Billing structure is one of the most overlooked differences between ED telehealth providers — and it changes the real cost of trying a service, not just the sticker price. Broadly, the providers on this page split into two camps: recurring subscriptions with auto-refill, and one-time, pay-per-visit models.
Confirmed Subscription-Based Providers
Strut Health runs its ED plans as a monthly subscription — medication, provider support, and auto-refill shipping billed on a recurring basis until you cancel through their patient portal, typically with advance-notice requirements.
Several other providers on this page also default to recurring billing once a prescription is active, since that's the standard model for most direct-to-consumer telehealth pharmacies. Always confirm the specific billing terms — monthly charge, cancellation process, advance-notice window — directly on each provider's site before your first order, since terms can change.
Flexible or Pay-As-You-Go Options
MangoRx sells by the pill with an optional "Subscribe and Save" auto-refill add-on — you're not required to opt into recurring billing to order.
Sesame Care has no subscription tied to the ED visit itself. You pay the clinician's fee once, per visit, and medication is billed separately when it's filled — there's no recurring charge unless you choose to book again.
| Provider | Billing Structure |
|---|---|
| Sesame Care | Pay per visit, no subscription |
| MangoRx | Pay per pill, optional auto-refill subscription |
| Strut Health | Monthly subscription, auto-refill |
| Others on this page | Varies — confirm current terms on each provider's site |
The Real Trade-Off
A subscription front-loads the decision: you commit once, and reordering happens automatically without you having to think about it again. That's convenient if you know you'll need treatment consistently, but it also means a recurring charge sits on your card until you actively cancel it. A pay-per-visit model like Sesame's puts the decision back in your hands every time — more friction if you need treatment regularly, but nothing to remember to cancel if you don't.
Sesame Care
Book directly with a licensed clinician for an ED evaluation — FDA-approved treatment only, no compounded formulations under this listing.
Brand-name treatment only through this program. Confirm current pricing and availability on their site — it varies by provider.
View Sesame CarePaid LinkHow to Decide
- If you already know ED treatment is something you'll need consistently, a subscription's convenience likely outweighs the recurring charge.
- If this is your first time trying telehealth ED treatment, or your need is occasional, a pay-per-visit model like Sesame's avoids committing before you know what you actually want.
Neither billing model is inherently better value — it depends on how predictable your usage is. When in doubt, start with a pay-per-visit option before committing to a subscription you might forget to cancel.