Your questions, answered

Telehealth means you see your provider by secure video instead of in person. You book a visit, then join from your phone, tablet, or computer at your appointment time. It’s private, HIPAA-compliant, and means no commute or waiting room.

We currently accept patients in Michigan and Iowa. Contact us with any questions.

No — Rubi Health is 100% virtual. Every visit happens by secure video, so you can be seen from wherever is most comfortable for you.

Yes. In Michigan and Iowa, a Family Nurse Practitioner (FNP-C) is licensed to practice independently and prescribe medications, including hormone replacement therapy. Your Rubi Health provider is a board-certified FNP-C with specialized training in women’s hormone health — she can evaluate your symptoms, order labs, and prescribe HRT entirely through telehealth, with no in-person visit required.

No — Rubi Health is a cash-pay practice, so insurance is never required. Our flat-rate visit fees mean you always know what you’ll pay, with no deductibles, prior authorizations, or surprise bills.

New patient evaluation is $250, follow-up visits are $150, and urgent/sick visits are $99. HSA and FSA cards are welcome. Lab work is billed separately by the lab.

While we don’t bill insurance directly, many visits and labs may be partially reimbursable. Ask us — we’ll provide a superbill you can submit to your insurer.

Yes. Rubi Health accepts HSA and FSA cards for visit fees.

Rubi Health is designed exactly for this. We’re a cash-pay telehealth practice — no insurance required, ever. You pay a flat fee per visit ($250 new patient, $150 follow-up), we order your labs at a location near you, and prescriptions are sent electronically to your preferred pharmacy. HSA and FSA cards are accepted. Many patients find the total out-of-pocket cost is comparable to or less than insured care once deductibles and co-pays are factored in.

Perimenopause often starts in the early-to-mid 40s, though it can begin earlier. Common early signs include irregular periods, sleep disruption, increased anxiety or mood changes, brain fog, low energy, hot flashes or night sweats, and changes in libido. Many women experience these symptoms for years before their periods stop — and many are told it’s “just stress.” If something feels off, it’s worth talking to a provider who specializes in this transition.

Perimenopause typically lasts 4 to 8 years, though it can be shorter or longer. It begins when hormone levels start to fluctuate — often in the early 40s — and ends 12 months after your last period, at which point you’ve reached menopause. Symptoms can be mild early on and intensify as you get closer to menopause. Treatment can help at any stage.

Yes. Your provider will review your symptoms and history, order any needed hormone labs to a lab near you, and build a personalized HRT plan — all by secure video. Follow-up and dose adjustments are handled online too.

Yes — for most women, telehealth is a safe and appropriate way to start HRT. Your provider will do a thorough symptom and history review, order labs before prescribing, and follow up regularly to make sure your plan is working. An in-person visit is only needed if your provider identifies something that requires physical examination. Leading medical organizations including the Menopause Society support telehealth as a valid care delivery model for hormone therapy.

We treat the full range of perimenopause and menopause symptoms — hot flashes, night sweats, sleep changes, mood shifts, brain fog, and more. Your provider will help you understand what’s happening and discuss options, including HRT when appropriate.

HRT is considered safe and effective for most healthy women under 60 or within 10 years of their last period. The 2002 WHI study overstated certain risks, and more recent guidance from NAMS and the Menopause Society confirms that for most women the benefits outweigh the risks. Your provider will review your personal and family history to make sure it’s the right fit for you.

Yes. We prescribe FDA-approved bioidentical hormones including estradiol and progesterone, and can discuss compounded options when appropriate. Bioidentical means the hormone is chemically identical to what your body produces. Your provider will walk you through all options so you can make an informed choice.

Bioidentical hormones are chemically identical to the hormones your body produces naturally — like estradiol and progesterone. Synthetic hormones have a different molecular structure and may behave differently in the body. Most FDA-approved HRT products today are actually bioidentical (estradiol patches, gels, and oral micronized progesterone). Compounded bioidentical hormones are custom-mixed by a pharmacy; they aren’t FDA-regulated the same way, so we prescribe them only when standard options aren’t the right fit. Your provider will explain the differences and help you choose what’s right for you.

We prescribe a range of delivery methods including oral pills, transdermal patches, creams, and gels. The right form depends on your symptoms, health history, and personal preference — your provider will walk you through the options and help you find the best fit.

Most women notice improvement within 4–8 weeks, with full benefit often felt by 3 months. Sleep and mood tend to shift first; hot flashes and night sweats typically improve within the first month. Dose adjustments are common early on — your provider will check in at follow-ups to make sure you’re on track.

Possibly, yes. Many women are dismissed or told to “just wait it out” when evidence-based options are available. We take a thorough look at your symptoms, health history, and labs — and if HRT isn’t the right fit, we’ll discuss alternatives. You deserve a provider who takes your symptoms seriously.

Yes. Low testosterone in women can contribute to fatigue, low libido, brain fog, and mood changes — symptoms that estrogen alone doesn’t always address. We can evaluate whether testosterone therapy is appropriate for you and prescribe it when indicated.

Yes. Vaginal dryness, irritation, and pain with intercourse are common and very treatable. We prescribe low-dose vaginal estrogen and other options that are safe for most women, including those who can’t use systemic HRT. You don’t have to live with this.

Alongside hormone care we handle weight loss and metabolic support, everyday primary and sick visits, prescription refills, chronic condition follow-up (thyroid, blood pressure, cholesterol), and midlife wellness — bone, heart, and metabolic health, plus age-appropriate screenings.

This is one of the most common and frustrating things women tell us. As estrogen declines during perimenopause and menopause, your metabolism slows, your body shifts where it stores fat (often toward the abdomen), and insulin sensitivity changes. These are hormonal changes, not a sign that you’re doing something wrong. Addressing the underlying hormonal picture — not just cutting more calories — is usually what actually moves the needle.

Yes. We provide medical weight management entirely by telehealth — starting with a comprehensive evaluation of your health history, hormones, and metabolic factors, then building a personalized plan that may include lifestyle guidance, lab work, and prescription support when clinically appropriate. Everything is managed online, including follow-up visits and medication adjustments.

We prescribe weight loss medications, including injectable and oral options, when they’re clinically appropriate. Whether medication is right for you depends on your health history, current medications, weight loss goals, and other factors your provider will review. Medication is always part of a broader plan — not a standalone solution.

No — weight loss support is available as a standalone service. That said, for many women in perimenopause and menopause, hormones and weight are closely connected. Your provider will look at the full picture and may discuss how addressing hormone changes could support your metabolic goals, but there’s no requirement to pursue HRT.

For many women, yes — reducing excess weight can lessen the frequency and severity of hot flashes, improve sleep, and support better energy and mood. It also reduces risk for the cardiovascular and metabolic conditions that become more important to watch in midlife. Weight and hormonal health are deeply connected, and we look at both together.

We’re a medical practice, not a diet program. That means we start with your health history, labs, and hormonal picture — not a one-size-fits-all eating plan. We look at what’s actually driving weight changes in your body (hormones, metabolism, insulin resistance, sleep, stress) and build a plan around that. When medication is appropriate, we can prescribe it. And because we’re your primary care provider too, we can manage everything together.

We typically have same-week availability, and sick visits may be available the next business day. Request a visit through the patient portal or by phone to check open times.

Yes. Your provider can prescribe most medications electronically to your preferred pharmacy. Certain controlled substances may require additional steps or in-person evaluation.

Your provider can order labs and imaging during your visit. Orders are sent to a location near you, and results are reviewed and shared through your patient portal.

Call 911 or go to your nearest emergency room immediately. Rubi Health is not an emergency service.