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Testosterone Therapy Cost and Options for Men Over 40: Telehealth Providers Compared
What four online testosterone services say they offer, what they cost, what labs you need, and what the FDA and major guidelines say about benefits and risks.
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.
Testosterone levels drift down slowly as men age, and tiredness, low drive, softer muscle and a flat mood are common complaints in the 40s and 50s. Those symptoms also come from poor sleep, sleep apnea, depression, excess weight, alcohol, thyroid problems and some medications. That is why a real diagnosis matters before anyone starts a prescription hormone, and why this guide spends as much time on labs and risks as on price.
Telehealth has made testosterone therapy easy to start. A questionnaire, a home blood draw and a video or phone visit can replace a trip to a urologist or endocrinologist. Convenience is useful, but the services differ a lot in what they sell, how they price it, and whether insurance plays any part. Testosterone is a controlled prescription drug, and only a licensed clinician can decide whether it is appropriate for you.
Below we compare four services from the information on their own public pages, explain how a diagnosis is made, summarize what the FDA and the major urology and endocrine guidelines say, and list what to ask before you pay. If you are looking at over-the-counter “T boosters” instead, read our testosterone boosters guide first, since they are not the same thing.
Our top picks at a glance
Henry Meds
Published price that includes provider visits, labs, medication and shipping.
Marek Health
Starts with advanced diagnostics and a provider consult to decide eligibility.
Hims (enclomiphene)
Non-testosterone option with a published monthly price, if a clinician finds it suitable.
Quick comparison
| Service | Best for | What it offers | Insurance | Approx. price* | |
|---|---|---|---|---|---|
| Henry Meds | Bundled monthly price | Compounded cream or injection; oral Kyzatrex | Not required | about $129 to $179 per month | View |
| Marek Health | Labs-first, detailed work-up | Provider-led TRT/HRT evaluation with coaching | Does not bill insurance | Not listed; contact company | View |
| Hims | Non-testosterone option | Enclomiphene (compounded); no TRT injections | Not required; HSA/FSA not accepted | about $99 to $199 per month | View |
| Maximus | Wide range of therapy forms | Cream, injectable, oral, enclomiphene | Direct pay | Not listed on page | View |
*Prices at time of writing; check the retailer for current pricing.
How we chose
We did not sign up for or test any service. We compared what each company publishes on its own site, then checked those claims against clinical guidelines and independent medical sources. Pricing and availability change often, so treat every figure as a starting point.
- Transparency: is a price, what it includes, and the cancellation policy stated publicly?
- Whether labs and a clinician evaluation come before any prescription.
- Which therapies are offered, and whether they are FDA-approved products or compounded.
- Insurance and HSA/FSA handling.
- Whether state availability is disclosed.
Telehealth testosterone services for men over 40
Henry Meds
Henry Meds states that its compounded testosterone starts at $129 a month and that the oral product Kyzatrex is $179 a month and not available in California. The page says the price covers provider visits and support, labs, medication and supplies, and shipping, with no long-term contract, and that an aromatase inhibitor is added at no extra cost if a provider considers it appropriate. It lists eligibility as men 35 to 65 and says eligibility depends on clinical requirements based on lab results.
The trade-offs are worth knowing. Compounded drugs are made by pharmacies and are not individually approved by the FDA, and the American Urological Association guideline prefers commercially manufactured products where possible. The page does not list served states or the specific lab tests required, and it describes about 8 to 10 business days from consult to medication. Multi-month plans may require paying a remaining balance if you cancel.
Pros
- Single published monthly price with labs and shipping included
- Includes a branded oral option (Kyzatrex)
- No insurance required, no long-term contract stated
Cons
- Entry price is for compounded products
- States and exact lab panel not listed on the page
- Multi-month plans may carry a cancellation balance
Best for: men who want predictable all-in pricing and have no insurance coverage for testing. Skip if: you want to preserve fertility or prefer an FDA-approved, commercially made product under a local specialist.
Marek Health
Marek Health describes itself as a platform that connects clients with providers rather than a clinic. Its public page says the process starts with lab work, includes a video intake with a health coach, advanced diagnostics, a provider consultation to determine TRT or HRT eligibility, and clinician-prescribed supplements and medications. It says there are no set subscription plans and you can cancel at any time.
The page does not list prices, and it says Marek does not bill insurance or supply billing codes, though clients may use HSA or FSA funds and receive invoices and lab requisitions. It also says some insurers consider its services elective. You would need to contact the company to learn the cost and state availability before committing.
Pros
- Diagnostics come first, which matches guideline advice
- Provider decides eligibility rather than a fixed product
- HSA/FSA funds may be usable
Cons
- No published pricing
- No insurance billing
- States not listed on the page
Best for: men who want a broad lab work-up and are comfortable asking for a quote. Skip if: you need a price you can see before starting.
Hims (enclomiphene program)
Hims takes a different approach. Its testosterone page says the program is a daily oral medicine containing enclomiphene alone or with tadalafil, and that it “does not currently offer access to TRT injections.” Enclomiphene works by prompting the body to make more of its own testosterone rather than supplying the hormone. The page states plainly that enclomiphene is not FDA-approved and is available through compounding pharmacies or clinical trials. Published prices are about $99 a month on a 10-month plan paid upfront, about $139 a month on 5 months, and about $199 a month on 3 months, plus a one-time lab kit of about $94.
Lab testing is required: you collect two blood samples at home and a provider reviews them. Insurance is not required and HSA/FSA payment is not accepted, and the page says the program is not available in every state and some states require a video visit. Because enclomiphene is unapproved, the evidence base and quality oversight differ from approved testosterone products, so discuss it carefully with a clinician.
Pros
- Published prices and plan lengths
- Lab testing required before prescribing
- Approach does not directly supply testosterone
Cons
- Enclomiphene is not FDA-approved
- No TRT injections or gels
- Longest plans are paid upfront; HSA/FSA not accepted
Best for: men who want to explore a non-testosterone route and value a clear price. Skip if: you want standard testosterone replacement or an FDA-approved drug.
Maximus
Maximus lists testosterone in several forms: cream, injectable, oral and enclomiphene, alongside other men’s health products. Its page describes an online health questionnaire, a visit with a Maximus physician, optional at-home lab work (including a comprehensive panel of up to 146 markers and a 10-marker testosterone test), and a shipped protocol with ongoing physician-led adjustments. It states there is no membership fee, that services are direct-pay, and that insurance is not required.
The page did not show testosterone prices or the list of states served, so both need to be confirmed at sign-up. Confirm that labs are completed and reviewed before any prescription is issued.
Pros
- Several therapy types under one roof
- No membership fee stated
- At-home lab options
Cons
- Testosterone pricing not shown on the page
- State availability not listed
- Labs described as ordered “if needed”
Best for: men who want to compare several formats with a physician. Skip if: you need upfront pricing or want a labs-before-anything process spelled out.
The option many men skip: your own clinician
Primary care physicians, urologists and endocrinologists can diagnose and treat low testosterone, and visits and standard labs are often billed to insurance. FDA-approved gels, injections and other products may be partly covered, depending on your plan. If you have heart disease, prostate concerns, sleep apnea or fertility plans, an in-person specialist is often the better starting point.
Buying guide: what matters after 40
Diagnosis comes first
The Endocrine Society guideline says to diagnose hypogonadism only in men with symptoms and signs of deficiency and consistently low testosterone, confirmed with repeat morning fasting measurements, and recommends against routine screening of the general male population. The AUA guideline uses a total testosterone below 300 ng/dL as a reasonable cutoff, confirmed with two early-morning measurements, and notes that testosterone deficiency is diagnosed only when low levels come with symptoms. Doctors also usually check LH to learn whether the cause is in the testes or in the pituitary, and look for sleep apnea, thyroid problems, obesity and medication effects, as Mayo Clinic notes.
Labs you should expect
Beyond total testosterone, the AUA guideline calls for LH, hemoglobin and hematocrit before starting, and a PSA in men over 40 to help exclude prostate cancer. Fertility-minded men should have a reproductive evaluation first. Follow-up testing, including testosterone, is typically repeated every 6 to 12 months while on treatment. A service that prescribes without these steps is a warning sign.
Compounded versus approved products
Compounded testosterone and enclomiphene are made by pharmacies and are not individually reviewed by the FDA for safety and effectiveness. The AUA guideline says to prefer commercially manufactured products over compounded testosterone when possible. That does not make every compounded product unsafe, but it is a fair question to ask any provider.
What it really costs
Published telehealth prices run from roughly $100 to $200 a month for the services that list them, before any lab fees not included. Insurance rarely applies to these direct-pay services. Seeing your own clinician may cost less out of pocket if your plan covers labs and approved drugs. Watch for auto-renewing plans and multi-month commitments.
What the research says
Labeling. FDA labeling has long limited testosterone products to men with low levels from specific medical conditions rather than age-related decline alone. According to Urology Times, the FDA removed the boxed cardiovascular warning in 2025 and added blood pressure warnings. In June 2026, according to Urology Times, HHS requested further label updates, including removing the statement that safety in age-related hypogonadism has not been established, and narrowing the prostate cancer contraindication to metastatic disease. These were requests at the time of that report; check the current label with your clinician.
TRAVERSE. The trial enrolled 5,246 men aged 45 to 80 with symptoms of hypogonadism and existing or high cardiovascular risk. Major adverse cardiac events (cardiovascular death, nonfatal heart attack or stroke) occurred in 7.0% of men on testosterone and 7.3% on placebo, per Cleveland Clinic, a difference that was not significant. The testosterone group had more atrial fibrillation, acute kidney injury and venous clot events. That trial studied one population, and it does not settle every question about long-term use.
Benefits and uncertainty. The AUA guideline says therapy may improve erectile function, libido, anemia, bone density, lean mass and depressive symptoms, while evidence is inconclusive for cognition, energy, fatigue and quality of life. Mayo Clinic describes symptom relief as often modest and notes men with normal levels generally see no effect.
Prostate and fertility. The AUA guideline reports no evidence linking therapy to prostate cancer development and recommends PSA checks. The Endocrine Society recommends against therapy in men with prostate or breast cancer or elevated hematocrit and in men planning fertility soon, since therapy can lower sperm production. Alternatives such as clomiphene-type drugs are sometimes used when fertility matters.
Age 65 and older. The Endocrine Society suggests against routinely prescribing testosterone to all older men with low levels and favors individualized decisions for those with symptoms and consistently low morning levels.
Why “testosterone boosters” are different
Over-the-counter boosters are supplements, not hormones. They are not reviewed by the FDA before sale and have a thin evidence base for raising testosterone. They cannot replace a diagnosis. Our boosters guide goes through what the ingredients can and cannot do.
What to ask a clinician
- Is my testosterone low on two separate morning tests, and what else could explain my symptoms?
- Do I need a sleep study, thyroid test or review of my medications first?
- Is this product FDA-approved or compounded, and why?
- What are my heart, prostate and blood-count risks, and how often will you check?
- How will this affect fertility, and what options exist if I want children?
- What happens if I stop?
Frequently asked questions
Can I get a testosterone prescription without lab tests?
Guidelines call for a symptom review and repeat morning blood tests before diagnosing low testosterone. Hims states labs are required, and Henry Meds says eligibility depends on lab results. Be wary of any service that prescribes without them.
Does insurance cover telehealth testosterone?
Usually not for the services in this guide. Henry Meds, Hims and Maximus describe themselves as not requiring insurance, and Marek says it does not bill insurers. A visit with your own doctor may be billed to insurance instead.
Is enclomiphene the same as testosterone therapy?
No. It is a pill meant to prompt your body to produce more testosterone. Hims says it is not FDA-approved and is made by compounding pharmacies. Ask a clinician whether it suits your situation.
Does testosterone therapy cause heart attacks?
In the TRAVERSE trial of men with hypogonadism and cardiovascular risk, major cardiac events were 7.0% on testosterone and 7.3% on placebo. Other events, such as atrial fibrillation, were more common with testosterone, and the FDA now carries blood pressure warnings. Your own risk depends on your history.
Will it affect fertility?
Yes, testosterone can lower sperm production, so guidelines advise against it for men trying to conceive. If fertility matters, tell your clinician before starting.
Can lifestyle changes raise testosterone?
Weight loss, treating sleep apnea and limiting alcohol can help some men, and Mayo Clinic lists these as contributors to check before prescribing. They are worth trying alongside a medical evaluation.
Are testosterone boosters a substitute?
No. They are supplements, not prescriptions, and they cannot treat diagnosed deficiency. See our boosters guide for details.
Related guides
Sources
- Testosterone Therapy in Men With Hypogonadism: Clinical Practice Guideline — Endocrine Society
- Evaluation and Management of Testosterone Deficiency — American Urological Association
- TRAVERSE trial announcement — Cleveland Clinic
- HHS requests testosterone label updates — Urology Times
- Mayo Clinic Q&A: Testosterone therapy — Mayo Clinic
- Testosterone therapy — Henry Meds
- Testosterone — Hims
- Enclomiphene price — Hims
- Maximus home page — Maximus
- Marek Health home page — Marek Health
ⓘ Medical disclaimer: This guide is for educational purposes only and is not medical advice. Testosterone is a prescription drug that requires evaluation by a licensed clinician and proper lab diagnosis, and it can affect heart health, blood counts, the prostate and fertility. Provider details come from company websites and may change. Talk to your doctor before starting supplements, devices or treatments.