Roughly half of men between 40 and 70 experience some degree of erectile dysfunction, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Despite how common ED is, many men delay treatment for years, often because of the awkwardness of discussing it face to face with a doctor. That’s precisely why the best telehealth for ED platforms have become so popular: a private online consultation, a prescription if appropriate, and medication delivered to your door. No waiting rooms, no uncomfortable conversations under fluorescent lights.
But these platforms aren’t all the same, and treating ED is about more than convenience. Pricing, medication options, clinician qualifications, and whether insurance is accepted vary significantly, and prices and even company ownership change often. Our telehealth guide covers how virtual visits work in general. Below, we compare several leading ED telehealth platforms so you can find the right fit for your situation and budget, and, just as important, we explain why ED deserves a real medical evaluation rather than a quick pill.
The short version: Telehealth can make starting ED treatment easier and more private, but ED is often an early signal of cardiovascular disease, diabetes, or low testosterone, so the smart move is to get evaluated, not just treated. PDE5 inhibitors like sildenafil and tadalafil are prescription medications that a clinician must match to your health and current medications, especially because they can be deadly when combined with nitrate heart medicines. All prices, plans, and company details below are estimates that change frequently; verify current pricing directly and never buy pills from a site that skips the medical questions. This article is educational and is not medical advice.
ED Is a Symptom, Not Just a Nuisance
Before comparing platforms, it’s worth stressing the single most important point about online ED care. Persistent erectile dysfunction is frequently an early warning sign of an underlying condition, most notably cardiovascular disease, because the small blood vessels of the penis often show trouble before the larger arteries of the heart. ED is also linked to diabetes, high blood pressure, low testosterone, sleep apnea, depression, and the side effects of other medications.
The Mayo Clinic notes that persistent ED should prompt a broader health evaluation, not just a prescription. A responsible telehealth platform will screen for these issues and refer you for in-person testing (such as blood pressure, blood glucose or A1c, cholesterol, and sometimes testosterone) when your history warrants it. If a service is willing to ship pills without asking meaningful health questions, that is a red flag, not a convenience. The best outcome from an ED visit may be catching a treatable heart or metabolic problem early.
How Online ED Treatment Works
Most telehealth ED platforms follow a similar workflow. You complete a medical questionnaire covering your symptoms, health history, current medications, and lifestyle factors. A licensed physician or nurse practitioner reviews your information, sometimes followed by a synchronous video or phone consultation, sometimes handled asynchronously through messaging. If the clinician determines you’re an appropriate candidate for treatment, they may write a prescription.
Medications are typically shipped from a partner pharmacy directly to your home in discreet packaging. The most commonly prescribed ED medications are PDE5 inhibitors, including sildenafil (the active ingredient in Viagra), tadalafil (Cialis), and vardenafil (Levitra), along with branded formulations. Because the right medication, dose, and frequency depend on your individual health, this article does not provide dosing; those decisions belong with your prescribing clinician. Follow-up consultations are usually available to adjust treatment if needed.
Hims: Best for Affordability and Brand Recognition
Hims (operated by Hims & Hers Health, Inc.) is arguably the most recognized name in men’s telehealth. The platform launched in 2017 and has built a large user base through heavy marketing and competitive pricing on generic ED medications.
Pricing and Plans
Hims generally advertises generic sildenafil at low per-dose prices through subscription plans, with generic tadalafil somewhat higher, and bundled monthly plans that include the consultation, medication, and shipping. Hims also markets branded chewable products and combination products at higher price points. Exact prices change often and depend on the medication and dosage a clinician prescribes, so check the current rates on the platform directly rather than relying on any figure here.
Pros and Cons
Pricing is the standout advantage; Hims consistently offers some of the lowest advertised per-dose costs for generic sildenafil and tadalafil. The platform also offers a wide range of men’s health products beyond ED, including hair loss and mental health treatments. On the downside, Hims often uses asynchronous consultations, meaning you may not speak with a provider directly unless you request it, and it generally does not bill insurance for ED treatment.
Insurance Coverage
Hims generally does not accept insurance for ED medications; pricing is cash-pay. HSA and FSA cards may be accepted for eligible products.
Ro (Roman): Best for Comprehensive Men’s Health
Ro’s men’s health brand, Roman, was one of the first telehealth platforms dedicated to ED treatment. The company has since expanded into weight management, heart health, and other areas, but ED treatment remains a core offering.
Pricing and Plans
Roman typically prices generic sildenafil and tadalafil competitively, with the online consultation fee usually folded into the medication price, plus combination options and daily tadalafil plans. Branded Viagra is available at a premium. As with all these services, current pricing varies and should be confirmed on the platform.
Pros and Cons
Roman’s strength is its clinical depth. The platform offers convenient shipping and integration with its broader health services, so if your ED is related to weight, cardiovascular health, or testosterone, Roman can help address those through the same platform. The main drawbacks are pricing that can run slightly higher than Hims for some products and, like most competitors, no insurance billing for ED medications.
Insurance Coverage
Roman operates on a cash-pay model for ED medications; insurance is generally not accepted, though the platform may accept HSA/FSA payments.
Lemonaid Health: A Prescription-to-Pharmacy Model
Lemonaid Health focuses on fast, straightforward telehealth consultations. Ownership note for 2026: Lemonaid was previously part of 23andMe, which filed for Chapter 11 bankruptcy in March 2025; its assets, including Lemonaid Health, were acquired by the nonprofit TTAM Research Institute in mid-2025. Because ownership and service availability can shift after events like this, confirm that Lemonaid still offers ED consultations in your state and check current terms before relying on it.
Pricing and Plans
Lemonaid has historically charged a flat consultation fee for ED visits, with medications priced separately. A useful feature is that you can have the prescription sent to your local pharmacy and fill it using your insurance or a discount card, rather than only through a platform pharmacy. Verify the current consultation fee and options directly, as these may have changed.
Pros and Cons
The separated consultation-plus-pharmacy model is Lemonaid’s key differentiator. Because you receive an actual prescription (not just platform-dispensed medication), you have the flexibility to fill it wherever you get the best price. This makes it a strong choice if you have pharmacy benefits through insurance. The trade-off is a slightly less seamless experience compared to all-in-one platforms, since you manage the pharmacy step yourself, plus the ownership uncertainty noted above. If you’ve used services like GoodRx virtual visits, this model will feel familiar.
Insurance Coverage
The consultation fee is typically cash-pay. However, because prescriptions can be sent to external pharmacies, you may be able to use your insurance pharmacy benefit to cover the medication itself.
BlueChew: Best for Chewable Formulations
BlueChew has carved out a niche by offering ED medications in chewable tablet form rather than traditional pills. The company offers sildenafil, tadalafil, and vardenafil chewables on a subscription model.
Pricing and Plans
BlueChew’s subscription plans are tiered by the medication and the number of tablets per month, with the online consultation included in the subscription price. Higher tiers (more tablets, or vardenafil) cost more. Check current plan pricing on the platform, as tiers and prices change.
Pros and Cons
The chewable format appeals to men who dislike swallowing pills or want a faster-absorbing formulation, and it can feel less medicalized, which matters psychologically for some users. BlueChew also offers vardenafil, which isn’t available on many competing platforms. The key downside is that BlueChew operates through a compounding-pharmacy model, so its specific chewable formulations are not FDA-approved products in the way brand-name and standard generic pills are. Compounded medications are not reviewed by the FDA for safety, effectiveness, or quality the same way, so discuss this with a clinician. The platform also does not bill insurance.
Insurance Coverage
BlueChew does not accept insurance; plans are subscription-based and cash-pay only.
Sesame: Best for One-Time Consultations Without Subscriptions
Sesame takes a marketplace approach rather than a subscription model. You browse available clinicians, book a telehealth visit for ED at a transparent price, and receive a prescription that you fill at any pharmacy. There’s no ongoing subscription requirement.
Pricing and Plans
ED consultations on Sesame are typically priced per visit and vary by clinician and appointment type. Medication pricing depends entirely on where you fill the prescription; using discount programs such as GoodRx, generic sildenafil can be inexpensive for a monthly supply at major retail pharmacies. We reviewed Sesame’s telehealth platform in detail if you want a broader look at their services. Confirm current visit prices on the platform.
Pros and Cons
No subscription lock-in is Sesame’s biggest advantage. If you just need a prescription written or renewed, one visit may be all it takes. You also have full control over where you fill the script, which means you can price-shop pharmacies. The downside is that Sesame doesn’t offer the bundled convenience of medication delivery that platforms like Hims or Roman provide.
Insurance Coverage
Sesame visits are typically cash-pay, but prescriptions sent to external pharmacies can be processed through your insurance or discount programs.
Side-by-Side Comparison
Here’s how these platforms tend to compare on the factors that matter most for ED treatment. Treat this as a general guide, since offerings change:
- Lowest advertised per-dose price: Hims and Roman, which compete aggressively on generic sildenafil and tadalafil
- Best for using pharmacy insurance: Lemonaid and Sesame, which send prescriptions to your pharmacy of choice
- Chewable options: BlueChew (chewable sildenafil, tadalafil, and vardenafil, via compounding)
- Fastest, simplest visit: Lemonaid and Sesame for a single, no-subscription prescription
- No subscription required: Sesame and Lemonaid
- Most comprehensive men’s health: Roman (integrates ED with heart health, weight, and testosterone)
Keep in mind that all of these platforms serve as a starting point for treatment. If you experience ED alongside other symptoms such as significant fatigue, weight gain, depression, or reduced libido, the underlying cause may be hormonal. Our guide to telehealth HRT platforms covers testosterone replacement options that may be relevant, always under clinician supervision.
ED medication red flags — act immediately:
- Priapism: an erection lasting more than 4 hours is a medical emergency. Untreated, it can permanently damage the penis. Go to the emergency room.
- Chest pain, pressure, or severe shortness of breath during or after sex: call 911. Do not take a nitrate medication (such as nitroglycerin) to relieve it if you have taken a PDE5 inhibitor.
- Sudden vision loss in one or both eyes, or sudden hearing loss or ringing: stop the medication and seek urgent medical care.
- Fainting, severe dizziness, or a sudden severe drop in blood pressure: seek emergency care.
Safety Considerations for Online ED Treatment
ED medications (PDE5 inhibitors) are generally safe for many men when properly prescribed, but they carry important contraindications, which is exactly why a clinician must review your full medication list. You should not take sildenafil, tadalafil, or vardenafil if you use nitrate medications for chest pain or heart disease (such as nitroglycerin or isosorbide) — the combination can cause a sudden, dangerous, potentially fatal drop in blood pressure. Certain recreational drugs known as “poppers” (amyl nitrite) carry the same deadly risk. Use with alpha-blockers (often prescribed for blood pressure or an enlarged prostate) also requires caution and careful timing because of blood-pressure effects. Men with severe cardiovascular disease, recent heart attack or stroke, very low blood pressure, or unstable angina should be evaluated before starting an ED medication.
Common side effects include headache, flushing, nasal congestion, and indigestion. These are typically mild. Rare but serious side effects include priapism (an erection lasting more than four hours) and sudden vision or hearing changes, both of which require immediate medical attention, as noted in the red-flag box above. The FDA labeling for all PDE5 inhibitors includes these warnings.
Any reputable telehealth platform will screen for these contraindications in its intake questionnaire. Be completely honest about your medical history, current medications, and any recreational drug use; withholding information from your telehealth provider puts your safety at risk.
Beware Counterfeit and “No-Evaluation” Pills
The convenience of buying ED medication online has a dark side. Numerous websites sell “generic Viagra” or “Cialis” with no medical evaluation, no questions, and no prescription. The FDA has repeatedly warned that such products are often counterfeit and may contain the wrong dose, no active ingredient, or undisclosed and dangerous substances. Because these pills bypass the medication-safety review that protects you from the nitrate interaction and other risks, they can be genuinely life-threatening.
Protect yourself with a few simple rules: use a platform that requires a genuine health questionnaire and a licensed clinician’s review, insist that a prescription be involved, prefer pharmacies that are clearly US-licensed, and be skeptical of any site offering prescription ED drugs with no evaluation or at prices that seem too good to be true. If a service will sell to anyone who can pay, it is not screening for the interactions that can hurt you.
How to Choose the Right Platform
Selecting the best telehealth for ED comes down to a few practical questions. If you want the lowest per-dose price with maximum convenience, Hims or Roman deliver medication directly at competitive rates. If you prefer to use your pharmacy insurance benefit, Lemonaid or Sesame give you a transferable prescription. BlueChew fills a niche for men who prefer chewable tablets, with the compounding caveat noted above.
Don’t overlook the clinical side. Persistent erectile dysfunction can signal cardiovascular disease, diabetes, low testosterone, or depression. The American Urological Association recommends a thorough evaluation for men with ongoing ED, particularly younger men in whom ED more strongly suggests an underlying vascular problem. If your telehealth provider isn’t asking about your broader health, consider a more comprehensive evaluation, ideally with your primary care clinician.
Frequently Asked Questions
Do I need to see a doctor in person for ED medication?
In many states, a licensed telehealth provider can prescribe ED medications like sildenafil and tadalafil based on an online consultation and health questionnaire, without an in-person exam. However, if the provider suspects an underlying condition, they may recommend lab work or an in-person visit, and that follow-through is a feature, not a hassle.
Is generic Viagra as effective as brand-name Viagra?
Generic sildenafil contains the same active ingredient as brand-name Viagra and, when FDA-approved, is required to meet the same standards for safety, quality, and effectiveness. The main difference is price; generic sildenafil typically costs a fraction of the brand. This is different from unapproved compounded or counterfeit products, which are not held to the same FDA review.
How much does telehealth ED treatment cost without insurance?
Costs vary widely by platform, medication, and where you fill a prescription, and they change over time. In general, generic sildenafil is inexpensive, especially with discount programs, while branded products and bundled subscription plans cost more. Consultation fees, where charged separately, are usually modest. Always confirm current pricing on the platform before signing up.
Can telehealth platforms prescribe daily tadalafil (Cialis)?
Yes. Many ED telehealth platforms offer a low-dose daily tadalafil option in addition to on-demand dosing. Daily dosing provides continuous readiness rather than timing a dose around activity, and some men find it more convenient. Which option and strength is right for you is a decision for your prescribing clinician, based on your health and other medications.
Is it safe to take ED medication with blood pressure drugs?
It depends on the specific drugs. PDE5 inhibitors must never be combined with nitrates, and they require caution with alpha-blockers and some other blood-pressure medications because of additive blood-pressure lowering. This is exactly why a clinician needs your complete medication list before prescribing. Never combine an ED pill with a nitrate, even in an emergency.
What to Do Next
Start with a quick self-assessment: how often does the issue occur, how long has it been happening, and are there any accompanying symptoms like fatigue, mood changes, or chest pain? That information will make your telehealth consultation more productive. If this is a new or worsening symptom, prioritize platforms that offer more thorough clinical evaluations rather than bare-bones questionnaires, and consider looping in your regular doctor.
Pricing should be your secondary consideration after clinical quality and safety. The difference between platforms is often just a few dollars per dose, but the quality of the medical evaluation, and the screening that keeps you away from dangerous interactions, matters far more for your long-term health. Pick a reputable platform, complete the intake honestly, and remember that treating ED well can also mean catching a heart or metabolic problem before it becomes serious.
This article is for general education and is not medical advice. Prescription decisions, including whether an ED medication is appropriate for you and at what dose, must be made by a licensed clinician who knows your full health history. If you have priapism, chest pain, or sudden vision or hearing loss, seek emergency care.
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) — Erectile Dysfunction: niddk.nih.gov
- Mayo Clinic — Erectile Dysfunction: mayoclinic.org
- U.S. Food and Drug Administration (FDA) — PDE5 inhibitor labeling and counterfeit-drug warnings: fda.gov
- American Urological Association — Erectile Dysfunction Guideline: auanet.org