Who telehealth GLP-1 programs turn away: eligibility rules and exclusions by program

Most programs publish only part of their rules. Here is what each one says, and how it compares with the drug labels.

What do the FDA labels actually rule out?

Three things, on all three labels. The contraindications sections of Wegovy (effective June 18, 2026), Zepbound (August 28, 2026) and Foundayo (July 29, 2026) list a personal or family history of MTC, MEN 2, and a prior serious allergic reaction to the drug or its ingredients. Each label also carries a boxed warning for thyroid C-cell tumors.

Everything else is a warning or precaution: pancreatitis, gallbladder disease, low blood sugar with insulin or sulfonylureas, kidney injury from dehydration, diabetic retinopathy in type 2 diabetes, and aspiration under anesthesia. Foundayo adds that it is "not recommended in patients with severe gastroparesis." A warning means your clinician weighs the risk; it is not an automatic no.

The labels print no BMI number in their Indications sections. They say "adults with obesity" or "adults with overweight in the presence of at least one weight-related comorbid condition." The familiar numbers appear in Section 14, Clinical Studies, as trial enrollment criteria: BMI 30 or higher, or 27 to under 30 with at least one weight-related condition. Clinicians widely use those numbers, but they are trial definitions, not label rules.

All three labels address pregnancy under use in specific populations. Wegovy says to stop at least 2 months before a planned pregnancy. Zepbound and Foundayo tell people on birth control pills to switch to a non-oral method or add a barrier method for 4 weeks (Zepbound) or 30 days (Foundayo) after starting and after each dose increase. Our contraindications page covers the full list.

What do the 32 programs publish?

Less than you might expect. On October 16, 2026 we read each program's own pages and recorded only what was written there. A blank means "not published," not "allowed." Five programs were fully verified, 24 published some fields, and 3 (Ro, Hims and TMates) blocked our page requests, so all their fields are blank.

The MTC and MEN 2 exclusion is the most common published rule, at 15 of 32. Most of those lines sit on medication safety pages that restate the label, not on an eligibility checklist. The same is true for many pancreatitis, kidney and retinopathy lines, which say "tell your provider." All 7 programs that mention insulin or sulfonylureas use precaution wording. None excludes you for taking them.

Which programs publish the most rules?

Calibrate publishes the strictest and most complete list. Its FAQ requires a BMI of 30, or 27 with a listed metabolic condition, age 18 or older, and no pregnancy plans within one year. It also excludes pancreatitis in the past six months, active gallbladder disease, an active eating disorder and bariatric surgery within 18 months. It is the only program here that requires blood work before the first visit.

Sesame is one of only two programs that mention type 1 diabetes, saying GLP-1s "should be avoided by" people with it. Eden lists type 1 diabetes only in its branded Mounjaro and Zepbound sections. Henry Meds is the only program with a maximum age (70). Mochi runs a separate pediatrics program, which fits Wegovy's labeled use from age 12.

NexLife publishes four fields. Its FAQ says "Most adults with a BMI of 27 or higher may qualify for NexLife's compounded semaglutide or tirzepatide program." Its telehealth consent sets a minimum age of 18. It names Adam Kennah, M.D. as medical director, and it says care may be by live video or physician review "depending on your state and your physician's judgment." It does not publish a separate comorbidity tier or a list of exclusions on the pages we read.

What BMI do you need to get a GLP-1 online?

It depends on the program, and the published floors range from 25 to 30. BMI is weight in pounds times 703, divided by height in inches squared. You can also use our BMI eligibility guide.

• 5'6", 190 lb: 66 inches squared is 4,356. 190 × 703 = 133,570. 133,570 ÷ 4,356 = 30.7. That clears the trial obesity line of 30 with no other condition needed.
• 5'10", 195 lb: 70 inches squared is 4,900. 195 × 703 = 137,085. 137,085 ÷ 4,900 = 28.0. Under the trial criteria, this person would also need a weight-related condition such as high blood pressure, high cholesterol or sleep apnea.

The second person shows why published floors differ. At 28.0, Calibrate, GobyMeds and Sesame would look for a weight-related condition. NexLife's wording ("27 or higher") does not mention one. Noom's microdose program says you "may be eligible" at 25. LifeMD gives 30 on one page and 25 in its FAQ. Found's compounded tirzepatide page says 25 or higher with a condition, while a 2023 Found blog says 30, or 27 with a condition. A lower published floor is not a promise. A clinician still decides.

Do you need labs or a video visit?

Usually not up front. Of the 15 programs that mention labs, only Calibrate requires them before the first visit. Found's requirement comes from a 2023 blog post. Most say labs are ordered "when needed," and Collective says none are needed to begin.

Of the 28 programs that say something about the visit, 4 require live video (Mochi, Calibrate, WW Med+ and Sesame). Twelve review a questionnaire and add a call only if needed. Eight, including NexLife, Henry Meds and Pallas, say it depends on your state or program. The other four describe a visit without saying whether it is live or a questionnaire. Pallas lists its video states as AR, MS, NM, ND, RI, SD, WV and DC.

Why should a questionnaire-only intake still ask these questions?

Because the risks do not change with the visit format. A clinician reviewing a form needs the same facts as one on video: thyroid cancer history, prior pancreatitis, your diabetes medicines, pregnancy plans. If a form does not ask, you should still say it, in the free-text box or a message to the care team.

Two programs in our data use OpenLoop Health clinicians (Embody and SnagRx), and the exclusion criteria of that network are not published. Silence on a program page does not mean a condition is safe.

What should you tell the clinician before your first visit?

Use this checklist on video or on a form. Each item maps to a label contraindication or warning.

• Any personal or family history of medullary thyroid cancer, or MEN 2. This is the one firm label exclusion.
• Past pancreatitis, or gallbladder problems or gallbladder removal.
• Pregnancy, breastfeeding, or plans to conceive. See GLP-1s, pregnancy and fertility.
• Birth control pills, if you are offered tirzepatide or orforglipron (Foundayo).
• Insulin or a sulfonylurea such as glipizide, which raise the risk of low blood sugar. See drug interactions.
• Diabetic retinopathy, and kidney disease or a history of dehydration.
• Any history of an eating disorder.
• Planned surgery, a procedure with sedation, or an endoscopy. See GLP-1s before surgery.
• Any other GLP-1 you take or took recently. Zepbound and Foundayo say not to combine them with another GLP-1.

If you are on Medicare, note that the Medicare GLP-1 Bridge excludes people with type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease, according to Medicare.gov. Their Part D plan "might cover" a GLP-1. LifeMD says people with any government coverage cannot join its GLP-1 programs. Our eligibility quiz walks through these questions in two minutes.

Where does cash-pay compounded treatment fit?

Many of these programs sell compounded semaglutide or tirzepatide. These are made with the drug in Wegovy or Zepbound, but they are not the same product and are not FDA-approved, so the label trial results do not apply to them. The same safety screening still matters. NexLife's published price is $95 a month for semaglutide or $115 for tirzepatide on a 12-month plan, or $109 and $129 month to month (read November 6, 2026). That is not the lowest price we track. Compare every program in our compounded GLP-1 price index.

No program or drug can promise a set amount of weight loss. Results vary, and the decision to prescribe rests with a licensed clinician who has your full history.