TLDR
Menopause telehealth exists because traditional healthcare largely ignores the transition. Only 5% of US women aged 45-64 received menopause-specific care. Midi Health has the broadest reach across all 50 states. Elektra is cheapest with qualifying insurance. Evernow is the lowest cash-pay option. Gennev works through employers. Horiva is not telehealth but complements any of these with daily symptom tracking.
| Service | Price | Insurance | States | Prescribing | Daily Tracking |
|---|---|---|---|---|---|
| Midi Health | $150 + $99/mo | Limited | All 50 | Yes | No |
| Elektra Health | $199 + insurance | Medicare/Medicaid/ACA | 11 (ACA) | Yes | No |
| Evernow | $49/mo | No | Varies | Yes | No |
| Gennev | Employer-based | Via employer | Varies | Via network | No |
| Horiva | $9/mo | N/A | N/A | No | Yes |
Midi Health
Largest menopause telehealth platform with $150M+ revenue, operating in all 50 states with cash-pay pricing.
Pros
- ✓ Available in all 50 states
- ✓ $150M+ annual revenue indicates established infrastructure
- ✓ Can prescribe HRT and manage treatment directly
Cons
- × $150 initial + $99/month is expensive long-term
- × Cash-pay model with limited insurance acceptance
- × No daily symptom tracking between visits
Pricing: $150 initial + $99/mo
Verdict: Best for nationwide access when insurance is not a factor.
Elektra Health
First menopause telehealth platform to accept Medicare and Medicaid, with $0 copay ACA plan in 11 states.
Pros
- ✓ First to accept Medicare and Medicaid
- ✓ HelloMeno ACA plan at $0 copay
- ✓ Insurance-based model reduces out-of-pocket costs
Cons
- × ACA plan limited to 11 states
- × Smaller provider network than Midi
- × No daily symptom tracking
Pricing: $199 initial + insurance
Verdict: Best for women with qualifying insurance in available states.
Evernow
Lowest cash-pay menopause telehealth at $49/month with prescription management.
Pros
- ✓ Lowest cash-pay subscription at $49/month
- ✓ Straightforward pricing model
- ✓ Prescription management included
Cons
- × Narrower service scope than Midi or Elektra
- × Less established than larger competitors
- × No daily tracking tools
Pricing: $49/mo
Verdict: Best budget option for cash-pay menopause prescriptions.
Gennev
Employer-sponsored menopause platform with 2,700+ providers, acquired by Unified Women's Healthcare in 2022.
Pros
- ✓ 2,700+ menopause-trained provider network
- ✓ Coaching plus clinical care model
- ✓ Employer-sponsored access can be free to the user
Cons
- × Acquired October 2022 - priorities may shift
- × Employer-dependent access creates job-change risk
- × Direct access pricing is less transparent
Pricing: Varies by employer plan
Verdict: Best if your employer offers it as a benefit.
Horiva
Not telehealth - a privacy-first daily symptom tracker that complements any clinical platform with on-device storage and doctor reports.
Pros
- ✓ On-device data storage - health data never leaves your phone
- ✓ 40+ perimenopause symptoms with doctor report PDF export
- ✓ Complements any telehealth service with daily tracking data
Cons
- × Not a clinical service - cannot prescribe or diagnose
- × No clinician access within the app
- × $9/month with no free tier
Pricing: $9/mo (1-month free trial)
Verdict: Best companion tool for daily tracking alongside any telehealth service.
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Try Horiva freeWhy This List Exists
Most women in perimenopause cannot find a knowledgeable provider. 68.7% of OB/GYN residency programs have no dedicated menopause curriculum. Only 5% of US women aged 45-64 received menopause-specific care. Telehealth platforms exist because the traditional system does not.
1. Midi Health - Broadest Access
Midi Health operates in all 50 states and has grown to $150M+ in annual revenue. The clinical team can prescribe HRT and manage ongoing treatment. At $150 initial plus $99/month, it is the most expensive option on this list but also the most broadly available.
The problem is cost. $1,338 in the first year adds up. No insurance pathway for most patients means you pay the full amount.
2. Elektra Health - Best with Insurance
Elektra is the first menopause telehealth platform to accept Medicare and Medicaid. Their HelloMeno ACA plan offers $0 copay in 11 states. For women with qualifying insurance, this is the most affordable option by a wide margin.
The limitation is geographic. The ACA plan covers 11 states. Elektra is expanding, but availability depends on where you live and what insurance you carry.
3. Evernow - Lowest Cash-Pay Price
Evernow charges $49/month for menopause prescription management. No initial consultation fee at the same scale as Midi or Elektra. The scope is narrower - focused on prescription management rather than comprehensive clinical care.
For women who know they want HRT and want the cheapest path to a prescription, Evernow is straightforward.
4. Gennev - Employer-Sponsored
Gennev pivoted to employer-sponsored benefits after the October 2022 acquisition by Unified Women’s Healthcare. The 2,700+ provider network is substantial. Access depends on whether your employer offers Gennev as a benefit.
Tying menopause support to your job means a career change could interrupt care during a transition that lasts years.
5. Horiva - Daily Tracking Companion
Horiva is not telehealth. It is a symptom tracker that complements any of the services above. None of the four telehealth platforms above include daily symptom tracking. Horiva fills that gap at $9/month with on-device storage and PDF doctor reports.
Walking into a Midi, Elektra, Evernow, or Gennev appointment with months of documented symptom data changes the clinical conversation. The Andrews RCT showed 42% symptom reduction from structured tracking alone, which means tracking has independent value even before adding clinical care.
Q&A
What is the best menopause telehealth service?
It depends on your insurance and budget. Elektra is cheapest with qualifying insurance in their 11 ACA states. Midi Health has the broadest access across all 50 states at $99/month. Evernow is the lowest cash-pay option at $49/month. None of these platforms include daily symptom tracking. Pair any of them with a tracker for better clinical conversations.
Q&A
Why do menopause telehealth platforms exist?
Because traditional healthcare fails most women during the menopause transition. 68.7% of OB/GYN residency programs lack dedicated menopause curriculum. Only 5% of US women aged 45-64 received menopause-specific care in one national survey. Telehealth platforms fill a gap that most gynecologists and primary care providers are not trained to address.
Frequently asked