Menopause Telehealth Compared: Midi, Evernow, Alloy, More

Creator: Project M
Published: 2026-08-24

Updated August 2026

For decades, the hardest part of peri/menopause care was finding anyone trained in it. You could have insurance, a good doctor, and a list of symptoms, and still leave the appointment with nothing.

That has changed fast. There is now a wave of clinics built for nothing but this transition, staffed by clinicians who chose it as their specialty, reachable from your kitchen table.

So the problem has flipped. The question is no longer whether specialized care exists. It is which clinic fits your insurance, your state, and what you want from care. This guide compares the five biggest names, evenly and without a horse in the race.

Menopause telehealth is virtual medical care from clinicians trained in perimenopause and menopause, who evaluate your symptoms by video or online visit and can prescribe hormone therapy, non-hormonal medications, and order labs where needed.

Key takeaways

Only 31.3% of OB/GYN residency programs report having a menopause curriculum, which is the gap these clinics were built to fill. Source: Menopause journal, 2023 (PMID 37738034)
The main dividing line is payment model: Midi and Gennev work with insurance, while Alloy, Winona, and (mostly) Evernow use membership or cash-pay models.
All five can prescribe hormone therapy where appropriate. They differ on visit style, state coverage, and extras like dietitians or coaching.
Telehealth handles the prescription layer well. It does not replace physical exams, cancer screenings, or a local doctor who knows your full history.

Why menopause-only clinics exist

These clinics exist because most doctors were never trained in this. A 2023 survey found that just 31.3% of OB/GYN residency programs had a menopause curriculum. Source: Menopause journal, 2023 (PMID 37738034)

That gap left millions of women describing brain fog, sleep changes, and mood swings to clinicians with no framework for them. So women went looking for specialists directly. US searches for "menopause specialist" rose roughly sixfold between 2021 and 2025. Source: Forty Fifty, The State of Midlife report

Read that trend plainly: women stopped expecting their GP to know. Investors noticed too. Midi Health closed a $100 million round in early 2026, at a valuation above $1 billion, to scale its AI-supported platform. Source: Midi Health press release, February 2026

What menopause telehealth actually is

A menopause telehealth visit is a real medical appointment, done by video or online intake instead of in an office. You describe your symptoms and history, and a licensed clinician builds a treatment plan.

Most of these clinics can prescribe:

Hormone therapy (HRT): estradiol patches, pills, gels, or sprays, plus progesterone, and vaginal estrogen for dryness
Non-hormonal options: medications such as low-dose paroxetine for hot flashes, plus sleep and mood support
Labs: some order bloodwork through local labs when it changes the plan; others follow guidelines that do not require hormone testing to start treatment

Prescriptions go to your pharmacy or ship to your door. Follow-up usually happens through messaging or short check-in visits.

The comparison table

Details and prices below are current as of August 2026. Offerings, prices, and state coverage change often, so confirm on each company's site before you book. Costs shown are approximate cash-pay figures; with insurance you typically pay your plan's copay and deductible instead.

Provider	Care model	Payment model	Typical cost	Strongest fit	Considerations
Midi Health	Video visits with clinicians specializing in midlife women's health; labs when needed	Accepts many major commercial insurance plans; available in all 50 states	Copay with insurance; around $250 initial and $150 follow-up without it	Women who want insurance-covered specialist visits	Does not work with Medicare or Medicaid; visit-based rather than unlimited messaging
Evernow	Menopause-focused prescriber network; membership with ongoing messaging, or single visits	Membership-based; some video visits and medications may be insurance-eligible	Membership around $35 to $49 per month; single visits around $150 cash	Women who want continuous message-based access to a menopause prescriber	Not available in every state; membership itself is typically out of pocket
Alloy	Online intake reviewed by menopause-trained doctors; prescriptions shipped; unlimited messaging	Cash-pay with FSA/HSA accepted; no insurance	$49 one-time consult; medications around $35 to $75 per month	Women who know they want HRT and value speed and home delivery	No video visit by default; medications ship in multi-month supplies
Gennev	Video visits with OB/GYNs plus registered dietitians and health coaches	In-network with some commercial insurance plans; cash-pay also available	Copay in network; around $199 initial and $149 follow-up cash	Women who want a whole-picture plan including nutrition and lifestyle	Insurance coverage depends on your specific plan; check before booking
Winona	Online intake with physician review; compounded and standard HRT shipped; free ongoing follow-ups	Cash-pay only; FSA/HSA eligible	Free consult; medications around $39 to $149 per month	Women comfortable with cash-pay who want compounded formats like creams	Not available in about a dozen states; no insurance billing

Cost sources: Midi pricing page, Evernow FAQ, Alloy consult page, Hormone Therapy Hub on Gennev pricing, and Innerbody's Winona review.

Short profiles of each provider

Midi Health

Midi is the largest of the group and the closest to a traditional clinic experience, delivered virtually. Its clinicians specialize in women's midlife health, it operates in all 50 states, and it bills many major commercial insurance plans, which is rare in this category. Beyond hormone therapy it covers sleep, mood, sexual health, and preventive midlife care. Source: Midi Health

What reviewers say: around 4 stars on Trustpilot across 1,000+ reviews. The praise: finally feeling heard. The complaints: surprise bills and slow message replies. Source: Midi Health review roundup
Track record: founded 2021; over $250 million raised. Backers include Serena Williams' Serena Ventures, with earlier investment from Tory Burch and Amy Schumer. Source: Fierce Healthcare
Best for: women who want a midlife specialist their insurance actually covers.

Evernow

Evernow is built around ongoing access rather than one-off appointments. Membership gives you continuous messaging with a menopause-certified prescriber, with single visits also available. It prescribes estradiol in several forms, progesterone, and non-hormonal options. Some visits and medications may be insurance-eligible, though membership is typically out of pocket, and it is not yet in every state. Source: Evernow

What reviewers say: review volume is thinner than its rivals. The Better Business Bureau rates it B+ with a handful of complaints, mostly renewal charges and refunds; Reddit users tend to praise the convenience and responsive staff. Sources: BBB, Fin vs Fin
Track record: founded 2019; $28.5 million raised, in a round backed by Gwyneth Paltrow, Cameron Diaz, and Drew Barrymore. Famous backers signal visibility, not clinical quality. Source: The Story Exchange
Best for: women who want a menopause prescriber in their pocket, not just on their calendar.

Alloy

Alloy is the most streamlined path from "I want HRT" to a prescription at your door. You complete an online intake, a menopause-trained doctor reviews it, and approved prescriptions ship free, with unlimited messaging afterward. It operates in all 50 states on a cash-pay model, with FSA/HSA accepted. The catalog runs from estradiol and vaginal estrogen to non-hormonal options and skin and hair treatments. Source: Alloy

What reviewers say: 4.4 stars on Trustpilot across 2,100+ reviews, praising home delivery and doctor access. Recurring complaints: managing subscriptions and occasional shipping delays. Source: Innerbody
Track record: founded 2021; around $21 million raised, including a $16 million Series A in 2024, a deliberately lean path compared with its biggest rival. Source: Forbes
Best for: women who have done their reading, want efficiency, and do not need insurance billing.

Gennev

Gennev pairs OB/GYNs with registered dietitians and health coaches, which makes it the most whole-picture option here. Care plans can include prescriptions alongside nutrition, movement, and lifestyle changes, reflecting its view of peri/menopause as a years-long transition. It is in-network with some commercial insurance plans, including Aetna. Sources: Gennev, MobiHealthNews

What reviewers say: independent review volume is thin, so read sentiment cautiously. The few public reviews praise the coaching and community, and mention scheduling glitches and billing friction. Source: US-Reviews
Track record: founded 2016; raised about $8 million, then acquired by Unified Women's Healthcare in 2022, which now backs its growth. Source: GeekWire
Best for: women who want food, sleep, and stress addressed alongside any medication.

Winona

Winona focuses tightly on hormone therapy, offering both standard FDA-approved and compounded bioidentical formats, including creams, patches, and pills. A physician reviews your online intake, follow-up messaging is free and unlimited, and medications ship to your door. It is cash-pay only, with no insurance billing, and serves most but not all states. Source: Winona

What reviewers say: 4.6 stars on Trustpilot, praising the free physician messaging and fast, discreet shipping. Complaints center on subscription confusion and the lack of live video visits. Source: Innerbody
Track record: founded 2020; grown without publicized venture funding, keeping a lower profile than its rivals. Source: LeadIQ company profile
Best for: women who specifically want compounded formats and predictable cash pricing.

What telehealth does not replace

None of these clinics replaces hands-on medicine. Keep your regular doctor in the picture for:

Physical exams and screenings. Pelvic exams, Pap tests, mammograms, and bone density scans still happen in person, on schedule.
Complex histories. A history of breast cancer, blood clots, or complicated surgery deserves a clinician who can examine you and coordinate specialists. Several telehealth intakes will screen you out for these, which is appropriate.
Continuity. A local doctor who has known you for ten years holds context no intake form captures.

The best setup is usually both: a telehealth specialist for the peri/menopause plan, and your own doctor kept informed. If that conversation feels hard to start, our guide to talking to your doctor about perimenopause can help.

How to choose between them

Four questions sort this quickly:

Insurance or cash? If you want visits billed to insurance, start with Midi or Gennev. If you would rather pay directly for speed and simplicity, Alloy or Winona are built for that.
HRT-focused or whole-picture? If you mainly want hormone therapy handled well, Alloy, Winona, or Evernow are direct routes. If you want nutrition and lifestyle woven in, Gennev's dietitians and coaches stand out.
Do you want ongoing messaging or scheduled visits? Evernow, Alloy, and Winona lean on continuous messaging. Midi and Gennev feel more like scheduled appointments.
Is it available in your state? Midi and Alloy cover all 50 states. Evernow and Winona cover most but not all. Check before you get attached.

If you are still weighing hormone therapy itself, our comparison of herbal supplements vs. HRT and our explainer on the HRT FDA label change cover that decision in depth.

Where The Shift fits

Whichever clinic you choose, they handle the prescription layer. There is a second layer that medication often leaves unresolved: the daily stress-response load that shows up as tension you can't unwind, sleep wakings, irritability, and brain fog.

The Shift is Project M's daily herbal protocol for perimenopause, built on a 600-year-old Traditional Chinese Medicine formula and designed to support that stress-response layer. In our 30-day consumer research study, women on HRT still reported brain fog, tension, and sleep wakings at nearly the same levels as women not on HRT. Source: Project M study results

The Shift works alongside any of the clinics above, with one condition: tell your clinician you are taking it. Good care is coordinated care. More on pairing the two in The Shift with HRT.

You choose the clinic. The formula supports the layer in between.

Frequently asked questions

What is the best menopause telehealth service?

There is no single best service; the right one depends on your insurance, your state, and what you want from care. Midi fits if you want insurance-covered specialist visits. Gennev fits if you want dietitians and coaching alongside an OB/GYN. Alloy and Winona fit if you want a fast, cash-pay path to HRT shipped home. Evernow fits if you want ongoing messaging with a menopause prescriber.

Does insurance cover menopause telehealth?

Sometimes. Midi accepts many major commercial insurance plans, and Gennev is in-network with some plans, including Aetna. Evernow's visits and medications may be insurance-eligible even though its membership usually is not. Alloy and Winona are cash-pay but accept FSA/HSA funds. Medicare and Medicaid are generally not accepted in this category.

Can telehealth prescribe HRT?

Yes. All five providers in this guide can prescribe hormone therapy where clinically appropriate, including estradiol patches, pills, gels, and vaginal estrogen, plus progesterone. Major guidelines do not require hormone blood tests before starting treatment in most cases, which is why some services use an online intake instead of labs. Our guide to perimenopause testing covers what labs can and cannot tell you.

Do I still need my regular doctor?

Yes. Telehealth does not replace physical exams, Pap tests, mammograms, bone density screening, or care for complex medical histories. Think of the telehealth clinic as your peri/menopause specialist and your regular doctor as home base, and make sure each knows what the other is prescribing.

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