Midi vs. Winona 2026: Cost, Insurance, & my personal experience
- Peggy B. - Experienced HRT Patient Reviewer
- 16 hours ago
- 4 min read
The landscape of telehealth hormone replacement therapy (HRT) has shifted significantly heading into 2026, with Midi Health and Winona emerging as the two dominant players. However, 'convenience' shouldn't come at the expense of clinical depth or your bank account. Here is a side-by-side look at my personal experience navigating their protocols, their platforms and the specific costs you can expect to encounter today.
The Onboarding Process: Ease of Use and Clinical Depth
Both Midi Health and Winona will ask you to create an account so you can communicate and receive messages via their HIPAA compliant patient portals. You will fill out an in-take form where you'll answer questions around your age, health history, symptoms and your lifestyle.
Once your account is created with Midi Health, they'll send you a link to their appointment calendar where you will schedule your first initial 30-minute consultation with an HRT specialist. When I became a patient of Midi Health, I was able to schedule for the next business day.
Winona, once your account is created will ask you to put a credit card on file so if and when you choose to purchase Hormone Replacement Therapy medications from them, they already have everything they need to charge your card.
Midi Health is ran more like a traditional doctor's office. They charge $250 for the initial consultation, which they'll bill your insurance, if they take yours. You may still have a co-pay or deductible. Winona doesn't charge for consultations, you'll immediately find yourself in text communication with an HRT clinician where you'll begin to strategize on which products might be best for you.
Do You Actually Need a Hormone Test? The Midi vs. Winona Philosophy
Neither Midi Health or Winona require up-front testing of hormone levels. Both companies practice evidence based medicine, meaning they will let your symptoms, age and health history dictate which medications might be best for you.
If you are generally curious around hormone levels, there are many at-home solutions that you can purchase and then use that data to take to your appointment or offer up to your provider. My pick for at-home hormone testing is the Mira Hormone Monitor. You can test your FSH which if elevated is a clear sign that you are somewhere in the perimenopause to menopause transition phase of life.
Let’s Talk Money: The Real Cost of Midi Health
Medications prescribed my Midi Health will come from whichever pharmacy you tell them you want to purchase from. I used my local CVS and was able to pick up my prescriptions the same day as my appointment. Costs below are what I experienced using my prescription insurance.
The standard I see many HRT providers prescribing are the tried and true, Estradiol Patch + Progesterone Tablets + Estradiol Vaginal Cream. These products are FDA approved and have been around for over 30 years.
Midi Health
Service or Product | Cost Out-of-Pocket (My insurance wasn't accepted by Midi Health) |
Midi Health Initial Appointment (1X Year) | $250.00 (or your Co Pay) |
Midi Health Check-In Quarterly $150 (3X Year) | $450.00 (or your Co Pay) |
Cost Using my Express Scripts Prescription Insurance | |
Estradiol Patch (.0375) - (12-Months) | $387.36 |
Progesterone 200 MG - (12 Months) | $445.20 |
Total Annual Cost out of Pocket | $1,532.56 ($127.71/mo) |
Keep in mind with Midi Health, if your HRT specialist prescribes products for you that are different than what I was prescribed, your costs will be different than mine.
Transparent and Direct: Navigating Winona’s Out-of-Pocket Costs
Winona offers a direct to consumer model where they provide customized Hormone Replacement Therapy Medications from an approved 503B compounding pharmacy. They don't take insurance, but you'll know from the beginning what products they offer and what you can expect to pay.
DHEA Pills - $27/3 Mos
Estrogen Body Cream - $89/Mo
Estrogen w/Progesterone - $89/Mo
Estrogen Patch - $149/Mo
Estrogen Tablet - $54/Mo
Progesterone Body Cream - $89/Mo
Progesterone Caplet - $39/Mo
Vaginal Estrogen Cream- $89/Mo
Blossom (female Viagra cream) - $79/Order
Estriol Face Cream with Tretinoin - $150/3-mo supply
Traditional vs. Tailored: Navigating the 2026 Medication Options
Providers like Midi Health, only offer FDA approved medications that can be picked up at your local pharmacy. You'll be able to utilize your insurance, but you'll be pegged at whatever doses are available in those HRT medications.
Winona works with a compouding pharmacy and will be able to 'customize' your Hormone Replacement Therapy regimen. The ingredients in those products are FDA approved, but because the dose may be customized for you, you won't be able to use your insurance.
Insurance vs. Self-Pay: Will Your Plan Cover Midi or Winona?
It's likely that if you go down the Midi Health track, you'll be able to use your prescription insurance for medications and if Midi Health partners with your insurance provider, they'll take that as well. They didn't take mine, so I had to pay out of pocket.
Winona doesn't take insurance, but you do have the benefit of them being able to customize your dose and formulation. For many, that aspect makes Winona a better choice, but only you know whats best for you.
Midi vs. Winona 2026: Cost, Insurance, & My Personal Experience
Midi Health is about $127 per month, if they don't take your medical insurance, Winona will be about $89 per month. If you have insurance and Midi takes it, your average monthly cost will be less than the $127 I quoted in chart above.
With Winona, you'll know up front what product's cost and so there will be no surprises. No consultation fee. No time off work for a consultation. Just text communication between you and your HRT clinician to arrive at the product(s) that might work best for you. No guessing on the final cost.
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