Getting a GLP-1 medication requires meeting specific medical criteria, obtaining a prescription from a licensed provider, and navigating insurance or out-of-pocket costs. The process can take anywhere from a single telehealth visit to several months of documentation, depending on your health profile and how you plan to pay.
Who Qualifies for a GLP-1 Prescription
GLP-1 medications fall into two broad categories: those approved for type 2 diabetes (Ozempic, Mounjaro) and those approved for weight management (Wegovy, Zepbound). If you have type 2 diabetes, your doctor can prescribe a GLP-1 as part of your blood sugar management plan without the same weight-based restrictions that apply to weight loss indications.
For weight management specifically, the FDA eligibility thresholds are a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related condition such as high blood pressure, type 2 diabetes, high cholesterol, or obstructive sleep apnea. These medications were not tested in, and are not approved for, people who are overweight but otherwise metabolically healthy. A BMI of 27 with no related health issues would not qualify.
Starting With Your Doctor
The most straightforward path is through your primary care physician or an endocrinologist. Before prescribing, most providers will want baseline lab work. This typically includes an HbA1c test (which measures your average blood sugar over the past two to three months), a cholesterol and lipid panel, and kidney function markers. These tests help your doctor confirm that a GLP-1 is appropriate and establish a baseline to track your progress. If you already have recent lab results from an annual physical, that may be enough.
Your provider will also review your medical history for contraindications, which include a personal or family history of certain thyroid cancers and a history of pancreatitis. If everything checks out and you meet the criteria, the prescription itself is simple. What comes next, getting it filled and paid for, is where things get more complicated.
The Telehealth Option
Several direct-to-consumer telehealth platforms now prescribe GLP-1 medications entirely online. The typical process starts with a detailed health questionnaire covering your medical history, current medications, risk factors, and contraindications. You’ll usually need to upload a photo ID and images that verify your body size. A licensed physician reviews your information and decides whether to write a prescription.
If approved, the medication ships from an affiliated pharmacy to your home, often within 48 hours. The convenience is real, but there are trade-offs. One study of a direct-to-consumer telehealth platform found that no objective weight verification or in-person medical supervision was conducted, and all outcome tracking relied on patient-reported data. If you go this route, keeping your primary care doctor in the loop is important so someone is monitoring your overall health with actual lab work.
What Insurance Requires
Insurance coverage for GLP-1 weight loss medications almost always requires prior authorization, which means your provider must submit documentation proving you meet the plan’s criteria before the pharmacy will fill the prescription at the covered price. This is where many people hit delays.
A representative example from Cigna’s coverage policy shows what major insurers commonly require. You must be 18 or older (or 12 and older for pediatric approval with a BMI at or above the 95th percentile). You need to have already tried behavioral modification and dietary changes for at least three months. You must meet the BMI thresholds. And the medication must be used alongside ongoing behavioral modification and a reduced-calorie diet, not as a standalone treatment.
That three-month diet-and-lifestyle requirement is the step that catches many people off guard. If you don’t have documented evidence of a prior weight loss attempt in your medical records, your insurer will likely deny the authorization. Some providers will start this documentation process at your first visit, meaning you may need to wait three months before reapplying. If you’re considering a GLP-1, bringing up weight management goals at your next doctor visit creates a paper trail even if you’re not ready to start medication yet.
Approval periods vary by medication. Cigna, for instance, approves initial Wegovy injection prescriptions for seven months, Zepbound for eight months, and older options like liraglutide for four months, after which your provider must submit for reauthorization.
Paying Without Insurance
Many insurance plans, particularly Medicare Part D, do not cover GLP-1 medications for weight loss at all. Without coverage, the list price for brand-name GLP-1 injectables runs roughly $900 to $1,300 per month. Cost is the leading reason people stop treatment. In one study of patients using a telehealth-prescribed GLP-1, 56% of those who discontinued cited the price as the primary barrier, ahead of side effects.
Manufacturers offer savings programs that can significantly reduce your costs, but eligibility rules vary and change frequently. Check the manufacturer’s website directly for the most current offers: Novo Nordisk runs programs for Wegovy and Ozempic, while Eli Lilly has savings cards for Zepbound and Mounjaro. These programs often exclude patients on government insurance like Medicare or Medicaid.
Compounded Versions: What to Know
During a shortage that began in 2022, compounding pharmacies stepped in to produce custom-made versions of semaglutide and tirzepatide. As of February 2025, the FDA determined that the semaglutide injection shortage is resolved, meaning the manufacturer confirmed it can meet current and projected national demand. The tirzepatide shortage status was also re-evaluated in late 2024.
When a shortage is officially resolved, the legal basis for compounding those drugs narrows significantly. The FDA has been clarifying its enforcement policies for compounders as supply stabilizes. If you’re currently using a compounded version, this is worth discussing with your prescriber, since availability and legal status may shift. Brand-name versions go through rigorous FDA review for potency, sterility, and consistency. Compounded products do not undergo the same level of oversight.
What the Process Looks Like Start to Finish
If you have insurance coverage and documented weight management history, the fastest realistic timeline looks like this: one visit with your provider for labs and a prescription, a few days to a couple of weeks for prior authorization to process, and then a pharmacy fill. Total time: roughly two to four weeks.
If you’re starting from scratch with no prior documentation of weight loss attempts, expect a longer runway. Your provider will likely document your current diet and exercise plan, schedule follow-ups over three months, and then submit for authorization. During that period, you’re building the paper trail your insurer requires.
Through telehealth with cash pay, the process can be as fast as a few days from questionnaire to delivery. But you’ll pay full price or the platform’s negotiated rate, and you’ll need to arrange your own lab monitoring.
Regardless of how you access the medication, GLP-1s are started at a low dose and gradually increased over several weeks to months. This titration schedule helps minimize gastrointestinal side effects like nausea, which are common early on and tend to improve as your body adjusts. Your provider will set the schedule, but expect the ramp-up to your full maintenance dose to take roughly four to five months depending on the specific drug.