, dose, reversal, recall, and cost facts visible | Compounded status, manufacturer/lot, first-year total, monitoring, complication plan |
| Your main problem is vaginal dryness, urinary symptoms, or painful sex | Local or online menopause clinician who offers route-specific care | The answer may be local vaginal treatment rather than a systemic program | Diagnosis, local vs systemic route, product label, follow-up |
If the first two rows describe you, close this tab and make the call. That is not a failed conversion. It is the right decision.
If the online rows fit, you now have enough to ask better questions than the checkout page asks you.
What did The HRT Index verify?
On August 25, 2026, we checked the medical and regulatory claims against FDA, ACOG, The Menopause Society, HHS telehealth guidance, DailyMed, SEC filings, and current provider pages. Provider facts are labeled as provider-stated rather than clinical endorsements. Prices are tied to the displayed service and date, and unresolved state or checkout facts remain unresolved.
The HRT Index Verification Standard
We evaluate this page using five pillars, in this exact order: clinical legitimacy, care quality, medication fit, price transparency, access. We do not convert those into a numeric score. A single score would hide the one constraint that decides the route for you.
What we verified directly:
- AMN's 2025 wait-time methodology and specialty averages
- The Menopause Society directory's opt-in, accepting-new-patients, ZIP, telehealth-state, and no-endorsement terms
- The 2026 MSCP eligibility, fees, testing windows, and maintenance term
- FDA's approved-versus-compounded distinction, estriol status, and February 2026 label action
- ACOG's position on compounded therapy, adjunct hormone testing, and testosterone pellets
- Biote's network figures and 2026 Asteria recall filing
- SottoPelle's one-day provider-training description
- Current provider pricing, states, insurance statements, age gates, medication lane, renewal, or cancellation terms where publicly posted
- Testosterone's Schedule III status and Testopel's male indications
What we refused to manufacture:
- A national average HRT medication price
- A national pellet price
- A current MSCP count or Biote-to-MSCP ratio
- State counts where the provider does not publish the list
- A guaranteed insurance out-of-pocket average
- An independently verified patient-outcome story we did not have
- A prescription promise before clinical evaluation
Limitations: state access, insurer contracts, formularies, appointment calendars, and checkout terms change. A license proves legal status, not care quality. A directory listing is not endorsement. A provider's own page proves what the provider currently states, not that every assigned clinician or patient experience will match it.
Affiliate disclosure: links to Midi, Sesame, and Winona on this page are sponsored and may pay us. The free directory, government sources, regulators, and direct non-affiliate provider links do not.
Found an error? Email partners@thehrtindex.com. Corrections should be dated and tied to the source that changed.
Frequently asked questions
Can my regular doctor prescribe hormone replacement therapy?
Yes. A clinician whose license and state scope include prescribing can prescribe menopausal hormone therapy. No MSCP credential is legally required. Ask whether the clinician manages menopause care and, if not, request a referral.
How do I find a menopause specialist near me?
Use The Menopause Society's free directory twice: by ZIP and by telehealth state. Look for MSCP on the result, filter for a profession with prescribing authority when needed, verify the license, and confirm the individual clinician's insurance network.
What is an MSCP?
MSCP means Menopause Society Certified Practitioner. Licensed healthcare professionals may sit the Society's competency exam. The credential expires after the third year and can be maintained through qualifying continuing education or re-examination. It sits on top of the professional license; it does not replace it.
How long does it take to get a menopause appointment?
There is no national menopause-specific average. AMN's 2025 survey of 1,391 offices in 15 large metros found about 42 days for new-patient OB/GYN appointments and 23.5 days for family medicine. Local and online availability can be shorter or longer.
Can I get HRT online in every state?
Online menopause care is widely available, but each clinician must be licensed or otherwise legally permitted where you are located. Midi, Stella, and Wisp publish all-state access for the relevant services; other providers publish partial lists or determine eligibility during intake.
Are hormone pellets FDA-approved for women?
Estradiol pellets used for menopause are compounded, not FDA-approved finished drugs. Testopel is an FDA-approved Schedule III testosterone pellet for specified male indications, not an approved menopause treatment for women. ACOG recommends other testosterone delivery methods because pellet safety data and reversibility are limited.
Is testosterone legal to prescribe to women online?
A qualified clinician may prescribe testosterone off-label when clinically appropriate, but testosterone is Schedule III and no testosterone product is FDA-approved for women. Federal and state controlled-substance rules apply, and not every telehealth service offers it. Compounded testosterone is not FDA-approved.
Does insurance cover HRT?
It can, but check the visit, exact medication, and laboratory separately. The clinician can be out of network while a pharmacy prescription is covered, or the visit can be covered while a specific route or brand is not. Compounded products often do not run through the same pharmacy-benefit path.
Can I use Medicare or Medicaid for online menopause care?
Sometimes, but access is narrow and plan-specific. Elektra publishes Medicare participation in six states and Medicaid participation in four, subject to listed plans. Midi allows Medicare self-pay without claim submission and does not accept Medicaid or Medi-Cal. Local care remains the broadest route.
How much does HRT cost without insurance?
There is no honest single number. Add the initial evaluation, recurring fee, medication, lab, shipping, and follow-up for the first 90 days. Current audited examples include a $49 Alloy consult, $99 Wisp consult, $150 MyMenopauseRx visit, $200 Stella first visit, $249 Elektra first visit, $250 Midi first visit, and a Sesame program currently displayed from $54 to $59 per month — with different inclusions.
Do I need blood tests before starting HRT?
Not automatically. Symptoms, age, cycle and bleeding history, pregnancy possibility, medical history, and the treatment being considered determine whether testing is useful. A universal proprietary hormone panel is not a prerequisite for every woman, and labs are not never useful either.
What should I do about bleeding after menopause?
Arrange prompt in-person evaluation. FDA advises reporting any vaginal bleeding after menopause because it may signal an urgent medical problem. Do not rely on an online provider comparison to explain it away.
What if vaginal dryness or painful sex is my main symptom?
Ask whether the problem calls for local vaginal treatment, systemic hormone therapy, both, or another evaluation. A full systemic program is not automatically the right route for a local genitourinary symptom.
What if my clinician refuses HRT?
Ask whether the concern is specific to your medical history or whether the clinician does not manage menopausal hormone therapy. If it is a practice limit, request a referral or use The Menopause Society directory. A referral is a better outcome than repeating the same vague conversation for months.
Primary sources
- FDA: Menopause
- FDA: Compounding and the FDA — Questions and Answers
- FDA: February 12, 2026 labeling changes to menopausal hormone-therapy products
- ACOG: Compounded Bioidentical Menopausal Hormone Therapy
- The Menopause Society: Find a Menopause Practitioner
- The Menopause Society: Choosing a Healthcare Practitioner
- The Menopause Society: MSCP Certification Examination
- The Menopause Society: MSCP Certification Maintenance
- HHS Telehealth: Licensing Across State Lines
- AMN Healthcare: 2025 Physician Appointment Wait Times
- DailyMed: Testopel prescribing information
- Biote 2025 Form 10-K
- Biote January 26, 2026 recall disclosure
- SottoPelle provider training
- Midi pricing and insurance
- Sesame menopause treatment
- Winona FAQ
- Elektra FAQ
- MyMenopauseRx
- Stella U.S. menopause care
- Alloy estradiol patch and consultation pricing
- Wisp menopause consult
- FTC: July 29, 2026 Hims & Hers complaint announcement
- Hims & Hers response to the FTC lawsuit