#1Midi Health
86/100 · From $0/mo · Accepts insurance · 10 states
Insurance-covered telehealth platform specializing in perimenopause and menopause care for women 35+.
Menopause · 2026
1st Optimal alternatives: 4 top Menopause providers compared
Menopause telehealth focuses on perimenopause and menopause symptom management — hormone replacement therapy (HRT), vasomotor symptoms, sleep, mood, and genitourinary care. Alternatives differ on insurance acceptance, prescribing speed, and clinician training (NAMS certification, ABOG board status).
At-a-glance comparison(5)
| Provider | Score | Starting | Insurance | States |
|---|---|---|---|---|
| 1st Optimal BASELINE | 71/100 | $89/mo | Cash only | 30 |
| Midi Health | 86/100 | $0/mo | Yes | 10 |
| Elektra Health | 85/100 | $30/mo | Cash only | 30 |
| Tia Women’s Health | 84/100 | $0/mo | Yes | 5 |
| Alloy Women's Health | 83/100 | $49/mo | Cash only | 28 |
Top 4 alternatives to 1st Optimal
Each ranked by our 8-dimension editorial score. How we score →
#2Elektra Health
85/100 · From $30/mo · Cash-pay · 30 states
Comprehensive midlife women's health platform. Care team includes menopause-trained clinicians plus a community membership component.
#3Tia Women’s Health
84/100 · From $0/mo · Accepts insurance · 5 states
Hybrid in-person and virtual clinic for women with full-spectrum care including perimenopause and HRT.
#4Alloy Women's Health
83/100 · From $49/mo · Cash-pay · 28 states
Cash-pay menopause telehealth with FDA-approved HRT delivered monthly. Co-founded by Healthline ex-CEO.
Common questions(4)
Why look for alternatives to 1st Optimal?
Common reasons include state coverage gaps (30 states currently), pricing fit, insurance compatibility, or preference for a different clinical model. The alternatives below all operate in the same category (Menopause) with varying tradeoffs.
Is 1st Optimal still a good choice?
1st Optimal ranks 71/100 in our editorial scoring. Worth comparing against alternatives below — see full 1st Optimal review for pros/cons.
Do these alternatives accept insurance?
Insurance acceptance varies. 2 of 4 alternatives below accept major insurance — see comparison table for specifics. 1st Optimal is cash-pay only.
How do I switch from 1st Optimal to another provider?
Most telehealth platforms accept transfers — request your medical records from 1st Optimal (HIPAA right of access, typically 30 days), then provide them during the new platform's intake. If on HRT or controlled medication, plan the switch to avoid prescription gaps.