Fountain HRT Vs. Winona Vs. Midi Health
- Peggy B. - Experienced HRT Patient Reviewer
- 6 days ago
- 7 min read
I have been a patient of Winona and of Midi Health. I've not been a patient of Fountain HRT, however in researching their website I was able to find all the details needed to be able to help you compare these three providers.
Hormone Replacement Therapy
Options
There are several standard products out there when it comes to treating a women for Menopause. If you still have a uterus, you'll likely be prescribed an estradiol product plus a progesterone product. If you struggle with energy, motivation or low sex drive you may also be prescribed testosterone, but only if your selected online provider offers it. The final product you might be prescribed is a vaginal cream/insert for dryness or painful sex.
So, it's possible you might have as many as four different HRT products to juggle.
Estradiol - comes in a patch, tablets, troches (melt under your tongue) and topical sprays, creams or gels that can be rubbed on your inner arms or thighs. Estradiol can come from your local pharmacy in standardized doses or it can come from a compound pharmacy in standard or customized doses.
Of the estradiol formulations mentioned, the patch is the most expensive and in my personal opinion, after trying seven online providers, the most effective estradiol product, with the exception of a BRAND NEW FORMULATION; Inner Balance's Oestra which is a vaginal cream that contains estradiol and progesterone together. Use Coupon Code Peggy10 for 10% off!
Oestra is a proprietary vaginal cream that can be applied either with your fingers or a vaginal applicator. To my knowledge, no other provider—except Inner Balance—offers a vaginal estradiol/progesterone cream that matches the results I’ve personally experienced, especially when it comes to improving sleep. Oestra is my current therapy. The cost is $199 for the first six months, then drops to $99 per month from month seven onward. Use Coupon Code Peggy10 for 10% off!
Progesterone - comes in oral capsules, troches, vaginal gels/suppositories, transdermal gels and creams and injections. The most popular and affordable is the oral capsules or mixing progesterone in a topical cream (that you rub on inner thighs or arms) along with estradiol, so you get the two hormones in one cream. Progesterone can come from local pharmacy in standard doses or from a compound pharmacy.
Testosterone - comes in transdermal gels & creams and injections. Injections are the most expensive. Testosterone is NOT approved for Women by the FDA, so if it's prescribed, it's prescribed "off label." This is a very common thing, so don't let the fact that there isn't an approved dose or formulation from the FDA scare you. Doctors have been prescribing testosterone to women for years, however, not all docs are comfortable prescribing drugs off label, so be sure to inquire before you choose an online provider. Also, there are different rules that pertain to prescribing testosterone that require a more comprehensive exam than when prescribing Estradiol or Progesterone, so be prepared for an actual 1:1 visit with a HRT Clinician.
Vaginal Estradiol - If you suffer from Vaginal atrophy, pain during sex or dryness, you might also be prescribed a vaginal estradiol cream or inserts. Vaginal estradiol is typically applied twice per week and is about $15 per month. Vaginal estradiol primarily acts locally to improve vaginal tissues. It's not systemic, meaning it never makes it from the vagina to the rest of the body.
How much is HRT
I mention all the information above, so you can understand why the difference in cost of Hormone Replacement Therapies from different providers.
If the provider is offering the "less expensive options" then you can expect them overall to be in a lower price point, think topical creams for example. If you find yourself challenged by a higher cost of an online provider, it might due to the fact that they are offering products that are generally more effective than other less costly and less effective products.
The best way to really compare is to look at the formulation and it's cost from one provider to the next. For example, it doesn't appear that Fountain HRT offers the estradiol patch, but rather only the topical cream which isn't nearly as effective and is less costly. It wouldn't be fair to judge an estradiol topical cream to an estradiol patch as the formulations are night and day different as are results.
Cost of Hormone Replacement Therapy from Midi Health with Insurance
Let me help you break it down. If you have even, mediocre prescription insurance at best, it likely covers HRT that comes from your local pharmacy. You are restricted to formulations in doses that have been approved by the FDA. You might also want to check out prices from GoodRx for comparison.
The last time I picked up my HRT meds from my local pharmacy using my prescription insurance, I paid the following:
Estradiol Patches - $31.03 for 90-day supply
Estradiol Vaginal Inserts - $44.80 for a 90-day supply
Progesterone Capsules - $20.81 for a 90-day supply
The total for all three was $96.64 or $32.22 per month. This doesn't include the cost of a consultation with an HRT clinician. When you choose to use insurance, you'll utilize your medical insurance for the visit and your prescription insurance for the medications.
Of the three providers we are comparing in this blog, Midi Health is the only that offers to write prescriptions that you can pick up at your local pharmacy. You can utilize your medical insurance for the visit, which means it could be $0 or the cost of your co-pay depending on your plan and where you are with deductibles for the year. They didn't take my insurance, so I had to pay $250 (30 minute visit) out of pocket for the visit and then the $96.64 for 90-days of medications. They will want to see you about three times per year to follow up and for refills, so count on two additional follow-up visits at $125 (15 min visit) each.
All in all, Midi Health would be a monthly average of $73.88 per month. As a comparison, another provider who offers the exact same model, MyMenopauseRX, but they only charge $99 for 20 minute initial consultation and $49 each for message visits for follow-up and refills. The average monthly cost for this provider would be $48.63 per month.
All docs at MyMenopauseRx are Menopause Society certified and they only prescribe meds that are FDA approved and can be picked up at your local pharmacy.
Both Midi Health and MyMenopauseRx take HSA Credit cards.
How much is Winona HRT per month
Winona will not charge you to create an account and also doesn't charge for doctor consultations. All communication is done via their patient portal and once you and your HRT Clinician land on a Hormone Replacement Therapy that you want to try, they will send your prescription to their partner compound pharmacy and have the medications shipped directly to your home. Easy Peasy.
All Winona products are disclosed with price on their website and also on the Winona Page of my website. Winona doesn't take prescription or medical insurance, but does accept HSA credit cards.
Estradiol/Progesterone Topical Cream - $89 per month
(purchased in 3 month quantities)
OR
Estradiol Patch + Progesterone Tablets - $188 per month
(no additional cost for doc visit or follow ups)
If you are only prepared to 'dip' your toe in the water and you are not sure which formulation might be best for you, then I'd go with the Estradiol/Progesterone Cream at $89 per month. If, after three months, you still don't feel as great as you had hoped, you can step up to the patch and tablets for just a bit more money. In either case, you won't have any other costs as all communication is free via their patient portal. Click here to get 15% off your first Winona Order.
Fountain Hormone Replacement Therapy Cost
Fountain HRT is an off-shoot of Fountain Testosterone Replacement for men. The website focuses on men's HRT much more than women, so it appears that treating women for menopause was an after-thought to their original business plan.
They don't accept insurance, but they do accept HSA Credit Cards.
Fountain only offers All-Inclusive monthly plans that you can purchase in different bundles. They don't disclose which products you might get or if you get to choose specific formulations. For example, if they only allow you to have estradiol topical cream in lieu of patches, then you are way over-paying with this provider.
They also offer Testosterone for women and indicate that if appropriate and prescribed, it is included in the monthly cost. However, if you don't require T, then this one might be a bit pricey for just the standard basic HRT products.
Pro-Plan $150/4 Weeks (billed every 48 weeks) $1,799 out of pocket initially
Standard Plan $167/4 Weeks (billed every 12 weeks) $499 out of pocket initially
Starter Plan $199/4 Weeks $199 out of pocket initially
The cost for hormone testing and doctor consultations are included in the subscription monthly cost of $199/month. If you want to meet with a doctor and if you are curious about your hormone levels, this one might be a good fit, but you are paying more to have those services included.
If you don't necessarily want to see a doc and if you don't want to be bothered with labs, then I'd go with Winona or even consider Effecty. Effecty charges $145 for the estradiol patch + Progesterone Tablets (Winona's cost of patch and tablets is $188) and Effecty doesn't require a doctor consultation. However, if you want a consultation, it's free at Effecty with no added fees.
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