Marek Health vs Defy Medical: Which One Fits How You Want TRT Care to Run?

Marek Health vs Defy Medical comes down to coaching versus pay-per-service care. Marek advertises $299 to start, with labs and prescriptions extra. Defy publishes an illustrative under-$175 monthly average, not a fixed plan. Neither figure proves which costs less. Proper evaluation, fertility plans, insurance needs and your written quote should decide the next step.

By TRT Provider Guide · Last verified: October 2026 (provider pages checked October 15, 2026) · Editorial research — not medically reviewed · How We Review TRT Providers
Last updated October 15, 2026 · Last reviewed October 15, 2026

Three things change that answer:

• Your low testosterone hasn't been properly evaluated yet? Start with your own doctor or our testing guide. Symptoms or signs plus consistently low results and repeat early-morning testing matter more than either price. Endocrine Society guidance
• Trying for a baby now or soon? See a reproductive urologist first. Testosterone can lower sperm production. Fertility guidance
• Want insurance to pay for an FDA-approved testosterone product? Neither company bills insurance. Start by checking an in-network prescriber and your plan's covered product and pharmacy. Marek offer · Defy terms

Price isn't the biggest difference we found, though. Defy's terms promise a coded superbill on request. Marek Diagnostics says it does not provide diagnostic codes for retail lab purchases. That difference matters when you need insurance paperwork—but it does not establish reimbursement or savings. The details are in the insurance section. Defy terms · Marek Diagnostics FAQ

Quick verdict

These are provider-stated offers, not quotes for your care. The retail lab price is not a clinical enrollment package. Marek offer · Marek TRT page · Defy cost FAQ · Defy retail panel · Defy service page

Ready to look closer? See Defy's new-patient contact form or see what Marek's $299 offer includes. Neither link is a payment checkout. Not sure either fits? Keep reading. We'll tell you plainly who should choose a different starting point.

Educational information, not medical advice. Testosterone is a Schedule III controlled substance and requires a valid prescription. For emergency symptoms such as chest pain, severe trouble breathing or signs of a stroke, call 911 or seek emergency care. DEA scheduling · Federal prescribing rule

TRT Provider Guide is the independent decision resource for testosterone replacement therapy — helping U.S. adults understand how low testosterone is evaluated, compare online and local care models and providers, and choose the next step that fits their health needs, fertility plans, budget, state, and care preferences, with every material claim verified and dated.

This comparison concerns U.S. adult men evaluating testosterone deficiency. It is not a treatment guide for women, adolescents, gender-affirming care or athletic performance.

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Marek Health vs Defy Medical: how do they compare at a glance?

Marek Health and Defy Medical both advertise cash-pay, lab-based testosterone care, but they are built differently. Marek describes a coaching platform connected to partnered medical providers; Defy presents a medical practice with physicians, nurse practitioners and physician assistants, plus a clinic in Tampa, Florida. These are service-model differences, not proof of better medical outcomes. Marek process · Defy team · Defy services

We built this table from published offers, retail lab listings, available FAQs and dated terms checked on October 15, 2026. Provider-stated means the company publishes the claim; confirming that wording is not an independent test of the service. Prices below are listed U.S. dollars, not a patient-specific quote.

Sources for the comparison: Marek offer and process, TRT offer, advertised lab minimum, published follow-up FAQ, booking policy, retail initial panel, lab FAQ and lab refund policy; Defy services, cost FAQ, April 2, 2026 terms, retail initial panel, retail-lab FAQ, patient portal, pharmacy directory and team; Marek Trustpilot and Defy Trustpilot. Review scores describe customer feedback, not clinical quality.

The right TRT provider is not the same for every person — it depends on whether low testosterone has been properly evaluated, your symptoms and health history, your fertility plans, your state, your insurance or cash-pay preference, your treatment-format preference, your budget, and whether online or in-person care is the better starting point. Some situations belong with primary care, urology, endocrinology, reproductive urology, or urgent or emergency care when the symptoms warrant it. Because a general answer cannot resolve those for you, use TRT Provider Guide's Find My TRT Path tool to map your situation to the right care route and the questions to ask before you pay.

What we actually verified (October 15, 2026)

We checked: Marek's accessible how-it-works and TRT offer pages; published pricing and booking-policy text; Marek Diagnostics' panel listings, FAQ and refund policy; Defy's service and team pages, contact form, patient-portal terms effective April 2, 2026, pharmacy directory and retail lab listings; attributable reviews; and the medical and regulatory sources linked below.

Confirmed in published documents: The selected retail prices and test lists, advertised visit lengths, Defy's coded-superbill and follow-up terms, separate lab-store refund rules, support hours and named pharmacy contacts. These remain provider-stated policies and offers, not proof of what every patient receives.

What we could not confirm: Complete patient-specific first-year costs, exact prescription and shipping charges, all state-by-state prescriber and pharmacy authorizations, personal lab acceptance, or actual wait times. Several main-site FAQ and booking pages could not be fully inspected, so we do not present their unconfirmed details as settled checkout terms. We did not complete checkout, enroll, buy from, contact support at or receive care from either company. This is a public-source comparison, not a hands-on review.

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What's the real difference between Marek Health and Defy Medical?

Marek Health describes a platform that pairs coaching with care from partnered medical providers. A Marek Health Coach supports the program, while a medical provider makes clinical and prescribing decisions. Defy presents a medical practice whose providers see you, with a support team between visits and a physical clinic in Tampa. Marek process · Defy team · Defy services

That one difference shapes almost everything else on this page.

With Marek, your main relationship is with a coach. Marek advertises dedicated coaching and ongoing support. The coach walks you through your labs, while a partnered provider handles medical evaluation and any prescription. Marek's own landing page says the $299 fee gives you lifetime access to coaching and clinician consultations. Labs, supplements, and prescriptions are billed separately. Treat that as the advertised offer, and confirm the exact access and charges in your agreement. Marek how-it-works page

With Defy, your main relationship is with a medical provider. Defy advertises hour-long consults with its in-house physicians, nurse practitioners, and physician assistants. A patient support team handles ordering and scheduling. One Trustpilot reviewer described a provider who "spent the entire hour with me" (Dani Coleman, published August 23, 2026, invited review). That is one person's experience, not a guaranteed appointment length. Defy services · Defy team · Original review

One inconsistency to know about. Marek's TRT landing page displays $299 in its headline and $299.99 on a button. Its broad inclusion language also sits alongside a FAQ that says required labs and prescriptions cost extra. Ask Marek in writing which total and inclusions apply before you pay. The how-it-works page advertises a 45-minute provider appointment. TRT offer · How it works

Defy does not advertise a dedicated monthly health coach in the care pages we checked. If having a dedicated coach is your priority, Marek is the better fit to explore. Read our Marek Health TRT review for how its coaching works. Defy instead describes pay-per-service billing with no monthly fee. That is a billing difference—not proof that skipping coaching creates savings or better medical care. Marek process · Defy services · Defy cost FAQ

Does that trade sound right to you? Start Defy's new-patient request. The form asks a Defy Patient Advocate to contact you about requirements. It does not itself collect payment or book a visit.

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How much does Marek Health cost vs Defy Medical?

Marek Health advertises a $299 starting fee, with required labs and prescriptions separate; its TRT page also advertises a lab minimum of $450. Defy Medical publishes an illustrative average of under $175 a month in year one and about $125 a month afterward, not a fixed monthly plan. Neither offer establishes your complete first-year bill. Marek offer · Marek TRT page · Defy cost FAQ

Here's the catch. These are two different kinds of numbers. Marek gives you an advertised starting subtotal. Defy gives you an average you can't check line by line until you talk to them. So we did the math the companies didn't do side by side.

Step 1: What you pay before anyone decides whether to prescribe

This is your real risk: you may pay for an evaluation without receiving a prescription. Marek's booking policy describes a nonrefundable deposit. Defy's terms do not promise refunds for completed labs or consultations simply because treatment is not recommended. Unused lab orders have separate rules, explained below. Marek booking policy · Defy terms

Neither subtotal includes a verified medication price or every possible evaluation charge. A retail lab purchase does not automatically enroll you in clinical care. Marek offer · TRT page · Marek retail panel · Draw-fee FAQ · Defy panel

Step 2: A three-panel retail lab basket (our calculation)

We priced one initial panel plus two follow-up panels using each company's retail listings. This is an equal-count shopping comparison, not a claim that both companies require exactly three blood draws in your first year. Your clinician may need a separate diagnostic confirmation draw, different tests or more frequent monitoring.

Read this carefully. These are retail prices, not your clinical quote or complete first-year care costs. The panels aren't identical either. Marek's $595 Pre-TRT Panel includes a 45-minute coach review and advertises 80+ biomarkers. Defy's $299 retail panel advertises 50+ biomarkers and says it doesn't include a provider review of results. Marek's $300 monitoring panel offers a coach review as a separate $100 add-on. None of those coach reviews replaces a prescribing clinician's evaluation. Marek initial panel · Marek monitoring panel · Defy initial panel · Defy follow-up panel

Using the advertised $450 Marek starting panel with two separately purchased $300 retail monitoring panels would total $1,050, but that mixes an advertised member minimum with retail follow-up prices. It is not a verified care package. Do not assume follow-up labs are included in the $299 fee: the accessible offer FAQ says required labs cost extra. Get any different offer in writing. Marek TRT page · Marek offer FAQ

Step 3: What Defy's "under $175 a month" actually covers

Defy's published cost explanation says its average male TRT patient spends under $175 a month in year one. That's under $2,100 for the year. It drops to around $125 a month, about $1,500 a year, after that. The example covers testosterone, labs, consultations and an aromatase inhibitor. An aromatase inhibitor is a drug that lowers estrogen. Its appearance in a price example is not a recommendation that every person on TRT needs one. Defy calls the figure illustrative and not a price guarantee. Defy cost FAQ

We did not find a comparable complete-care Marek quote in the pages checked. Its patient-specific medication and other charges were not available, so we can't build a full Marek year one without inventing numbers. We won't do that.

Other charges to put in your quote

• Any separately charged physical examination or repeat diagnostic testing.
• Prescription shipping, supplies and refill-related fees. One Defy reviewer specifically wished shipping cost less (Debbie S., published August 25, 2026); that is a customer-experience signal, not a price list. Original review
• Supplements, extra testing or non-testosterone treatments. Have the clinician distinguish required care from optional purchases and quote each separately.

Your cost and commitment worksheet

Send the same questions to both companies. This makes the comparison about your care instead of two different advertisements.

Complete first-year cost = required one-time charges + all required repeat visits and tests + prescribed medication, supplies and shipping for the same 12-month period. Keep optional purchases separate. If a required item is not quoted, write “not quoted,” not $0, and do not label the subtotal a complete annual cost.

You can copy this request:

Please send an itemized first-year quote for the care you propose, separating fees due before the prescribing decision from ongoing charges. Include the required tests and visits, any separate early-morning confirmation test, medication and pharmacy details, shipping, physical-exam requirements and cancellation terms. Please identify anything you cannot price until after the clinical evaluation.

Want your own exact numbers? Ask a Defy Patient Advocate for an itemized quote. Ask for the consult fee, the patient lab price, and the medication pricing process in writing. For Marek, read our Marek Health TRT cost breakdown before you pay the starting fee.

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Does Marek Health or Defy Medical take insurance, HSA, or FSA?

Neither Marek Health nor Defy Medical accepts insurance for its services. Defy's Terms of Service say it will provide a superbill with CPT and ICD-10 codes on request, so you can try for out-of-network reimbursement. Marek Diagnostics says it does not provide diagnostic codes for retail lab orders; get a separate answer about paperwork from any partnered clinical practice. Marek offer · Defy terms · Marek Diagnostics FAQ

A superbill is a detailed receipt with two kinds of codes. One set describes the visit or test (CPT codes). The other describes the diagnosis (ICD-10 codes). Ask your insurer what documents and covered services your plan requires; a coded receipt is not a promise of payment. Defy's paperwork policy

What that means for you:

• You have a PPO or another plan with out-of-network benefits. Defy offers the coded document you can submit, but its terms say it will not process claims, contact your insurer or guarantee payment. Confirm coverage before budgeting any reimbursement. Defy terms
• You plan to pay with HSA or FSA funds. Marek's lab store offers payment through TrueMed. That is not proof that every lab, coaching service, supplement or prescription is an eligible expense. Check the expense and documentation rules with your administrator before paying. Marek Diagnostics FAQ · IRS guidance · See TRT providers that accept HSA or FSA.
• You want insurance to cover the medication itself. Start with your plan's covered product, pharmacy and prescriber requirements. Primary care, urology or endocrinology may be a better fit than paying cash for these programs. Cash-pay visits alone do not prove that a prescription can never be covered. Compare TRT providers that take insurance.

Have out-of-network benefits? Ask Defy about its coded-superbill process before booking care. Call your insurer first to ask what it covers and what documents it needs.

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What does each require: physical exams, labs, and follow-ups?

Physical-exam forms, diagnostic tests and follow-up labs are separate requirements. Defy's dated terms require a signed physical-exam form at least every 24 months and consultations and necessary testing at least every six months, unless the individual treatment plan says otherwise. Marek advertises quarterly consultations; obtain its current physical-exam, outside-lab and testing requirements before buying a panel. Defy terms · Marek process

These are published service descriptions, not a testing schedule for you. Get the prescriber's instructions for preparation and timing; an ongoing-treatment test is not a substitute for diagnostic confirmation. Marek offer · Marek follow-up FAQ · Marek lab FAQ · Defy terms · TestDefy FAQ · Diagnostic guidance

State limits that can stop a retail lab order. Marek Diagnostics lists New York, New Jersey and Rhode Island as restricted; another answer in the same FAQ also excludes Hawaii and U.S. territories and points residents of the four named states toward Guided Optimization for lab arrangements. TestDefy lists New York, New Jersey, Pennsylvania, Rhode Island and Massachusetts as excluded from on-demand retail testing. These limits apply to the lab stores, not proof of clinical prescribing availability. If you live in one of those places, confirm the required lab process before paying. Marek Diagnostics FAQ · TestDefy FAQ

A PSA detail worth knowing. PSA (prostate-specific antigen) is a blood test used in prostate screening. Defy's initial men's panel lists PSA. Marek's $595 Pre-TRT Panel doesn't list PSA in its published test list, though Marek's monitoring panel does. That is a panel-content difference, not proof of what a clinician will order for you. Ask how any prostate screening appropriate to your age and risk will be handled before treatment. Defy initial panel · Marek initial panel · Marek monitoring panel · Endocrine Society guidance

Defy's Terms of Service place responsibility for arranging prostate screening with your own primary care doctor or urologist and ask you to share the relevant records. Either way, keep your regular doctor in the loop. Defy terms

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Is your low T actually confirmed? The "optimization" catch

Both companies use optimization language, but marketing language is not a diagnosis. Testosterone deficiency requires compatible symptoms or signs plus consistently low results, confirmed with appropriate repeat early-morning testing. If you have not had that evaluation, make it the next step—not a choice based only on either price. Marek offer · Defy terms · Endocrine Society guidance

Read the consent, not just the sales page. Defy's general hormone-treatment consent includes treatment “even where lab test results are within reference ranges.” The same terms also say a prescription requires medical need and a clinical assessment. That is worth asking about; it does not prove that every Defy testosterone prescription follows the same approach. Defy terms

Here's what the medical guidance says:

• The Endocrine Society's guideline: Diagnosis requires symptoms or signs and consistently low testosterone, with a repeat morning fasting total-testosterone measurement. Free testosterone may help in certain cases, such as a borderline total result or a condition affecting the proteins that carry testosterone.
• The Endocrine Society's July 16, 2026 statement: It reiterates symptoms plus confirmed low results on at least two early-morning, fasting tests. A number near 300 ng/dL is not a universal diagnosis by itself; the assay, reference range and clinical setting matter.

Guideline · July 2026 statement

Total testosterone is all the testosterone in your blood. Free testosterone is the small share not bound to proteins and available for your body to use. Both selected initial retail panels list total and free testosterone. Marek panel · Defy panel

The Endocrine Society also flags a lab-quality problem. The same blood sample can read "low" at one lab and "normal" at another. It recommends tests certified by the CDC's Hormone Standardization (HoST) program. Ask whichever company you pick whether its testosterone assay is HoST-certified. July 2026 statement

What you're signing up for, risk-wise. The FDA added class-wide blood-pressure warnings to testosterone products in 2025. The TRAVERSE trial studied testosterone gel in men with confirmed hypogonadism and existing or elevated cardiovascular risk; its main cardiovascular result does not prove every formulation or patient group has the same risk. Pulmonary embolism—a blood clot in the lungs—and fractures were more frequent in testosterone groups in the TRAVERSE research. Those findings deserve a clinician discussion, not a claim that TRT is risk-free. FDA 2025 labeling change · FDA testosterone information · Endocrine Society statement

A 2026 update matters here. In June 2026, FDA requested further labeling changes concerning age-related hypogonadism, prostate cancer and benign prostate enlargement. A request to revise labels is not proof that every product's label has already changed, or that anyone with those conditions should receive testosterone. The Endocrine Society's July 2026 statement still says long-term prostate safety is not established. Your clinician should use the current label for the exact product and assess your own risks. FDA June 2026 update · Endocrine Society statement

Discuss these with primary care, urology, reproductive urology or endocrinology before choosing an online TRT program:

• Very low testosterone, or a known pituitary or testicular problem
• Trying to conceive now or soon
• High hematocrit (a high share of red blood cells) or a history of blood clots
• Untreated severe sleep apnea
• A history of prostate or breast cancer
• A recent heart attack or stroke

These situations can change whether treatment is appropriate and which clinician should lead your care. Endocrine Society guidance

Not sure your labs are enough to start? Use TRT Provider Guide's Find My TRT Path tool to map the care route that fits your situation. It's free and educational, and it shows you what to ask before you pay. It doesn't diagnose you or decide whether you qualify.

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Which treatment formats and pharmacies can you use?

Marek Health lists testosterone injections and topical cream. Defy Medical lists injections, topical options, pellets and nasal gel, and publishes a directory of three compounding pharmacies. The exact product, FDA approval status and assigned pharmacy still need confirmation for your prescription. Marek TRT offer · Defy services · Pharmacy directory

Advertised Marek formats · Advertised Defy formats · Defy directory · Defy terms

FDA-approved testosterone products

FDA approval applies to an exact finished drug, not every product containing testosterone or every product dispensed by a pharmacy. An injection, gel or pellet description alone does not establish the approval status of the prescription offered to you. FDA testosterone information · FDA compounding guidance

Compounded testosterone preparations

What "compounded" means. Compounding involves combining or changing ingredients to prepare a medication. The FDA says compounded drugs are not FDA-approved and aren't reviewed by the FDA for safety, effectiveness, or quality before they're sold. Traditional 503A pharmacies usually prepare patient-specific prescriptions and are primarily overseen by state boards. Registered 503B outsourcing facilities can compound without patient-specific prescriptions, must meet applicable manufacturing requirements and are subject to FDA oversight. FDA compounding questions and answers

Watch the wording. Defy's terms refer to pharmacies using “FDA-approved active ingredients.” That phrase does not establish FDA approval of the finished compounded preparation. Likewise, pharmacy licensure, FDA registration or an inspection is not FDA approval of every drug the pharmacy dispenses. Ask about the exact product, not just a pharmacy-quality slogan. Defy terms · FDA compounding guidance

Ask both companies, in writing:

1. What exact product and strength will I get?
2. Is it an FDA-approved product or a compounded preparation?
3. Which pharmacy fills it, and is that pharmacy licensed to ship to my state?
4. How do refills work, and how long do they usually take?

Defy's terms require prescriber approval of refills and compliance with the treatment plan, including required labs, exams and visits. Its patient portal advertises 24–72 hours for compounding before shipping, but that is not the total time from a refill request to delivery. Ask both companies who handles a delayed prescription, what must be completed first and when to contact the care team before the next fill is due. No fixed total turnaround was confirmed. Defy terms · Defy patient portal

If you specifically want a brand-name, FDA-approved testosterone product covered by insurance, confirm that exact product, pharmacy and coverage path before choosing either cash-pay program. See our TRT treatment options guide and talk to an in-network prescriber.

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What about fertility?

Testosterone replacement can suppress sperm production, because added testosterone tells your body to slow its own signals to the testes. If you want biological children now or soon, talk to a reproductive urologist before choosing either company. Medicines sometimes used alongside or instead of TRT are not interchangeable with it. Endocrine Society guidance

• The Endocrine Society advises against starting testosterone in men planning fertility in the near term. A fertility-focused evaluation belongs before the provider-price decision. Guideline
• An advertised fertility service or an hCG option does not prove that a particular plan will preserve sperm production. No one can guarantee you'll keep or recover your fertility.
• hCG, clomiphene, and enclomiphene are different drugs with different purposes and approval status. They are not “natural TRT.”

Non-testosterone medicines are not TRT

Pregnyl prescribing information · Clomid prescribing information · FDA advisory record · 2026 British Society for Sexual Medicine statement

Read the fertility-first TRT guide before you pay either company.

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What happens if you cancel, switch, or don't qualify?

A paid evaluation does not guarantee a prescription or a refund. Marek's published booking policy describes a nonrefundable deposit and a late-change fee up to $50. Defy can charge the full consultation fee for a late cancellation or no-show, but unused lab orders have seller-specific refund or credit rules. Marek booking policy · Defy terms · TestDefy FAQ

The seller matters. TestDefy's unused-test refund FAQ is not the same as Defy's clinical account-credit policy. Save the terms attached to the exact purchase; ask which policy governs before paying. Marek booking policy · Marek Diagnostics refund policy · Defy clinical terms · TestDefy retail FAQ

"No subscription" doesn't mean "no money at risk." For Marek, identify the booking deposit and the specific lab order you are paying for. For Defy, separate the consultation fee from the lab purchase and check the seller's unused-order rules. An advertised startup subtotal is not automatically the amount that becomes nonrefundable at every stage.

Before you pay either company, confirm in writing whether a purchase is a lab order, a consultation, or both.

Switching later? Ask for your records and lab results before you cancel. Expect the new provider to review your history and decide which outside tests and examinations it accepts; a new evaluation or testing may be needed. Don't stop or change any prescription without your prescribing clinician. Read how to switch TRT providers.

Ask who holds the medical record, how to request a copy, whether there is a release form or records fee, and how pending results and refill requests will be handled. With Marek, distinguish the coach's records from those held by the partnered medical practice. A transfer request does not guarantee that a new clinician will continue the same prescription. Marek care model · Defy prescription and refill terms

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What support is available, and what do patients report?

Defy Medical publishes phone and email support hours through 7 p.m. Eastern on weekdays and from 9 a.m. to 2 p.m. on Saturdays. Marek publishes weekday hours from 9 a.m. to 5 p.m. Eastern, plus email and phone contact details. These are contact hours, not guaranteed clinician-response times. Defy patient portal · Marek offer page

Published Marek contact information · Defy patient portal · Marek Trustpilot · Defy Trustpilot

Star ratings tell you about service experience, not medical quality or results. Here are three real, attributable comments, chosen because they answer questions readers actually ask:

"Thorough first appointment… On time and spent the entire hour with me." — Dani Coleman, Defy reviewer, Trustpilot, published August 23, 2026 (invited review; experience dated August 20). Original review

"the breakdown is in the timeline." — Daphne, Defy reviewer, Trustpilot, published August 26, 2026 (invited, 3 stars; experience dated August 17). She praised her practitioner but reported a three-week wait for her first appointment and said she was still waiting for the prescription to reach the pharmacy 11 days after that appointment. Defy replied on August 27 and offered to investigate. Original review and reply

"Bryan, my health coach, was friendly, welcoming and extremely thorough." — Tom, Marek reviewer, Trustpilot, published October 2, 2026 (unprompted, 5 stars; experience dated September 30). Original review

One more data point: replying to a different review on August 28, 2026, Defy acknowledged an ordering and checkout backlog and said it was working on it. That is a historical response, not confirmation that the same backlog continued in October. If speed matters to you, ask Defy about current wait times for a first appointment and for prescriptions. Ask Marek how long coach intake, labs, and the provider visit typically take. Original review and company reply

“Invited” and “unprompted” are Trustpilot's labels; an invitation alone does not establish that a reviewer was paid. We did not verify private reviewer relationships. These comments are not endorsements of treatment results.

These are individual experiences, not typical results. They don't prove either company's medical quality.

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Which states do they serve, and will telehealth rules change?

Marek describes nationwide service, but that does not establish that every treatment, lab order or prescriber is available to you. Defy's terms limit care to jurisdictions where it is authorized, and we did not confirm a complete state-by-state prescribing list. The current federal temporary telemedicine extension runs through December 31, 2026, with conditions. Marek company profile · Defy terms · Federal rule

Before you pay either one, confirm four things for the state where you will be physically located during care:

1. Is the assigned prescriber licensed or otherwise authorized to treat you in that state?
2. Can the assigned pharmacy legally dispense and ship the prescribed product there?
3. How will you get your required labs?
4. Which physical examination or in-person evaluation is required, and who must perform it?

HHS licensure guidance · Federal prescribing rule

About federal rules. Testosterone is a Schedule III controlled substance. The DEA and HHS extended temporary telemedicine flexibilities through December 31, 2026. Qualifying DEA-registered clinicians can prescribe Schedule II–V controlled medications without a prior in-person evaluation under the extension when its conditions and other federal and state requirements are met; for testosterone, this is not an audio-only or questionnaire-only permission. DEA scheduling · Federal extension

A physical from another clinician does not automatically satisfy the federal in-person evaluation requirement for the prescribing clinician. A clinic's routine physical form and the legal basis for remote controlled-substance prescribing are separate questions. Ask the practice which requirements apply to your care and what its plan is if the rule changes. This page verifies the extension through December 31, 2026; it does not establish the rules for 2027. Federal rule, background and conditions

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Our verdict: Marek Health or Defy Medical?

For men who prefer pay-per-service billing, advertised hour-long consultations, phone support and a coded superbill, Defy Medical is the stronger fit. Choose Marek Health for a coaching-led program with broad lab panels, provided you accept separate required lab and prescription charges. Neither company can be called the cheaper or clinically better option for most men from these published figures alone. Defy services · Defy terms · Marek process

This is our editorial conclusion from the verified facts above. It's not a medical recommendation.

Pick Defy Medical if:

• You want your care run by a medical practice, not a coaching program
• You have out-of-network insurance benefits and want a superbill
• You are comfortable with Defy's documented 24-month physical-form interval, subject to your individual treatment plan
• You are willing to ask for a written decision on whether recent outside labs can be used
• You want to ask about pellets, nasal gel, or an in-person option in Tampa
• You want to pick up the phone, including on Saturday mornings

Pick Marek Health if:

• You want a dedicated health coach and ongoing program support
• You want a broad retail panel advertising 80+ biomarkers; its total-testosterone test uses LC/MS and its free-testosterone test uses equilibrium dialysis
• You like a structured program and will obtain a complete starting quote rather than treating $299 as the full bill
• You do not depend on retail lab diagnostic codes or unconfirmed clinical reimbursement paperwork

Choose a different starting point if:

• You have symptoms or one low test but have not had a proper diagnostic evaluation
• You're trying to conceive soon
• You want insurance to pay for an FDA-approved product
• You have one of the health conditions listed in the "optimization" section above

Does Defy sound like your situation? Start Defy's new-patient request. Ask the Patient Advocate for your state requirements, initial visit price and itemized quote before booking paid services.

Is dedicated coaching and deep lab data what you've been missing? Review Marek's Guided Optimization offer. Ask Marek in writing what the starting fee buys, which required labs cost extra, and what follow-up care will cost.

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If neither fits, where should you look instead?

If you prefer membership billing, compare what the membership actually includes; one monthly fee does not necessarily include medication. If you want insurance coverage for an FDA-approved product, start with your plan and an in-network clinician. If fertility is close, start with a reproductive urologist.

• You want to compare membership billing with per-service fees. Start with Male Excel vs Defy Medical or Male Excel vs Marek Health. Check each page's verification date and separate the membership fee from required labs, prescriptions and shipping. Male Excel is an alternative to compare, not an automatic winner.
• You want to compare Hone Health's testing and membership costs. Our Hone TRT cost guide breaks down the first-year math. Confirm what labs, visits, and medication cost before paying; treatment depends on clinical eligibility.
• You want insurance to cover the medication. Start with primary care, urology, or endocrinology. Compare online vs local TRT care.
• You want to see more options for one company. Read Marek Health alternatives or Defy Medical alternatives.

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How did we compare Marek Health and Defy Medical?

On October 15, 2026, we compared published offers, accessible provider and lab pages, available policy text and dated clinical terms. We checked medical and regulatory claims against the primary sources linked below and recalculated the listed-price examples. We have not been patients of either company, so this is a comparison, not a hands-on review.

Our method follows How We Review TRT Providers. We separate four kinds of information:

• Verified facts: what an authoritative source establishes, or what we independently calculate from stated inputs
• Provider-stated facts: a company's published prices, policies and service claims, reported as theirs
• Customer-experience signals: attributed individual reviews, not proof of a representative pattern or medical quality
• Editorial conclusions: our judgment, built from the facts above

We compare complete costs instead of repeating a teaser price. When required charges are missing, we label the known subtotal rather than invent a complete cost. We don't assign numeric scores.

What would change our verdict:

• A written quote showing that either service costs materially more or less for the same care obligations
• A written Marek offer changing which labs, provider visits and ongoing services are included after the starting fee
• A change in either company's insurance paperwork, physical-exam, or refund policies

If you spot an error or have newer information, tell us through our corrections process. Read our editorial standards for how we handle sources and updates.

Time-sensitive boundary: Prices and policies can change. Federal telemedicine information here is verified through the current extension ending December 31, 2026; confirm the rule in force for appointments or prescriptions after that date.

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Marek Health vs Defy Medical: what else should you know?

The remaining questions concern complete cost, paperwork, testing and continuity. None is resolved by a headline price or a review score alone; use the applicable written terms and your clinician's evaluation.

Is Defy Medical cheaper than Marek Health?

The public figures do not establish that. Defy's own average is under $175 a month in year one, while Marek publishes a starting fee with separate charges. Your actual cost depends on the required visits, tests and prescriptions, so get matching written quotes rather than comparing a monthly average with an upfront subtotal. Defy cost FAQ · Marek offer

Is Marek Health a real medical clinic?

Marek describes a coaching platform connected to partnered medical providers, rather than having a coach prescribe treatment. Confirm the legal name of the medical practice and the name and state authorization of the clinician who will evaluate you. Marek process · HHS licensure guidance

Is Defy Medical legit?

Defy Medical has an active public service site, a patient portal, a Tampa clinic and a named medical team. Its current team page lists Justin Saya, MD, as medical director. Those checks establish a visible care operation, not a complete license audit of every clinician or proof of good outcomes; verify your assigned prescriber's authorization for your state. Defy services · Defy team · Patient portal · HHS licensure guidance

Does Defy Medical or Marek Health take insurance?

Neither accepts insurance for its services. Defy's terms provide for a coded superbill on request for possible out-of-network reimbursement, without a payment guarantee. Marek Diagnostics does not provide diagnostic codes for retail lab orders; confirm any separate clinical paperwork before relying on reimbursement. Defy terms · Marek offer · Marek Diagnostics FAQ

Can I use HSA or FSA money?

Marek's lab store offers HSA/FSA payment through TrueMed. Before paying either company, check whether the exact expense qualifies and which documents your administrator needs; card acceptance is not a tax-eligibility guarantee. Marek Diagnostics FAQ · IRS guidance

Do I need an in-person physical exam?

Defy's terms require a signed physical-exam form at least every 24 months or as documented in the individual plan. Confirm the initial deadline and Marek's current exam requirements before booking. A routine physical form is separate from any federal or state requirement involving the prescribing clinician. Defy terms · Federal rule

Can I use lab results I already have?

Ask each company to confirm acceptance in writing before you pay for new tests. Acceptance can depend on the test list, date, methods and what the clinician needs to complete your evaluation. An existing lab report does not by itself settle whether repeat diagnostic testing is needed. Endocrine Society guidance

Will I get FDA-approved or compounded testosterone?

The format or pharmacy name alone does not answer that. Ask for the exact product, its approval status, and the dispensing pharmacy in writing before your first fill. Compounded drugs are not FDA-approved, even when the pharmacy also dispenses approved products. FDA compounding guidance · Defy pharmacy directory

Can I get a refund if I don't qualify for TRT?

Paying for an evaluation never guarantees a prescription. Marek's published policy describes a nonrefundable booking deposit; Defy's terms do not automatically refund completed labs or visits because treatment was not recommended. An unused lab order is a different question: TestDefy's retail FAQ offers a 90-day unused-order refund, while Defy's clinical terms describe different credit rules. Marek policy · Defy terms · TestDefy FAQ

How fast can I start?

We did not verify a guaranteed start date with either company. Marek's clinical landing page advertises 3–5 business days for results, while Marek Diagnostics says to allow 14 business days; TestDefy says typically 5–10 business days. Those are laboratory estimates, not total appointment, prescribing or delivery times. Ask for the current timing of each step. Marek offer · Marek Diagnostics FAQ · TestDefy FAQ

What if I want children?

Testosterone can suppress sperm production. Talk to a reproductive urologist before starting with either company. hCG, clomiphene, and enclomiphene are not interchangeable with TRT, and no add-on guarantees fertility preservation or recovery. Endocrine Society guidance

Can I switch from Marek to Defy, or the other way?

You can request a transfer, but acceptance and continuation of treatment are clinical decisions. Request your records first, ask which tests and examinations the new clinician accepts, and coordinate the timing with your current prescriber. Don't stop or change treatment without your prescribing clinician. Defy assessment and refill terms

Will the 2027 DEA rules affect my TRT?

The extension verified for this page runs through December 31, 2026; it does not establish what will apply in 2027. An examination by a different clinician does not automatically satisfy the prescribing clinician's federal in-person requirement. Ask about the rule in force and the practice's continuity plan before relying on future remote prescribing. Federal rule

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Which sources support this comparison?

The sources below support the specific claims linked in the article. Provider offers and policies were checked on October 15, 2026; patient-specific quotes, prescribing decisions and state authorizations were not established by those public pages.

Marek Health and Marek Diagnostics

• Marek Health how-it-works page: advertised $299 offer, 45-minute provider appointment, coaching, quarterly consultations, separate charges and contact details.
• Marek Health TRT landing page: $299/$299.99 display difference, treatment formats and offer exclusions.
• Marek Health TRT page: published $450 lab-minimum offer; confirm the applicable panel and total before payment.
• Marek Health FAQ: published initial follow-up and minimum ongoing lab frequency; confirm the individual care schedule.
• Marek Health cancellation and refund policy: published booking-deposit and late-change language; obtain the full terms for the exact booking.
• Marek Diagnostics Pre-TRT Panel: $595 price, listed tests and included coach review.
• Marek Diagnostics Testosterone Monitoring Panel: $300 price, PSA listing and optional review charge.
• Marek Diagnostics FAQ: collection fees, processing estimate, retail access restrictions and diagnostic-code/HSA/FSA policy.
• Marek Diagnostics refund policy: final web-sale policy.

Defy Medical and TestDefy

• Defy Medical TRT service page: advertised consultation model, formats and in-person option.
• Defy Medical cost FAQ: illustrative first-year and ongoing average—not an itemized patient quote.
• Defy Medical Terms of Service, effective April 2, 2026: superbills, clinical refund and credit terms, physical forms, monitoring, consent, pharmacy policy and refills.
• TestDefy initial men's panel: $299 price and test list; no included clinical review.
• TestDefy follow-up men's panel: $275 price and test list; no included clinical review.
• TestDefy homepage and FAQ: retail state restrictions, results timing and unused-test refund policy.
• Defy patient portal: patient-only access, published support hours and advertised pharmacy processing stage.
• Defy pharmacy contact directory: listed pharmacy names, not confirmation of an individual prescription's pharmacy or state authority.
• Defy medical team: current public clinician roster and medical-director role.
• Defy new-patient contact form: contact request, not payment or medical approval.

Attributable customer experiences

• Defy Medical Trustpilot reviews containing the August examples: Dani Coleman, Daphne, Debbie S. and the August 28 company response about ordering delays.
• Marek Health Trustpilot profile: October 15 rating snapshot and Tom's October 2 coaching review.
• Defy Medical Trustpilot profile: October 15 rating snapshot.

Medical, regulatory and payment sources

• Endocrine Society testosterone-therapy guideline: diagnosis, repeat testing, fertility, monitoring and situations requiring further evaluation.
• Endocrine Society statement, July 16, 2026: assay quality, diagnostic confirmation and remaining safety questions.
• FDA testosterone labeling changes, February 28, 2025: class-wide blood-pressure warning and cardiovascular-label changes.
• FDA testosterone information and June 2026 labeling-update request: current regulatory context and TRAVERSE scope.
• FDA compounding questions and answers: unapproved compounded drugs and the distinction between 503A and 503B facilities.
• DEA drug scheduling: testosterone's Schedule III status.
• DEA/HHS fourth temporary extension, published December 31, 2025: conditions and December 31, 2026 expiration boundary.
• HHS getting started with licensure: authorization where the patient and clinician are located.
• Clomid prescribing information: approved indication and limits of the male-use evidence in the label.
• Pregnyl prescribing information: specific hCG indications.
• FDA Pharmacy Compounding Advisory Committee record and British Society for Sexual Medicine's 2026 enclomiphene statement: enclomiphene's unapproved status; these are not an endorsement of treatment.
• IRS Publication 969: HSA/FSA qualified-expense rules.

TRT Provider Guide is the independent decision resource for testosterone replacement therapy care. We are not a clinic, pharmacy, laboratory, drug manufacturer, insurer, or medical practice. This page is educational information, not medical advice. Privacy policy.