Getting Started
Who Qualifies for a GLP-1 Prescription?
Eligibility for a GLP-1 medication comes down to three separate gates: the FDA-approved indication for the drug, the prescriber's clinical judgment about you specifically, and — if you want it covered — your insurer's own criteria. Passing one does not mean passing the others.
7 min read · Reviewed August 2026
The FDA-labeled criteria
The weight-management GLP-1 products are approved for adults who meet a body mass index threshold, with a lower threshold if you also have a weight-related health condition. The diabetes-labeled products are approved for adults with type 2 diabetes, which is a different gate entirely.
| Product | Labeled for | Adult criteria in the label |
|---|---|---|
| Wegovy (semaglutide) | Chronic weight management | BMI ≥30, or BMI ≥27 with at least one weight-related condition |
| Zepbound (tirzepatide) | Chronic weight management | BMI ≥30, or BMI ≥27 with at least one weight-related condition |
| Saxenda (liraglutide) | Chronic weight management | BMI ≥30, or BMI ≥27 with at least one weight-related condition |
| Ozempic (semaglutide) | Type 2 diabetes | Adults with type 2 diabetes, as an adjunct to diet and exercise |
| Mounjaro (tirzepatide) | Type 2 diabetes | Adults with type 2 diabetes, as an adjunct to diet and exercise |
| Rybelsus (oral semaglutide) | Type 2 diabetes | Adults with type 2 diabetes, as an adjunct to diet and exercise |
"Weight-related condition" is doing a lot of work
Conditions that commonly count include hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, and cardiovascular disease. If your BMI is between 27 and 30, whether you qualify often turns on whether one of these is documented in your chart.
What disqualifies you
Some exclusions are absolute. Others require a conversation and a risk assessment rather than an automatic no.
- •Personal or family history of medullary thyroid carcinoma, or Multiple Endocrine Neoplasia syndrome type 2 — an absolute contraindication for semaglutide and tirzepatide products.
- •Known hypersensitivity to the medication or any of its components.
- •Pregnancy, actively trying to conceive, or breastfeeding. Most programs require a plan to stop well before conception.
- •A history of pancreatitis — not automatically disqualifying for every product, but it changes the risk discussion.
- •Severe gastrointestinal disease such as gastroparesis, where the drug's mechanism is itself the problem.
- •Active eating disorder, which most responsible programs screen for.
- •Type 1 diabetes and diabetic ketoacidosis, which these medications are not indicated to treat.
- •Age. Most telehealth programs treat adults 18 and over; some cap at 64 or 75 and refer older patients to in-person care.
What a telehealth program will actually ask you
Nearly every online GLP-1 program starts with a structured intake questionnaire, then routes it to a licensed clinician in your state. The questionnaire is doing eligibility screening, and answering it inaccurately puts you at real risk rather than getting you a better outcome.
- •Height and weight, to calculate BMI.
- •Existing diagnoses, particularly diabetes, hypertension, sleep apnea, heart disease, thyroid conditions, and pancreatitis.
- •Family history of thyroid cancer and MEN 2.
- •Every medication and supplement you take, including insulin and sulfonylureas, which usually need dose adjustment when a GLP-1 is added.
- •Prior weight-loss attempts and whether you have taken a GLP-1 before, which affects the starting dose.
- •Pregnancy status and contraception plans.
- •Whether you have recent lab work, and if not, whether you will complete labs the program orders.
Labs: who needs them and when
Lab requirements vary widely between programs, and this is one of the clearest quality signals when comparing providers. Some order baseline labs for everyone, some accept recent labs from your own doctor, and some prescribe without labs at all.
Commonly requested baseline tests include a hemoglobin A1c or fasting glucose, a metabolic panel covering kidney and liver function, a lipid panel, and a thyroid panel. If you have diabetes or kidney disease, labs matter more, not less.
- •A program that never asks for labs and never asks for your medical records is doing minimal screening. That is faster, and it is a trade-off you should make knowingly.
- •If you already have recent labs, ask whether the program accepts them — it saves both time and money.
- •Ask who pays for lab work and whether it is included in the membership fee.
Insurance criteria are a separate hurdle
Meeting the FDA criteria and getting a prescription does not mean your plan will pay. Many commercial plans apply their own utilization management on top of the label.
Common insurer requirements include documented BMI at or above a threshold, a documented weight-related comorbidity, evidence of a supervised lifestyle-modification attempt over a set period, prior authorization, and step therapy through a cheaper medication first. A large number of plans exclude weight-management drugs from coverage entirely while still covering the same molecule for diabetes.
- •Ask your plan for its specific coverage criteria in writing before you assume anything.
- •If your plan excludes weight-loss drugs as a category, prior authorization will not help — that is a benefit design decision, not a clinical one.
- •Denials can be appealed, and programs that offer insurance concierge support are useful precisely here.
Providers Worth Comparing
Our current picks from best online glp-1 providers, with the full reviews behind each.
Amazon One Medical
Best for brand-name medication
Care from $39 per visit (no membership required)
Zealthy
Best for using your insurance
$39 first month, then monthly membership
Fridays
Best bundled pricing
From $117/month (semaglutide, annual plan)
Clover Meds
Best value
From $96/month (semaglutide, 12-month plan)
Frequently Asked Questions
What BMI do you need for a GLP-1?
For the weight-management products, the labeled adult criteria are a BMI of 30 or higher, or 27 or higher with at least one weight-related condition such as hypertension, type 2 diabetes, dyslipidemia, or obstructive sleep apnea. Insurers may apply stricter thresholds of their own.
Can I get a GLP-1 without diabetes?
Yes. Wegovy, Zepbound, and Saxenda are approved for chronic weight management in adults without diabetes who meet the BMI criteria. The diabetes-labeled products such as Ozempic and Mounjaro are a different indication.
Do I need lab work before starting?
It depends on the program and on your health history. Many prescribers want a baseline A1c or fasting glucose and kidney function before starting. Some telehealth programs prescribe without labs, which is faster but represents less screening.
Can I qualify if my BMI is under 27?
Not under the labeled weight-management indication. Some providers advertise treatment at lower BMIs, which would be off-label prescribing. That is legal for a clinician to do, but it is worth understanding that it sits outside the studied and approved population.
Will a telehealth provider check my medical records?
Practices vary widely. Some request records and labs, some rely entirely on your self-reported questionnaire. If continuity with your existing doctor matters to you, ask upfront whether the program shares notes with your primary care provider.
Keep Reading
Sources & Disclaimer
Date reviewed: August 2026
Sources
Medical disclaimer: This article is general information, not medical advice, and it does not list every criterion or contraindication. Eligibility is a clinical determination made by a licensed prescriber who has your full history. Never withhold or misstate medical information to qualify for a prescription.
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