This guide contains affiliate links. If you buy through them, we may earn a commission at no cost to you. See our Affiliate Disclosure for details.
Alloy vs. Midi vs. Evernow: Menopause Telehealth Compared for Women 40+
Three well-known online menopause clinics, side by side: what each offers, how you pay, and what to know before a clinician writes a prescription.
Reviewed against NIH & PubMed research. By HealthSpan40 Editorial Team · Last updated October 10, 2026.
ⓘ Pending expert review: This guide was written and cited from published research as a reference starting point. It has not yet been reviewed by a credentialed medical professional. Treat it as background reading, not clinical guidance.
If you are in your 40s or 50s and dealing with hot flashes, broken sleep, mood shifts or changing periods, finding a clinician who takes menopause seriously can be harder than it should be. Many primary care visits are short, and not every office has someone with deep training in midlife hormone care. That gap is why online menopause clinics have grown quickly.
Three names come up most often: Alloy, Midi Health and Evernow. They are not interchangeable. They differ in how you pay (insurance versus self-pay), what the first visit looks like, and how much ongoing support is built in. This guide lays out the differences using each company’s own published information and independent reporting, and it flags where we could not confirm a detail.
One point applies to all of them: hormone therapy and other menopause prescriptions require an evaluation by a licensed clinician. No service can promise you a specific medication in advance, and a good one will say no when treatment is not a fit. We compared published service descriptions and the available research. We did not personally use these services, and nothing here is a ranking of medical quality.
Our top picks at a glance
Midi Health
Virtual menopause clinic that says it is in-network with most major insurers and available in all 50 states.
Evernow
Pay per visit or join a membership that starts at $35 per month; also lists insurance for video visits.
Alloy
Cash-pay model reported at a $50 annual fee with prescriptions from about $40 per month; no insurance.
Quick comparison
| Service | Best for | Insurance | Model | Approx. price* | |
|---|---|---|---|---|---|
| Midi Health | Insurance-covered visits | Says in-network with most major insurers | Virtual visits, labs and bone density options | Varies by plan; self-pay available | View |
| Evernow | Flexible pay | Accepts some plans for video visits | Pay per visit or membership | Membership from about $35/month | View |
| Alloy | Cash-pay simplicity | No insurance reported | Annual fee plus prescriptions | About $50/year plus about $40+/month for prescriptions | View |
*Prices at time of writing; check the retailer for current pricing. Telehealth pricing changes often, and prescription and pharmacy costs are usually separate from visit fees.
How we chose
We compared the published descriptions of each service, independent reporting where we could find it, and current medical guidance on menopause care. Alloy’s own site could not be read by our research tools, so its details come from a trade-press article and may be out of date; we say so where it matters. We looked at:
- How a clinician evaluates you before any prescription is written
- Whether insurance is accepted, and what self-pay costs look like
- Which states are served
- Whether labs or screenings (thyroid, bone density) are part of the offering
- Whether non-hormone options are described alongside hormone therapy
- How clearly the company states its limits and results
The best menopause telehealth services for women over 40
Midi Health
Midi Health describes itself as a virtual clinic focused on perimenopause and menopause. Its site lists care for perimenopause and menopause symptoms, weight, urinary and vaginal health concerns, longevity-oriented care, and cancer survivorship. Visits are with clinicians described as board-certified, and no referral is required. The company states it is available in all 50 states.
The feature that stands out is insurance. Midi says it is in-network with most major insurance providers and shows logos for Blue Cross Blue Shield, Health Net, UnitedHealthcare, Cigna and Aetna. Deductibles, coinsurance and copays can still apply, so check your own plan before booking. Care plans may include hormone options such as patches, estradiol cream, vaginal estrogen and progesterone, as well as non-hormone options. The site also lists metabolic, thyroid and hormone labs and bone density screening. Midi also sells supplements and skincare; those are optional and not required for care. Midi reports that 95% of patients saw symptom improvement after at least two months of care, but that figure comes from the company’s own retrospective analysis, not a controlled trial, and the company notes results are not guaranteed.
Pros
- Says it is in-network with most major insurers
- Available in all 50 states, per the company
- Lists labs and bone density screening in its care offering
- Describes both hormone and non-hormone options
Cons
- Out-of-pocket cost depends on your plan; the main page lists no prices
- Outcome figures are company-reported
- Supplement and skincare upsells are part of the site
Best for: women with employer or marketplace insurance who want a menopause-focused clinician and possibly labs or a bone density referral. Skip if: your plan is not accepted and the self-pay price is more than you want to spend.
Evernow
Evernow offers online care for menopause and perimenopause and also lists weight management, hair and skin, sexual wellness, mental health, sleep and joint concerns. Treatments listed include hormone therapy, non-hormonal therapy and wellness supplements. The company also lists GLP-1 medications for weight, which are separate prescriptions with their own eligibility rules and costs.
The pricing structure is the main draw. You can pay for a one-time virtual visit with a menopause clinician, which includes a care plan and access to medication, with no membership required. If you want ongoing support, membership starts at $35 per month and includes messaging, ongoing prescriptions, refill management and care plans. Evernow also says it accepts insurance for video visits and shows logos for Blue Cross Blue Shield, Anthem, UnitedHealthcare and Aetna. Its main page does not say which states it serves or whether it offers lab testing, so confirm both before you sign up. Medications can be sent to a pharmacy or delivered to your home; the cost of the medication itself is separate.
Pros
- One-time visit option without a membership
- Low-entry membership price
- Some insurance accepted for video visits
- Ongoing prescriptions and refills handled in the membership
Cons
- State availability not stated on the main page
- Lab testing not mentioned on the main page
- Broad menu (weight loss, hair, skin) can feel less menopause-specific
Best for: women who want to try one visit first or prefer a predictable monthly fee. Skip if: you want labs and bone density screening bundled into the same service.
Alloy
Alloy Women’s Health is a direct-to-consumer menopause platform. Trade-press coverage of its Series A funding describes a telemedicine service for perimenopause and menopause symptoms, working with roughly two dozen doctors, and a cash-pay model: a $50 annual fee, prescriptions starting at $40 per month, and no insurance. Those figures come from that coverage rather than from Alloy’s own site, which our tools could not open, so treat them as a starting point and confirm current pricing on Alloy’s website.
The cash-pay approach has a trade-off. Because insurance is not involved, you will know the cost upfront, and there are no claims or denials. But you also cannot apply a copay or count on coverage for visits. The same coverage did not specify which states Alloy serves, so check availability before you start. We could not verify from Alloy’s own pages whether lab testing is included.
Pros
- Cash-pay pricing reported as simple and upfront
- Focused on perimenopause and menopause
- No insurance paperwork
Cons
- No insurance reported
- Pricing and state details not verified from Alloy’s own pages
- Lab and screening offering unclear
Best for: women without a good insurance option who prefer a fixed cash price. Skip if: you want your visits to count toward a deductible or be billed to insurance.
What about Winona and Hers?
Two other names often appear in the same searches. Winona is a menopause-focused telehealth brand, and Hers is a broader women’s telehealth brand that has added menopause care. We did not review their current offerings in detail for this guide, so we are not ranking them. If you are comparing more options, use the same checklist below: who evaluates you, what it costs after the first visit, which states are covered, and whether non-hormone choices are on the table. Our earlier overview, telehealth HRT providers, covers more of the field.
Buying guide: what matters after 40
Insurance versus self-pay
The biggest practical difference is who pays. A service that bills your insurer may cost less per visit but can involve deductibles and coinsurance. A cash-pay service has a clear price but no reimbursement. Ask each company for the full first-year cost: visit fees, membership, labs, and the pharmacy price of any prescription. Pharmacy prices for patches, creams and other formulations vary widely.
A real evaluation before any prescription
Expect questions about your symptoms, cycle, medical history, family history and medications, and a review of blood pressure, past clots, breast or uterine cancer history and liver disease. Be wary of any service that guarantees a prescription or sells hormone products without a clinician review. In perimenopause, hormone levels swing from day to day, so a single blood test often cannot confirm or rule out anything. Mayo Clinic notes there is no single test for perimenopause and that blood tests play a limited role, with thyroid testing the main exception.
Hormone and non-hormone options
Menopausal hormone therapy is the most effective treatment for hot flashes and night sweats, but it is not the only option. Low-dose vaginal estrogen treats genital and urinary symptoms with little absorption into the bloodstream. Non-hormone prescriptions and lifestyle changes exist for women who cannot or do not want to use estrogen. A good service will discuss these alongside hormones. For background, see our guides on HRT after 40 and bioidentical versus traditional HRT.
Follow-up, labs and in-person care
Telehealth works best for evaluation, prescribing and follow-up. It cannot do a pelvic exam, a mammogram or a bone density scan. Make sure you stay current on breast cancer screening, cervical screening and, if recommended, bone density testing. Ask how to reach the clinician about side effects, and how dose changes are handled. If you notice unexpected bleeding, chest pain, a swollen painful leg or sudden severe headache, seek in-person or emergency care instead of messaging a clinic.
Privacy and marketing claims
Read how the company handles your health data, and treat outcome statistics with caution. Company-reported improvement rates are not the same as a controlled trial. Add-on supplements and skincare are optional.
What the research says
For years, menopausal hormone therapy carried a class-wide boxed warning, shaped largely by early Women’s Health Initiative findings. In November 2025, HHS and the FDA announced removal of the boxed warning, following a literature review, an expert panel and a public comment period, according to a PubMed-indexed commentary. The commentary describes a shift to product-specific labeling and guidance on starting therapy within 10 years of menopause or before age 60. A Patient Care Online report says that in February 2026 the FDA approved labeling changes for six products that removed boxed-warning statements about cardiovascular disease, breast cancer and probable dementia, with more updates expected.
That is a meaningful shift, but it is not the same as saying hormone therapy is risk-free. Individual risk depends on age, time since menopause, the type of hormone, the dose and route, whether you have a uterus (which determines whether a progestogen is needed to protect the uterine lining), and your personal and family history. Product labels still carry warnings and precautions, and the exact wording differs by product. The practical takeaway is that a clinician should weigh benefits and risks with you, which is exactly what a telehealth evaluation should do.
Evidence on telehealth itself is thinner. We did not find controlled trials comparing these three services. The company-reported outcomes, such as Midi’s retrospective analysis, are useful context but are not independent evidence.
Frequently asked questions
Can I get hormone therapy online?
Yes, if a licensed clinician evaluates you and decides it is appropriate. All three services use a clinician evaluation before prescribing. Conditions such as a history of certain cancers, blood clots, stroke or liver disease can make hormone therapy unsuitable.
Do these services accept insurance?
Midi says it is in-network with most major insurers. Evernow says it accepts insurance for video visits and lists several carriers. Alloy was reported to be cash-pay only. Always confirm with your own plan, because coverage and cost sharing vary.
Do I need blood tests first?
Often not required to start treatment for typical menopause symptoms, though a clinician may order thyroid or other labs. Hormone levels fluctuate in perimenopause, so they are rarely decisive on their own.
Is the FDA boxed warning gone?
The FDA has moved to remove boxed warnings from several menopausal hormone therapy labels, with more updates expected. Labels still list warnings and precautions, so ask your clinician how they apply to you.
Is telehealth as good as seeing my own doctor?
It can be a good option for evaluation and follow-up, especially if local menopause expertise is hard to find. It does not replace in-person screening such as mammograms or bone density scans.
What if hormone therapy is not right for me?
Non-hormone prescriptions, vaginal estrogen in some cases, sleep and exercise strategies, and cognitive behavioral approaches are alternatives. A good clinician will discuss these.
Related guides
Sources
- Midi Health — official site
- Evernow — official site
- Alloy Women’s Health funding coverage — Femtech Insider
- Elimination of the Black Box Warning on Menopausal Hormone Therapy — PubMed
- FDA removes boxed warnings from select menopausal hormone therapy labels — Patient Care Online
- Perimenopause: diagnosis and treatment — Mayo Clinic
- Thyroid tests — NIDDK
ⓘ Medical disclaimer: This guide is for educational purposes only and is not medical advice. Hormone therapy is not suitable for everyone, including some people with a history of breast or uterine cancer, blood clots, stroke or liver disease. Services, prices and insurance acceptance change; confirm details with each company. Talk to your doctor before starting supplements, devices or treatments.