Do You Qualify for a GLP-1?
Eligibility for GLP-1 medications is more standardized than the marketing suggests. Most legitimate providers apply the same clinical thresholds, screen for the same contraindications, and decline the same patients. Knowing what those are before you fill in an intake form saves you time — and tells you something about a provider that does not ask.
The standard clinical criteria
For weight management, the threshold used across the industry is:
A BMI of 30 or above (obesity), or a BMI of 27 or above (overweight) with at least one weight-related health condition.
This is not one company's policy — it reflects how the FDA-approved indications for weight management medications are written, and providers across the market publish exactly these numbers. Ivím Health publishes BMI ≥30 or ≥27 with a weight-related comorbidity. Form Health publishes 30+ or 27+ with weight-related health risks. Klinic and Aspire Health publish the same.
Qualifying weight-related conditions
If your BMI is between 27 and 30, at least one of these generally needs to be present:
- High blood pressure (hypertension)
- Type 2 diabetes or prediabetes
- High cholesterol or dyslipidemia
- Obstructive sleep apnea
- Cardiovascular disease
- Non-alcoholic fatty liver disease
- Osteoarthritis related to weight
- Polycystic ovary syndrome
This list is illustrative, not exhaustive, and which conditions a particular prescriber accepts is a clinical judgment.
Who should not take a GLP-1
Some exclusions are absolute. Both semaglutide and tirzepatide carry a boxed warning based on thyroid C-cell tumors observed in rodent studies, and are contraindicated in people with:
- A personal or family history of medullary thyroid carcinoma
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Known hypersensitivity to the medication or its components
Others require caution and a prescriber's judgment rather than being automatic disqualifiers:
- Pregnancy, breastfeeding, or planning pregnancy
- History of pancreatitis
- Gallbladder disease
- Severe gastrointestinal disease, including gastroparesis
- Diabetic retinopathy (particularly with type 2 diabetes)
- History of an eating disorder
- Significant kidney impairment
These exclusions show up in provider policies. TrimRx publishes contraindications covering medullary thyroid carcinoma, MEN 2, pregnancy or breastfeeding and severe pancreatitis history. Willow states patients with diabetes are excluded from its program while pre-diabetes and hypertension are accepted — a reminder that programs differ in whom they will take on.
What a telehealth intake actually asks
A reasonable intake covers your height and weight, weight history and previous attempts, current medications, medical conditions, thyroid cancer and pancreatitis history, pregnancy status, and your preferred medication form. Push Health's published intake covers exactly this ground.
Some providers add requirements. Form Health requires that you have seen a primary care physician within the last twelve months — a higher bar than most, and a reasonable one. Coby Health states that in certain cases a provider will request lab work before you start. Others do not require labs at all.
A screening test for the provider, not just for you. A program that asks nothing about thyroid cancer history, pancreatitis or pregnancy is not screening properly. So is one that promises approval before any clinical review. Providers that state plainly that not all patients will qualify — as Ivím Health does — are describing how prescribing is supposed to work.
Non-clinical things that can disqualify you
- Your state
- Telehealth is licensed state by state. Willow covers 34 states. Coby Health covers every state except Arkansas, Louisiana, Mississippi and New Mexico. Shapely covers only California, Florida, New York and Texas. Indigo Health is concentrated in Washington. MDLIVE notes its weight-management medications are not available in certain states.
- Your age
- Adult programs generally require you to be 18 or over. Some brand-name medications have adolescent indications, but most cash-pay telehealth does not serve minors.
- Your insurance status
- Not a clinical barrier, but it changes your options. NovoCare's $25/month savings offer requires commercial insurance covering GLP-1 medicines and excludes government beneficiaries. Conversely, eligible Medicare patients can access $50/month Wegovy through the Medicare GLP-1 Bridge program.
If you are declined
Being turned down by one telehealth provider does not necessarily mean GLP-1 therapy is wrong for you — programs set different acceptance policies. But it is worth understanding why before shopping around, because the reason changes what you should do next.
- Declined on a contraindication — take it seriously. A provider that refuses on thyroid cancer history or pancreatitis is doing its job, and a provider that would approve you anyway is a warning sign, not a better option.
- Declined on BMI — a different provider may have a different threshold, but if you are meaningfully below 27 the medication is not indicated for weight management. Talk to a clinician about what is actually driving your concern.
- Declined on program policy — for example Willow excluding patients with diabetes. Another provider may accept you straightforwardly.
- Declined on geography — check the state coverage of other providers before reapplying.
Some programs refund you if you complete an intake and are not approved, so being declined does not always cost you money. Check the refund terms before you pay.
Frequently asked questions
Can I get a GLP-1 without a prescription?
No. Semaglutide and tirzepatide are prescription medications in every form, including compounded. Any seller offering them without a clinical evaluation — for example as "research peptides" — is operating outside the legitimate market, and the FDA has warned about fraudulent compounded products carrying false label information.
Do I need labs first?
It depends on the provider. Some require or request lab work before starting, some offer it optionally, and some do not mention it. Baseline labs are generally good clinical practice even where they are not mandatory, particularly if you have not seen a physician recently.
Does BMI tell the whole story?
No. BMI does not distinguish muscle from fat or account for body composition and distribution, and it is a screening tool rather than a diagnosis. It remains the threshold used for prescribing eligibility, but a clinician should be weighing your full picture.
Will insurance cover it if I qualify clinically?
Not automatically. Clinical eligibility and insurance coverage are separate questions, and many plans exclude weight-management medication or require prior authorization even when you meet the criteria. See our insurance guide — and note that Klinic will handle prior authorization on your behalf.
Where to go next
Medical disclaimer
This article is general information, not medical advice, and it cannot tell you whether a GLP-1 medication is appropriate for you. Only a licensed healthcare professional who knows your medical history can make that determination. GLP-1 medications carry a boxed warning regarding thyroid C-cell tumors and other serious potential risks. Do not start, stop, or change any treatment based on this page. Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality.
Date reviewed: August 3, 2026