Here's the short version. Midi Health and Winona both prescribe menopause hormone therapy online, but they run on opposite models. Midi works like a doctor's office on video that bills your insurance. Winona works like a subscription: message a doctor, get a set price, get a box every 28 days. Everything below comes from each company's own pages.
Midi Health and Winona side by side
| Midi Health | Winona | |
|---|---|---|
| Visit type | Video: 30-minute first visit, 15-minute follow-ups | Portal messages with a doctor; no video or phone visits |
| Insurance | Visits in-network with most major and PPO plans; Medicare out of network (self-pay allowed); Medicaid not accepted | Not accepted |
| Self-pay visit cost | A fee for the first visit and a lower one for each follow-up | Free; doctor access included |
| HSA/FSA | Accepted | Accepted, plus CareCredit |
| FDA-approved HRT | Pill, patch, vaginal ring, cream or gel, sent to your pharmacy | Estradiol tablet, estradiol patch, progesterone capsule |
| Compounded HRT | Not for core HRT; Estriol+ face cream in its Custom Rx line | Estrogen body creams, progesterone cream, vaginal estrogen cream, from its own 503A pharmacies |
| Monthly medicine price | Your insurance copay or pharmacy price | Estradiol tablet from $58.66; patch from $161.86; progesterone capsule from $42.37 |
| Labs | Ordered as needed by your clinician | None needed for HRT |
| Who and where | Women in midlife; visits in all 50 states | Women 35 to 59, in 37 states plus Puerto Rico |
| Billing | Visits through insurance or self-pay; medicine through your pharmacy | Every 28 days, or every 84 days for a 90-day supply |
| Refunds and canceling | Cancel subscriptions online, by email or by phone | Full refund within 24 hours of ordering; pause 30, 60 or 90 days |
| Testosterone for women | Offered in 25 states, after a video visit and labs | Not offered (DHEA instead) |
Sources: [1] [2]. Neither company names an FDA-approved brand for its patch or tablet.
How a visit works at each
Midi puts you on video with a clinician; Winona has a doctor review your intake and talk with you by message. That's the biggest difference in day-to-day use.
At Midi, you book a 30-minute first video visit, and follow-ups run 15 minutes. Your clinician may order labs, then writes a care plan. Brand and generic hormones go to the pharmacy you choose [1]. Midi's clinicians work for named medical groups, and its pages describe a team of physicians, nurses and other licensed clinicians.
At Winona, the intake is free. A board-certified physician reviews it and prescribes through the patient portal. There's no video or phone visit, and you message the same doctor as often as you like [2]. Winona publishes bios for its 30-plus physicians. Medicine ships free by USPS Ground, with paid faster options.
If you want to see someone's face and ask questions live, that's Midi. If you'd rather answer questions on your own time, that's Winona.
Insurance vs self-pay: what you'll actually pay
At Midi you pay your plan's visit cost plus your pharmacy's price for the medicine; at Winona you pay one price every 28 days. So the comparison depends on your insurance.
Midi's visits are in-network with most major and PPO plans. Without coverage, Midi charges a self-pay fee for the first visit and a lower fee for each follow-up, on top of medication [1]. Medicare is out of network, though you can pay yourself, and Medicaid isn't accepted. Midi publishes no cash price for HRT, because your pharmacy sets it.
Winona lists "from" prices for its estradiol tablet, its patch and its progesterone capsule, with the doctor and shipping included [2]. The pages don't say whether higher strengths cost more. The catch: billing every 28 days means renewal dates that move across calendar months.
What each one prescribes
Both prescribe FDA-approved estradiol and progesterone; Winona adds its own compounded creams, and Midi adds broader midlife care. Midi says it prescribes FDA-approved bioidentical hormones as pills, patches, vaginal rings, and creams or gels [1]. Winona lists an FDA-approved estradiol tablet, estradiol patch and progesterone capsule, plus compounded body and vaginal creams [2].
Beyond HRT, Midi offers testosterone for women in 25 states, an NAD+ nasal spray, GLP-1 weight care and longevity visits [1]. Winona sticks to menopause: it doesn't prescribe testosterone or GLP-1s, and offers prescription DHEA instead [2]. On testosterone for women, see what testosterone therapy is.
Compounded vs FDA-approved on each menu
If you want FDA-approved hormones, both programs have them; if you want a compounded cream, Winona is where you'll find it for core HRT. Winona makes its creams in two pharmacies it owns, in El Dorado Hills, California and Twin Falls, Idaho, both 503A compounding pharmacies [2]. Midi's compounded items sit in a separate Custom Rx line, such as an Estriol+ face cream [1].
Two things to know. FDA-approved estradiol and progesterone are already bioidentical, so you don't need a compounded product for that. And several Winona body creams contain estriol, which is in no FDA-approved US product; we don't price estriol products while their pharmacy route is unclear. The background is in what menopause HRT is.
Where they're available, and for whom
Midi sees patients in all 50 states; Winona treats women 35 to 59 in 37 states plus Puerto Rico. Winona's 37 states: AZ, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KY, ME, MD, MA, MI, MN, MO, MT, NE, NV, NH, NJ, NY, NC, OH, OK, OR, PA, SC, TN, TX, VA, WA, WI and WY [2]. Midi's testosterone program for women covers 25 states [1]. Check your state at signup either way.
Refunds, pausing and canceling
Winona gives you 24 hours to get a full refund, then lets you pause; Midi's subscriptions cancel online, by email or by phone. At Winona, you can cancel or pause for 30, 60 or 90 days in your account settings. After the 24-hour processing window, there are no cancellations, refunds or returns on that order [2]. At Midi, your HRT medicine runs through your pharmacy, and Midi sends renewal reminders for its own subscriptions [1].
Heads up on Winona: if you order and change your mind the next day, it's too late for a refund. Pausing is your fallback.
Who each one fits
- Pick Midi Health if you have major or PPO insurance, want live video visits, may need labs, or want testosterone or other midlife care in the same place.
- Pick Winona if you're 35 to 59 in one of its states, want one set price with no visit fees, are fine messaging a doctor, and want the option of a compounded cream.
- Look elsewhere if you're on Medicaid (Midi doesn't accept it) or live outside Winona's states and want self-pay. Other menopause options include AgelessRx, Inner Balance and Gala.
Still deciding? The hormones shortlist lists programs by goal, or take the 30-second match.