How care works
How Midlife Medicine
Care Works
Midlife Medicine is a physician-led, direct-care menopause and midlife practice in Great Falls, Virginia. You book online, complete an intake form, meet with Dr. Todd for a longer-than-usual visit, receive an individualized plan, and refine it together at follow-ups — in person or by telehealth anywhere in Virginia or Washington, D.C.
Your path from first click to feeling better
Choose the right starting point
Not sure it's a fit? Book a 20-minute Meet & Greet Call ($30) to ask questions before committing. Ready for care? Go straight to the 60-minute Initial Consultation ($600). Both are booked online in a few clicks — no referral needed.
Complete intake before your visit
You'll receive a secure intake form through the patient portal covering your symptoms, health history, medications, and goals. Doing this ahead of time means your visit is spent on decisions and answers, not paperwork.
Meet with Dr. Todd
The Initial Consultation is a full hour — roughly four times the length of a typical insurance-based appointment. You'll review your whole midlife picture together: symptoms, personal and family risk factors, lab needs, treatment preferences, and the risk-benefit tradeoffs of hormone therapy, non-hormone medications, and lifestyle changes.
Leave with a written, personalized plan
Your plan may include hormone therapy, non-hormone prescriptions, supplements when useful, lab orders when helpful, and specific nutrition, strength, and sleep guidance — with prescriptions sent to the pharmacy you choose.
Follow up and refine
Treatment is not set-and-forget. A Follow-Up Visit ($250) is required eight weeks after your initial consultation to check your response, side effects, and dosing effectiveness. After that, an Annual Check-In ($350) keeps your plan and prescriptions current year to year.
Message between visits
Established patients use the secure patient portal to reach Dr. Todd directly for non-urgent questions, refill needs, and results — no phone tree, no nurse-line relay.
What makes direct care different?
Direct care (sometimes called direct-pay or cash-pay medicine) means the practice works for you, not an insurance network. Because no insurer dictates visit length or coding, appointments are longer, care is more personal, and prices are published up front.
Longer visits
60 minutes for a new-patient consultation and 30 minutes for follow-ups — enough time to actually address perimenopause and menopause symptoms, not just triage them.
Transparent pricing
Every visit has a flat, published price. No surprise bills, no coding games, no wondering what insurance will decide months later.
Direct physician access
You see the same physician every time and can message her directly through the portal between visits.
Specialist-level menopause expertise
Dr. Todd is a Menopause Society Certified Practitioner — care is grounded in current menopause evidence, not one-size-fits-all protocols.
In person or by telehealth
Visits are available in person at the Great Falls, VA office or by secure video for patients physically located in Virginia or Washington, D.C. at the time of the appointment. Most menopause and perimenopause care — evaluation, hormone and non-hormone planning, prescriptions, lab review, and follow-ups — works well over video; however, in-person appointments are also available at our Great Falls office location if preferred. See the full service area for details.
Pricing, insurance, and HSA/FSA
Midlife Medicine does not contract with insurance companies for visits, and is opted out of Medicare. Here is how the money side actually works:
Common questions about how care works
Do I need a referral to become a patient?
No. Midlife Medicine is direct care — you can book a Meet & Greet Call or an Initial Consultation online without a referral from another doctor.
Does Midlife Medicine take insurance?
No. Visits are paid directly at flat, published prices. Insurance usually still covers your labs and prescriptions, superbills are available for possible out-of-network reimbursement, and most visit fees are HSA/FSA eligible.
How long are appointments?
The Initial Consultation is 60 minutes, follow-ups are about 30 minutes, and the Annual Check-In is 45 minutes — substantially longer than typical insurance-based visits.
Can I do everything by telehealth?
Most care works well by secure video if you're physically in Virginia or Washington, D.C. at the time of the visit. In-person office visits are available at the Great Falls location if that is your preference.
Does Midlife Medicine replace my primary care doctor?
No — we work alongside your primary care team, focusing specifically on perimenopause and menopause. Records and results can be shared with your other clinicians.
How quickly can I be seen?
Booking is online and real-time — you pick from actual open appointment slots when you book, so you'll know your visit date immediately.
What happens after the Initial Consultation?
You'll receive a written plan with instructions for lab orders and prescriptions. A follow-up visit is required eight weeks after the initial consultation to check response and adjust the treatment plan as needed. After that, an Annual Check-In keeps care and prescriptions current.
Ready to start?
Book a $30 Meet & Greet to ask fit questions, or go straight to an Initial Consultation if you're ready for care.