Alloy vs Midi Health
Updated October 28, 2026
Women in perimenopause and menopause now have several online clinics that prescribe hormone therapy, and Alloy and Midi Health take opposite approaches to insurance. Alloy charges cash for everything and treats mostly by message, while Midi bills most PPO plans for video visits and sends prescriptions to your pharmacy. Which one costs less depends on your coverage and how many visits you expect.
Our analysts compared Alloy and Midi Health on price, insurance, how care is delivered, treatment range, and pharmacy options, using the HIR review of each company and each company's own price pages checked October 28, 2026. In the following sections, we compare them in one table, share what patients say, and describe the patient each one suits.
Alloy vs Midi Health at a glance, October 2026
| What buyers weigh | Alloy | Midi Health |
|---|---|---|
| Published price | A $49 one-time consult fee, which includes unlimited doctor messaging. The estradiol pill starts at $39.99 for a one-month supply. | Visits are billed to insurance. Self-pay visits cost $250 for a 30-minute first visit and $150 for a 15-minute return visit. |
| Pricing model | Alloy charges a one-time consult fee, then a cash price for each prescription. | Midi bills your insurance for each visit, or charges a self-pay price per visit. |
| What drives cost | For Alloy, cost depends on which treatments you are prescribed, the supply length you choose, and whether you add skin, hair, or sexual health products. | For Midi, cost depends on your plan's copay and deductible, how many follow-up visits you need, and whether your pharmacy coverage pays for your medications. |
| How care works | A menopause-trained doctor reviews an online intake and writes a plan, usually with no video visit, then messaging is unlimited. | Video visits with a clinician trained in menopause care, who sends prescriptions to your pharmacy. |
| Insurance | Does not take insurance; HSA and FSA cards work. | In-network with most PPO plans; Medicare is out of network and Medicaid is not accepted. Clear edge |
| Where prescriptions are filled | Medications ship to your door at its listed cash prices. | Sent to your local pharmacy, where your prescription coverage applies. |
| Treatment range | Scores 7.0; hormone therapy in several forms plus skin, hair, and sexual health products. | Scores 8.2; hormone therapy, testosterone, GLP-1 weight care, supplements, and treatment for UTIs, bacterial vaginosis, and yeast infections. Higher score |
| Symptom relief | Scores 7.2 on symptom relief and patient results. | Scores 7.8 on symptom relief and patient results. Higher score |
| Pricing clarity score | 7.9 Clearer pricing | 6.8 |
| HIR overall score | 7.4, Recommend. | 7.6, Recommend. |
| Best for | Women in perimenopause or menopause who want hormone therapy online. | Insured women in perimenopause or menopause who want visits billed to their plan. |
| Not a fit for | Patients who want insurance to cover visits. | Medicare and Medicaid patients who need coverage. |
Which fits which buyer
Start with your insurance card and how quickly you need a prescription.
Choose Alloy if
- You would rather pay one $49 consult fee and cash prices than visit copays.
- You want a doctor's plan by message, with no video visit.
- You want medications shipped to your door at a listed price.
Choose Midi Health if
- Your PPO plan covers Midi and you want visits billed to it.
- You want testosterone, weight care, or other midlife care from the same clinic.
- You want prescriptions at your local pharmacy, where your drug coverage applies.
What buyers say
“I waited six weeks for an appointment with Midi Health that got canceled 48 hours before because I missed a confirmation text (when I was recovering from surgery!). I was able to speak to an Alloy physician within 24 hours of getting started, and she set me up with HRT immediately.” Trustpilot, source
“Optum denied my claim because Alloy's pharmacy is out of network. I dirched Alloy and went to Midi. Since switching my Rxs have been covered” Trustpilot, source
“Very expensive. If your still paying your deductible they will charge you $250 per 30 minute visit. The short appointments was not nearly enough time to get all my concerns addressed. I hear Alloy is a better online choice.” Trustpilot, source
Verdict
Midi Health scores higher and fits insured women who want video visits and a broad menu of midlife care. Alloy fits women who want a fast, cash-priced start with care by message.
Medicare does not cover Midi visits, and Alloy takes no insurance, so Medicare patients pay cash at either clinic.
Methodology
Each row comes from the HIR reviews of Alloy and Midi Health, scored under the HIR method, and from each company's public pricing where it exists. Any published price for Alloy or Midi Health was checked on that company's own site on October 28, 2026.
A green check marks a clear edge for Alloy or Midi Health only where their review scores differ by at least 0.3 points or the two reviews show a plain difference. Rows with nothing published for either company are left out. Patient lines come from public reviews and forum posts that mention both companies.
Sources
- HIR review of Alloy and HIR review of Midi Health
- Alloy estradiol pill and consult fee, checked October 28, 2026
- Midi insurance and self-pay prices, checked October 28, 2026