A GLP-1 prescription for semaglutide (Ozempic, Wegovy, Rybelsus), tirzepatide (Mounjaro, Zepbound), liraglutide (Victoza, Saxenda), or dulaglutide (Trulicity) requires a clinician visit, a medical eligibility review, and usually a prior authorization for insurance coverage. You can obtain one through primary care, endocrinology, obesity medicine, or a telehealth platform. Costs vary from $25 monthly with good insurance to $1,400 self-pay for branded products. The fastest path is telehealth for compounded semaglutide; the cheapest is insurance-covered branded with a savings card.
Which GLP-1 for Which Indication
| Medication | Company | Indication | Frequency | Max Dose |
|---|---|---|---|---|
| Ozempic | Novo Nordisk | Type 2 diabetes | Weekly injection | 2 mg |
| Wegovy | Novo Nordisk | Weight loss, also cardiovascular risk reduction | Weekly injection | 2.4 mg |
| Rybelsus | Novo Nordisk | Type 2 diabetes | Daily oral | 14 mg |
| Mounjaro | Eli Lilly | Type 2 diabetes | Weekly injection | 15 mg |
| Zepbound | Eli Lilly | Weight loss, also obstructive sleep apnea | Weekly injection | 15 mg |
| Trulicity | Eli Lilly | Type 2 diabetes | Weekly injection | 4.5 mg |
| Victoza | Novo Nordisk | Type 2 diabetes | Daily injection | 1.8 mg |
| Saxenda | Novo Nordisk | Weight loss | Daily injection | 3 mg |
Who Qualifies
For Type 2 Diabetes
- Confirmed type 2 diabetes (A1C ≥ 6.5% on two occasions, or symptomatic with random glucose ≥ 200 mg/dL)
- On stable metformin (most insurance plans require first)
- A1C still above target after metformin trial
For Weight Loss
- BMI ≥ 30, or BMI ≥ 27 with at least one weight-related comorbidity (hypertension, dyslipidemia, type 2 diabetes, obstructive sleep apnea, cardiovascular disease)
- Adult (≥ 18); Wegovy and Saxenda also approved ≥ 12
- For Zepbound specifically, obstructive sleep apnea with BMI ≥ 30 is a separate indication
Exclusions
- Personal or family history of medullary thyroid carcinoma
- Multiple endocrine neoplasia type 2 (MEN2)
- Pregnancy or breastfeeding
- Severe gastroparesis
- History of pancreatitis (relative — discuss with clinician)
- Severe renal impairment (dose adjustment, not absolute contraindication for most)
The Typical Visit
- Intake — height, weight, BMI, blood pressure, medication list, medical history
- Labs if not current — A1C, comprehensive metabolic panel, TSH, lipid panel
- Discussion — weight history, prior attempts, GLP-1 mechanism, side effects, cost
- Eligibility decision — yes, no, or with caveats
- Drug selection — matched to indication, insurance coverage, and patient preference
- Prescription sent to pharmacy
- Prior authorization paperwork initiated (often 1 to 4 weeks for insurance approval)
- Follow-up appointment scheduled for 4 to 8 weeks
Access Paths Compared
| Path | Speed | Cost with Insurance | Cost Self-Pay | Product Type |
|---|---|---|---|---|
| Primary care | 1–6 weeks | $25–$550 | $950–$1,400 | Branded |
| Endocrinology | 4–12 weeks (scheduling) | $25–$550 | $950–$1,400 | Branded |
| Obesity medicine clinic | 2–8 weeks | $25–$550 | $950–$1,400 | Branded |
| Telehealth (Hims, Mochi, etc.) | Same day to 1 week | Self-pay only | $199–$499 | Usually compounded |
| Lilly Direct | 1–2 weeks | Self-pay program | $349–$499 | Branded Zepbound vial |
Prior Authorization: What to Expect
- Most commercial plans require PA for Wegovy and Zepbound
- PA documents usually list BMI, comorbidities, prior weight-loss attempts (sometimes a 6-month documented supervised lifestyle trial is required)
- For Ozempic and Mounjaro, PA typically requires documented type 2 diabetes with failed metformin
- Appeal denials in writing, often with your clinician’s help — first-pass denials are common and many succeed on appeal
- Savings cards (GoodRx, manufacturer) can bring commercial-insured copays to $25 or less
Manufacturer Savings and Support
- Novo Nordisk: Ozempic and Wegovy savings cards ($0 to $25 with commercial coverage, maximum benefit caps apply); patient assistance for low-income
- Eli Lilly: Zepbound and Mounjaro copay cards; Lilly Direct self-pay program for Zepbound vials
- GoodRx: discount pricing at participating pharmacies
- Medicare Part D: covers Ozempic, Mounjaro for diabetes; Wegovy and Zepbound generally not covered for weight loss (some plans cover for OSA)
- Medicaid: varies by state; many cover for diabetes indications
What to Ask at the Visit
- Which drug is the best fit for my profile and why?
- What is the titration schedule and when would I expect noticeable effect?
- What side effects are common and how do I manage them?
- What are sick-day rules (illness, vomiting, dehydration)?
- What is my insurance coverage likely to be, and will you help with prior authorization?
- What happens if the drug is in shortage or the FDA changes compounding policy?
- How often will we follow up, and what labs should I track?
- If it is not working after 6 months, what are the next steps?
Red Flags in Telehealth Offers
- No clinician visit, just a form
- No US state pharmacy license disclosed
- Ships from overseas
- Sells “research use only” product
- Advertises salt forms (semaglutide sodium, tirzepatide acetate)
- Crypto-only or wire-transfer payment
- DM-based sales through social media
Related Reading
See our treatment hub, reversibility overview, and A1C levels guide for broader context.
The Bottom Line
A GLP-1 prescription is now accessible through multiple paths — primary care, endocrinology, obesity medicine, or telehealth. Eligibility depends on indication: diabetes requires a confirmed diagnosis; weight-loss GLP-1s require a BMI threshold plus comorbidity profile. Insurance coverage is plan-dependent and usually needs a prior authorization; self-pay options range from $199 (compounded telehealth) to $1,400 (branded retail). Bring your weight history, current medications, and specific questions about side-effect management and long-term plan. The prescription is the start of a relationship, not a one-off transaction — expect regular follow-up and dose titration over the first year.
