2026 Comparison
Six services reviewed honestly for online ED treatment: Bidwell Health, Hims, Ro, Rex MD, Lemonaid, and BlueChew. Every legitimate service uses the same first-line medications — generic sildenafil, tadalafil, vardenafil. The differences are pricing model (flat-fee vs subscription), format (standard tablet vs chewable), and the breadth of men's-health conditions each service handles.
Four dimensions for an online ED service: clinical screening (does the intake adequately screen cardiovascular risk, nitrate use, Peyronie's, and other contraindications?), pricing transparency (flat-fee vs hidden subscription costs), speed (mail-order delivery vs pharmacy pickup), and scope (ED-only vs bundled men's-health). AUA guidelines support all three first-line PDE5 inhibitors as equally effective — the ranking below is about pricing, convenience, and service scope, not clinical efficacy.
| Service | Model | Medication price, read 5 Sep 2026 | Format | Coverage | Best for |
|---|---|---|---|---|---|
| Bidwell Health | $45 one-time visit, refunded if online treatment is not appropriate; you buy the medication at your pharmacy | Generic sildenafil 50 mg about $1.10 to $1.71 a tablet with a pharmacy coupon, or $0.21 by mail from Cost Plus Drugs; tadalafil 20 mg $0.84 to $0.94 with a coupon | Standard tablets (generic sildenafil or tadalafil) | 11 states | One-time visits, flat-fee preference, pharmacy pickup |
| Hims | Subscription plans, mail order | Sildenafil "from $4 per use"; $6 a dose on a six-dose monthly 50 mg plan; tadalafil $6.50 to $12.25 a dose; daily tadalafil $2.63 a tablet on a monthly plan, about $1.07 a tablet on a 12-month prepay | Standard tablets, mail-order | All 50 states + DC | Subscription convenience, multi-condition bundling |
| Ro (Roman) | Subscription plans, mail order | Sildenafil 50 mg $6 a dose; tadalafil 20 mg $44 a dose; daily tadalafil $8 a dose | Standard tablets, mail-order | All 50 states | Ro ecosystem users (Roman, Rory, Zero) |
| Rex MD | Subscription plans, mail order | Sildenafil 50 mg "as low as" $6 a dose, 20 mg $2; tadalafil "as low as" $6; daily tadalafil "as low as" $2 | Standard tablets, mail-order | Most states | Men wanting TRT + ED + hair loss bundled |
| Lemonaid | $25 one-time consult, then medication shipped | Sildenafil "starting at $2/pill" (20 mg); "$30 for the first shipment", renewal price not published; tadalafil not priced per strength | Standard tablets, mail-order | Most states | Patients comparing per-visit ED care |
| BlueChew | Subscription only, mail order | Chewable sildenafil "from $3.53 per tablet"; chewable tadalafil "from $4.47"; daily chewable $2.23 | Chewable tablets (sildenafil or tadalafil) | Most states | Patients preferring chewable format |
Strengths: Transparent $45 per-visit pricing with no required subscription; the visit fee is refunded if online treatment is not clinically appropriate. The same $45 visit model covers ED, hair loss, UTI, and bridge refills in the same account. Published AUA-based protocols, clinician NPI numbers on the provider page, Pharmacy pickup means eligible prescriptions are sent to the pharmacy you choose rather than locked into a mail-order subscription.
Limitations: Licensed in 11 states only. Medication and delivery are provided by your chosen pharmacy, with separate charges. No TRT offering.
Who wins with Bidwell: Adults in the 11 licensed states who want one-time pricing, prefer local pharmacy pickup, and specifically don't want subscription auto-renewal. See /ed-treatment
Pharmacy choice: If prescribed, medication can be sent to your chosen local, mail-order or compounding pharmacy, including Amazon Pharmacy or Cost Plus Drugs. The pharmacy must be able to fill the prescription. Medication and shipping costs are separate. Bidwell does not dispense or ship medication.
Strengths: Well-established brand with a mature ED program. Nationwide coverage. Mail-order delivery removes pharmacy trips. Bundles well with hair loss, mental health, and weight-loss programs under one account.
Limitations: Subscription auto-renews monthly — cancellation requires remembering to do it. Bundled medication plus membership pricing can be harder to compare directly against a one-time visit. Subscription model may be expensive for occasional use.
Who wins with Hims: Men already using Hims for hair loss or another condition who want to consolidate, or those preferring recurring mail-order delivery over pharmacy pickup.
Head-to-head: Bidwell Health vs. Hims
Strengths: One account covers Ro's other services (men's and women's health, weight loss, fertility). National coverage.
Limitations: Multi-fee structure (consult + membership + medication) is less transparent than flat-fee. Mail-order delays filling. Subscription lock-in.
Who wins with Ro: Patients already using Ro for another service who want ED treatment added to their existing subscription.
Head-to-head: Bidwell Health vs. Ro
Strengths: Broader men's-health scope than most ED services — includes testosterone replacement therapy (TRT) with lab-draw partnerships, weight-loss pathways, and hair loss alongside ED. One account for multiple men's-health concerns.
Limitations: Subscription model. Mail-order timing. Bundling means paying for breadth you may not need if ED is the only concern.
Who wins with Rex MD: Men managing testosterone, weight loss, hair, and ED together who want a single-platform experience.
Head-to-head: Bidwell Health vs. Rex MD
Strengths: A one-time $25 consult rather than a membership, broad state coverage, and the lowest published sildenafil price of the six at $2 a pill for the 20 mg tablet.
Limitations: Medication ships from Lemonaid rather than going to your own pharmacy, only the 20 mg sildenafil price is published, the renewal price after the "$30 first shipment" is not, and tadalafil is not priced per strength on its site.
Who wins with Lemonaid: Patients comparing pay-per-visit ED care across broad state coverage.
Head-to-head: Bidwell Health vs. Lemonaid
Strengths: Chewable sildenafil and tadalafil tablets — some patients find chewables preferable to swallowing pills, and the compounded format is BlueChew's signature. Subscription model with month-to-month flexibility.
Limitations: Subscription-only — no pay-per-visit option. Compounded chewables are pharmacologically similar to standard tablets but the regulatory pathway is different (compounded vs FDA-approved generic). Mail-order only.
Who wins with BlueChew: Men who specifically prefer chewable format over standard tablets, and who want a subscription model with fixed monthly pricing.
Best per-visit fit: compare Bidwell Health and other pay-per-visit ED services directly at checkout, because competitor prices change frequently. Best for subscription bundling (ED + hair + mental health): Hims or Ro. Best for TRT + ED + broader men's-health: Rex MD. Best chewable format: BlueChew. The clinical medication is similar across legitimate services — the ranking depends on pricing model preference, coverage, and whether you want mail-order or pharmacy pickup.
PDE5 inhibitors are absolutely contraindicated with nitrates (nitroglycerin, isosorbide, recreational "poppers") and relatively contraindicated with recent myocardial infarction, stroke, or life-threatening arrhythmia within six months. Every legitimate service has to screen for these before prescribing; Bidwell's intake asks about each one. If you have severe cardiovascular disease, sudden-onset ED under age 40, history of priapism, or Peyronie's disease, you need in-person evaluation (cardiology or urology) before starting PDE5 medication — not a telehealth service of any brand.
Priced over a year at six sildenafil doses a month, from the cost comparison (prices read 5 September 2026): Friday Plans $143, Rocket Rx $167, Lemonaid from $169 (20 mg tablets), two $45 Bidwell Health visits plus coupon-priced generic 50 mg tablets $170 to $215 (about $125 through Cost Plus Drugs), BlueChew about $360 (chewable), Hims $348 to $492, Ro $432, Rex MD $408 to $432. Of the six services on this page, Lemonaid is the cheapest at that volume on its 20 mg tablets, Bidwell is within a few dollars of it on 50 mg tablets and the only one where the medication is bought at your own pharmacy, and the subscription services cost two to three times as much. Plans change, so confirm at checkout.
Yes — same active ingredient (sildenafil), same doses, same FDA bioequivalence standards. Generic costs 5–10× less with no meaningful clinical difference.
Occasional use (a few doses per month) → pay-per-visit is cheaper. Daily or frequent use with mail-order preference → subscription may feel more streamlined though costs more over a year.
No legitimate ones. PDE5 inhibitors are Rx in the U.S. with cardiovascular contraindications — licensed clinician review is required. Any "no prescription needed" online ED offering is either a scam or operating outside U.S. regulatory boundaries.