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National prices. State rules.

Compounded GLP-1 providers by state

Most national GLP-1 programs take patients in most states, at the same price in each: compounded tirzepatide runs $139 to $399 a month in our price index (checked November 1, 2026). Your state sets who can prescribe it, which pharmacies can ship it and what Medicaid covers. NexLife’s price doesn’t change either: $139 a month for tirzepatide and $119 for semaglutide on the 12-month plan, at every dose.

  • Medicaid: 19 of these 26 states don’t cover weight-loss GLP-1s
  • State worker plans: 8 of 26 cover weight-loss GLP-1s; 2 partly
  • Pharmacies: all 26 license or register out-of-state pharmacies
Published by NexLifeLegitScript-certifiedUpdated By the NexLife Medical Team · Medically reviewed by Adam Kennah, MD (NPI 1144260043)

NexLife at a glance

Tirzepatide
$139 a month on the 12-month plan, every dose ($169 month to month)
Semaglutide
$119 a month on the 12-month plan, every dose ($139 month to month)
Your provider
Licensed or authorized in the state where you get care
Shipping
Free expedited, usually ships in 1 to 2 business days

Moving, or living in two states? Call or text (949) 818-8000 and we’ll check both addresses.

Check my eligibility
Call (949) 818-8000Text us

4.8 out of 5 on Trustpilot, 407 reviews · LegitScript certified

Compounded medicines aren’t FDA-approved. A NexLife provider prescribes one only if it offers a significant difference for you compared with an FDA-approved medicine.

Find your state

Is NexLife available in your state?

Both medicines are available in each state on the list NexLife confirmed on Nov. 1, 2026, at one price. Pick your state for its rules, its guide and your next step.

  • Available through NexLife
  • With a NexLife state guide
  • Your state
  • D.C.: call to check

Pick your state

  • Tirzepatide
  • Semaglutide

Available through NexLife in each state on the list NexLife confirmed on Nov. 1, 2026.

$139/moon the 12-month plan · $169 month to month · the same at every dose

Your provider
Licensed in the state where you are when you get care
Shipping
Free and expedited, from a partner pharmacy licensed to ship to your state
Your visit
About 3 minutes of health questions online; a licensed provider decides if treatment is right for you
Check my eligibility
Call (949) 818-8000Text us

Not prescribed? No charge for medication. Compounded medicines aren’t FDA-approved; a licensed provider prescribes one only when it offers a significant difference for you.

All states, A to Z

Tirzepatide state guides: Arizona Arkansas California Colorado Connecticut Florida Georgia Idaho Illinois Indiana Iowa Maine Maryland Massachusetts Michigan Minnesota Nebraska New Hampshire New Jersey New York North Carolina Ohio Oklahoma Oregon Pennsylvania South Carolina Tennessee Texas Utah Virginia Washington Wisconsin

Semaglutide state guides: Arizona California Colorado Florida Georgia Illinois Indiana Maryland Massachusetts Michigan Minnesota New York North Carolina Ohio Oregon Pennsylvania South Carolina Tennessee Texas Virginia Washington Wisconsin

Availability as NexLife confirmed on Nov. 1, 2026. Washington, D.C., and U.S. territories aren’t on the list: call or text (949) 818-8000 to check. State rules checked Oct. 21 to Nov. 2, 2026, from each state’s Medicaid program, employee plan and laws.

At a glance

How do GLP-1 rules, coverage and prices vary by state?

The short answer, from the 26 states we checked.

GLP-1 providers by state, at a glance (state rules checked October 21 to November 1, 2026; prices checked November 1, 2026)
QuestionAnswer
Who can prescribe?A provider licensed or authorized in the state where you are when you get care
Who can ship it?A pharmacy licensed or registered in your state. All 26 states we checked license or register out-of-state pharmacies
Does Medicaid cover weight loss?Not in 19 of the 26. Six do, with prior approval; Michigan only for morbid obesity
Do state worker plans cover it?8 of the 26 do, and 2 partly: California’s HMOs and Florida’s pilot
Does the price change by state?Not at most online programs: compounded tirzepatide runs $139 to $399 a month in our price index (checked November 1, 2026)
NexLife’s priceCompounded tirzepatide $139 a month on the 12-month plan, semaglutide $119, at every dose

State rules checked October 21 to November 1, 2026. Every source is listed at the end of this page.

  1. Tell us about you About 3 minutes of health questions
  2. A licensed provider decides You’re prescribed only if it’s right for you
  3. Your partner pharmacy ships Usually within 1 to 2 business days, free

Key takeaways

  • Most programs don’t price by state. Compounded tirzepatide runs $139 to $399 a month in our price index, checked November 1, 2026.
  • Your provider must be licensed or authorized in the state where you are when you get care.
  • Pharmacies: all 26 states we checked license or register out-of-state pharmacies; some add a sterile compounding license.
  • Medicaid: 19 of the 26 don’t cover weight-loss GLP-1s. Six do, with prior approval, and Michigan only for morbid obesity.
  • State worker plans: 8 of the 26 cover weight-loss GLP-1s and 2 partly, usually with prior approval or cost sharing.
  • At NexLife, compounded tirzepatide is $139 a month on the 12-month plan, semaglutide $119, offered where our providers are licensed.
NexLife

One of the most affordable, at every dose. Tirzepatide $139/mo on 12 months, or $169 month to month, all in. Pay less elsewhere? We match it.†About 3 minutes of health questions, no insurance needed. Compounded, not FDA-approved. A licensed provider prescribes it only when it offers a significant difference for you.

Check my eligibility

By state

What are the GLP-1 rules in 26 states?

Medicaid, state employee plans and pharmacy licensing in the 26 states we researched, one line each. Missouri, Nevada, Kentucky and Kansas are covered below. Each published NexLife state guide is linked under “Find your state” at the top of this page.

GLP-1 rules in 26 states: Medicaid, state employee plans and out-of-state pharmacy licenses (checked October 21 to November 1, 2026)
StateMedicaid covers GLP-1s for weight loss?State employee planOut-of-state pharmacy license
ArizonaNoNot confirmedNonresident permit, plus a home-state license
CaliforniaNo. Ended January 1, 2026HMOs: BMI 40+, with prior approval; self-funded plans: noNonresident license, plus one for sterile compounding
ColoradoNoYes. Restored May 1, 2026Out-of-state outlet registration, with an inspection report
FloridaNoPilot only: 2,800 spots in 2026Nonresident registration, plus a sterile compounding permit
GeorgiaNoYes, with prior approvalNonresident pharmacy permit
IllinoisNoYes, with a lifestyle programNonresident registration; Illinois-licensed pharmacist in charge
IndianaNo. Coverage announced July 30, 2026; no start date foundNo. Ended January 1, 2026Nonresident registration before the first shipment
KansasYes, with prior approval, since September 19, 2023Yes, at a BMI of 35 or more since January 1, 2026Nonresident registration, renewed every year
KentuckyNoYes: 25% or 30% coinsurance after the deductibleOut-of-state permit; Kentucky-licensed pharmacist in charge
MarylandNo; a 2026 law allows it from 2027NoNonresident permit naming a Maryland pharmacist
MassachusettsNo. Ended July 3, 2026, with exceptionsNo. Ended July 1, 2026Two nonresident licenses for sterile compounding; Massachusetts pharmacist in charge
MichiganLimited: morbid obesity (for example, a BMI of 40 or more), with prior approval, since January 1, 2026No. Ended January 1, 2026Michigan pharmacy license; Michigan-licensed pharmacist in charge
MinnesotaYes, with prior approval; renewal needs 5% weight lossExcluded, unless medically necessary and plan-approvedA Minnesota license for each out-of-state pharmacy
MissouriYes, with prior approval; Zepbound and Foundayo preferredNot confirmedMissouri Board of Pharmacy license
NevadaNo for weight loss; with prior approval, Zepbound for sleep apnea and Wegovy for heart risk or MASHBrand-name weight-loss drugs excluded from the CDHP, PPO and EPO (plan year 2027)Board of Pharmacy license; Nevada-registered pharmacist
New JerseyNoYes: $45 per 30-day fill for active employeesBoard of Pharmacy registration
New YorkNoYes, with prior approvalNonresident registration
North CarolinaYes. Back since December 12, 2025No. Ended April 1, 2024NC permit, with an inspection from the past 12 months
OhioNoNo. Ended July 1, 2025Nonresident terminal distributor license
OregonNoNo, and none added for 2027, SEIU 503 reportsDrug outlet registration, required of every compounder since June 17, 2026
PennsylvaniaNo. Ended January 1, 2026 (adults 21+)NoNonresident registration, renewed every 2 years
South CarolinaNo. Ended January 1, 2026NoNon-resident pharmacy permit, renewed every June
TennesseeYes, with prior approval, since August 1, 2025Yes, at 25% coinsuranceOut-of-state site license; Tennessee pharmacist in charge
TexasNo (orlistat only)NoClass E; Class E-S for sterile compounding
WashingtonNoNo; a May 4, 2026 ruling sent a challenge back to the lower courtNonresident license, with an inspection from the past 2 years
WisconsinYes, with prior approval; Zepbound and Foundayo preferred since July 1, 2026No in 2026; yes from January 1, 2027, at a $200 copayOut-of-state pharmacy license

“No” means no Medicaid coverage for weight loss alone; GLP-1s for type 2 diabetes stay covered, as federal Medicaid rules require (KFF, January 2026). Checked October 21 to November 1, 2026, against each state’s Medicaid notices or KFF’s January 2026 review, state employee plan documents and each state’s pharmacy law or board. Every source is listed at the end of this page.

Heat

How do you keep tirzepatide or semaglutide cold in summer heat?

Zepbound’s label lets an unopened single-dose pen or vial sit unrefrigerated at up to 86°F (30°C) for up to 21 days, and Wegovy’s single-dose pen can be kept at 46°F to 86°F for up to 28 days. Compounded vials follow their own pharmacy label, which is often stricter. In summer 2026, the hottest region we counted in Texas reached 86°F or more on 122 of 122 days.

  1. Texas122 of 122
  2. Arizona121 of 122
  3. California121 of 121
  4. Florida119 of 122
  5. Oklahoma118 of 122
  6. Arkansas117 of 122
  7. Georgia113 of 121
  8. South Carolina112 of 122
  9. Utah111 of 117
  10. Tennessee105 of 122
  11. Colorado103 of 122
  12. North Carolina100 of 121
Show all 32 states
  1. Virginia93 of 122
  2. Indiana88 of 121
  3. Illinois87 of 122
  4. Nebraska82 of 122
  5. Oregon81 of 122
  6. Maryland75 of 122
  7. Idaho74 of 122
  8. Washington70 of 122
  9. New Jersey64 of 122
  10. Pennsylvania64 of 122
  11. Iowa62 of 122
  12. Ohio50 of 122
  13. Minnesota46 of 122
  14. New York40 of 122
  15. New Hampshire39 of 122
  16. Connecticut38 of 122
  17. Michigan34 of 122
  18. Massachusetts32 of 122
  19. Wisconsin31 of 122
  20. Maine24 of 119
Days with a high of 86°F or more, June 1 to Sept. 30, 2026, in the hottest region we counted in each of 32 states (NOAA weather stations, ACIS daily data; our count). Days without data: Palm Springs (CA) 1, Albany (GA) 1, St. George (UT) 5, Jacksonville (NC) 1, Boonville (IN) 1, Sanford (ME) 3.

What to do. Plan deliveries for when you’re home and bring the box inside right away. Orders through NexLife ship with cold packs. A box that shows up warm shouldn’t be used: call or text (949) 818-8000 and we’ll take it from there.

Four more states

What do Medicaid and state plans cover in Missouri, Nevada, Kentucky and Kansas?

Medicaid and the state employee plan in each of these four states, read at their sources from October 25 to November 1, 2026.

Missouri

MO HealthNet, Missouri Medicaid, covers Zepbound and Foundayo for weight loss with prior authorization: an adult needs a BMI of 30, or 27 with a documented weight-related condition (its April 2026 form). We couldn’t confirm the state employee plan’s rule.

Nevada

Nevada Medicaid lists weight-management drugs first among those it won’t reimburse (Medicaid Services Manual, Chapter 1200, effective October 5, 2026), though Zepbound can be approved for moderate to severe sleep apnea with prior authorization. For plan year 2027, the CDHP, Low Deductible PPO and EPO of the Public Employees’ Benefits Program exclude brand-name anti-obesity drugs such as Zepbound and Wegovy, and cover only certain generic weight-loss drugs.

Kentucky

Kentucky Medicaid excludes drugs used for weight loss (907 KAR 23:010), and Senate Bill 65, enacted over the governor’s veto on April 14, 2026, nullified a regulation filed September 9, 2025 to lift that exclusion, and bars one “identical to, or substantially the same as” it until June 1, 2027. The Kentucky Employees’ Health Plan covers GLP-1s prescribed for weight loss in 2026, at 25% or 30% coinsurance after the deductible.

Kansas

KanCare, Kansas Medicaid, has covered anti-obesity drugs since September 19, 2023; for Zepbound, an adult needs prior authorization and a BMI of 30 or more, or 27 or more with a weight-related condition. Since January 1, 2026, the State Employee Health Plan has covered weight-management GLP-1s only at a BMI of 35 or higher, with prior authorization and Wegovy as the preferred drug.

The rules

What changes for GLP-1 providers from state to state?

Who can prescribe. Your provider must be licensed or authorized in the state where you are when you get care. Arizona, for example, lets providers licensed elsewhere register for telehealth, and Kansas grants telemedicine waivers.

Who can ship. States license pharmacies that ship into them. Texas requires a Class E-S license for out-of-state sterile compounders; California and Florida have their own sterile compounding licenses.

What Medicaid covers. Coverage of GLP-1s for weight loss is optional for states, so it changes with budgets: North Carolina dropped it and brought it back within three months.

How care can start. Each of the 26 states here sets its own rules for how a provider can start care online, and several add their own limits on prescribing online. Your provider follows the rules where you are, and the standard of care applies.

What doesn’t change. At most online programs, the price: compounded tirzepatide runs $139 to $399 a month in our price index and semaglutide $119 to $299, from one state to the next (checked November 1, 2026).

In their words

What do state boards and CMS say about GLP-1 care by state?

Three rules in the regulators’ own words: where care takes place, who can ship to you, and one federal program that doesn’t change by state.

Why your provider needs a license where you are, in the words of North Carolina’s medical board.

“The Board deems the practice of medicine to occur in the state where the patient is located.”

North Carolina Medical Board, Telemedicine position statement

States license the pharmacies that ship into them, not only their own. Minnesota’s statute, for example:

“The board shall require a separate license for each pharmacy located within the state and for each pharmacy located outside of the state at which any portion of the dispensing process occurs for drugs dispensed to residents of this state.”

Minnesota Office of the Revisor of Statutes, Minn. Stat. § 151.19 (2026 Minnesota Statutes), subd. 1(e)

Medicare’s GLP-1 Bridge is federal, so eligible Part D enrollees can use it wherever they live, at a $50 monthly copay.

“The Medicare GLP-1 Bridge is a short-term demonstration run by CMS that will provide eligible Medicare Part D beneficiaries with access to certain GLP-1 drugs between July 1, 2026, and December 31, 2027.”

Centers for Medicare & Medicaid Services, Medicare GLP-1 Bridge

Best for

What are the 5 ways to get a GLP-1, and what does each cost?

Five routes, what each suits, its price and its catch. NexLife is listed first because this is our page.

Five ways to get a GLP-1: what each suits, its price and its catch (state rules checked October 21 to November 1, 2026; prices checked November 1, 2026)
Best forProgramPriceThe catch
One price at every doseNexLife (compounded)Tirzepatide $139 a month on the 12-month plan, semaglutide $119; $169 and $139 month to monthOffered only where our affiliated providers are licensed; compounded, not FDA-approved
Eligible Medicare Part D enrolleesMedicare GLP-1 Bridge$50 monthly copayWegovy, Foundayo or the Zepbound KwikPen, with prior authorization; it ends December 31, 2027
Medicaid members where it’s covered, such as Kansas, Minnesota, Missouri, North Carolina, Tennessee or WisconsinYour state’s MedicaidCovered, with prior approval19 of the 26 states we checked don’t cover weight loss; Michigan covers only morbid obesity
State workers whose plan covers it, such as Colorado, Georgia, Illinois, Kansas, Kentucky, New Jersey, New York or TennesseeYour state employee planVaries: $45 per 30-day fill in New Jersey for active employees; 25% coinsurance in TennesseeUsually prior approval, cost sharing or a lifestyle program; in Kansas, only at a BMI of 35 or more
Comparing online pricesOther online programs in our price indexCompounded tirzepatide $139 to $399 a month, semaglutide $119 to $299, checked November 1, 2026Check your state first: PreventiveMD, for one, isn’t offered in AR, D.C., MS, NJ, NM, SD or WV

State rules checked October 21 to November 1, 2026; prices and where programs are offered, November 1, 2026. Compounded medications aren’t FDA-approved.

Check any program

How do you check a GLP-1 provider in your state?

Ask any program these six questions before you pay. Here’s how NexLife answers each one.

Six questions to ask any GLP-1 provider, with NexLife’s answers
Ask thisNexLife’s answer
Do you take patients in my state?Only where our affiliated providers are licensed. We check your state when you start.
Is my prescriber licensed in my state?Yes. Your provider is licensed or authorized in the state where you get care.
Is the pharmacy licensed to ship to me?Yes. A state-licensed partner pharmacy fills your prescription and is licensed to ship to you.
Does the price change by state or by dose?No. Compounded tirzepatide is $139 a month on the 12-month plan and semaglutide $119, at every dose, with no membership fee.
Is it LegitScript-certified?Yes. You can check our record on LegitScript’s site.
How do I cancel, and what if I’m not prescribed?Cancel by email; it takes effect 30 days after we receive it. If you’re not prescribed, you aren’t charged for medication.

Step by step

How do you get a GLP-1 online in your state, step by step?

Coverage, licenses and price, in the order to check them, using the state rules on this page.

  1. Check your coverage first. If you have Medicaid, a state worker plan or Medicare Part D, ask what it covers before you pay. Medicaid doesn’t cover weight-loss GLP-1s in 19 of the 26 states we checked.
  2. Find a program that serves your state. Most national programs take patients in most states, but not all. Check each program’s own list of states before you pay.
  3. Ask about your prescriber’s license. Your provider must be licensed or authorized in the state where you are when you get care. Arizona, for example, lets providers licensed elsewhere register for telehealth.
  4. Confirm the pharmacy can ship to you. In all 26 states we checked, a pharmacy must hold that state’s license, permit or registration before it ships to residents. Some add one for sterile compounding.
  5. Compare the all-in monthly price. At most online programs it doesn’t change by state: compounded tirzepatide runs $139 to $399 a month in our price index, and semaglutide $119 to $299 (checked November 1, 2026).
  6. Answer the health questions. A licensed provider decides whether treatment is right for you. At NexLife, the health questions take about 3 minutes, and if you’re not prescribed, you aren’t charged for medication.

Coverage and state rules first, then price, then the health questions.

Vial math

How many units is your tirzepatide or semaglutide dose?

On a compounded vial, the units depend on its strength. Here are the label doses at example strengths, with the math to check your own.

Tirzepatide

Tirzepatide doses on Zepbound’s label, with the volume and units on a U-100 syringe at an example strength of 25 mg per mL; your vial’s label decides
DosemL at 25 mg/mLUnits (U-100)On the label
2.5 mg0.1 mL10 unitsStarting dose, for 4 weeks
5 mg0.2 mL20 unitsA maintenance dose
7.5 mg0.3 mL30 unitsA step up
10 mg0.4 mL40 unitsA maintenance dose
12.5 mg0.5 mL50 unitsA step up
15 mg0.6 mL60 unitsThe maximum, and a maintenance dose

The math: mL = dose ÷ strength (mg per mL), and units = mL × 100. At 25 mg/mL, 10 mg is 10 ÷ 25 = 0.4 mL, or 40 units.

Semaglutide

Semaglutide dose steps from the Wegovy label, with the volume and units on a U-100 syringe at two example strengths, 2.5 mg/mL and 5 mg/mL
WeeksWeekly doseAt 2.5 mg/mLAt 5 mg/mL
1 to 40.25 mg0.1 mL (10 units)0.05 mL (5 units)
5 to 80.5 mg0.2 mL (20 units)0.1 mL (10 units)
9 to 121 mg0.4 mL (40 units)0.2 mL (20 units)
13 to 161.7 mg0.68 mL (68 units)0.34 mL (34 units)
17 onward2.4 mg0.96 mL (96 units)0.48 mL (48 units)

The math: mL = dose ÷ strength (mg per mL); units = mL × 100. At 2.5 mg/mL, 1 mg is 1 ÷ 2.5 = 0.4 mL, or 40 units. At 5 mg/mL, the same 1 mg is 0.2 mL, or 20 units.

25 mg per mL is an example only: it’s the strength of the 15 mg multi-dose vial on Zepbound’s label (15 mg per 0.6 mL). Read the strength on your own vial’s label; your provider sets your dose, in steps at least 4 weeks apart. Every step: the tirzepatide dosage chart. Both strengths are examples only. The same dose is a different number of units at a different strength, so read the strength on your own vial’s label. Your prescription sets your dose and schedule, which may differ from these label steps. Every step: the semaglutide dosage chart.

What does NexLife cost?
One flat price at every dose.

No membership fee. Provider care, a nutrition plan, coaching and shipping are included. Paying less with another licensed provider? We match your regular monthly price.†

Illustration of a compounded tirzepatide vialGIP + GLP-1

12-month plan $139/mo

Tirzepatide

Weekly and dual-action. Care, coaching and shipping included. On a 12-month plan; $169/mo month to month.

Check my eligibility

Compounded, not FDA-approved · Not prescribed? No charge for medication

Illustration of a compounded semaglutide vialGLP-1

12-month plan $119/mo

Semaglutide

Weekly GLP-1. Care, coaching and shipping included. On a 12-month plan; $139/mo month to month.

Check my eligibility

Compounded, not FDA-approved · Not prescribed? No charge for medication

Compounded, not FDA-approved. A licensed provider prescribes it only when it offers a significant difference for you. Vials shown are illustrations. Always use the strength on your pharmacy’s label. Every plan and price · Price Match Guarantee† terms

The NexLife Price Match Guarantee†

Paying less elsewhere?
Keep your price. Upgrade your care.

Already on compounded tirzepatide or semaglutide? Pay less with another licensed U.S. telehealth provider or clinic, and we match your regular monthly price for as long as your plan stays active.† Plus a provider who follows your dose, a nutrition plan, a coaching call and real people 24/7.

  1. 1Send a receipt from the last 60 days
  2. 2A NexLife provider reviews your prescription
  3. 3Pay your matched price, at every dose
Switch and keep my price

Locked while your plan is activeSame price at every doseNo membership fee

†Terms: see the Price Match Guarantee† details below. Compounded medications aren’t FDA-approved; a provider prescribes one only when it offers a significant difference for you.

GLP-1s by state: your questions

Fair questions about NexLife

Will my price go up with my dose?
No. You pay the same at every dose.
What if I’m not prescribed?
You aren’t charged for medication.
Can I cancel?
Yes, by email. It takes effect 30 days after we receive it. Plans renew until you cancel; our cancellation policy has the details.
Do I need insurance?
No. Pay with an HSA or FSA card, or with Affirm, Klarna or Afterpay at checkout.

Can I get compounded tirzepatide or semaglutide online in my state?

Usually, yes. A provider licensed or authorized in your state must prescribe it, and the pharmacy that ships it must be licensed or registered there; each of the 26 states in this guide licenses or registers out-of-state pharmacies. Care through NexLife is offered where its affiliated providers are licensed: call or text (949) 818-8000 to check your state.

Does the price change by state?

Not at most online programs. Compounded tirzepatide costs $139 to $399 a month and semaglutide $119 to $299, the same from one state to the next (GLP-1 price index, checked November 1, 2026). NexLife’s price doesn’t change either: $139 a month for tirzepatide and $119 for semaglutide on the 12-month plan, at every dose, with no membership fee.

Which states’ Medicaid programs cover GLP-1s for weight loss?

KFF counted 13 as of January 2026, and Healthline lists them: Delaware, Kansas, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, North Carolina, Rhode Island, Tennessee, Utah, Virginia and Wisconsin. MassHealth, in Massachusetts, has since stopped, on July 3, 2026. Of the 26 states in this guide, six cover them with prior approval, and Michigan only for morbid obesity.

Which state employee plans cover GLP-1s for weight loss?

Eight states in this guide do: Colorado, Georgia, Illinois, Kansas, Kentucky, New Jersey, New York and Tennessee, usually with prior approval or cost sharing. California’s HMOs cover them only at a BMI of 40 or more, and Florida only through a 2,800-spot pilot in 2026. Wisconsin’s plan adds coverage on January 1, 2027, with a $200 copay.

What does my state require before a GLP-1 is prescribed online?

Each state sets its own rules, and the care must meet the standard of care. California, Colorado, New Jersey, Texas and Maryland spell out how a provider can start care online (Maryland in COMAR 10.32.05, checked November 1, 2026). Several add limits on prescribing online, including Colorado, Georgia, Indiana, Maryland, New Jersey, North Carolina, Oregon and Wisconsin.

Why do states license out-of-state pharmacies?

Because the pharmacy that fills your prescription may be in another state. All 26 states in this guide require an out-of-state pharmacy to hold their license, permit or registration before it ships to residents. Some add one for sterile compounding. New York may exempt, on application, a pharmacy that sends 600 or fewer prescriptions a calendar year.

Does Medicare cover GLP-1s for weight loss?

Yes, through the Medicare GLP-1 Bridge, which runs from July 1, 2026, through December 31, 2027. Eligible Medicare Part D enrollees, wherever they live, can get Wegovy, Foundayo or the Zepbound KwikPen for weight loss at a $50 monthly copay. Prior authorization applies. Our Medicare GLP-1 guide has the details.

Which GLP-1 providers can I use in my state?

Most national programs take patients in most states, but not all. Here’s where each isn’t offered, per its own site (checked November 1, 2026): PreventiveMD: AR, D.C., MS, NJ, NM, SD, WV. Alloy: AL, AR, CA, LA, MS, NV, D.C. for compounded GLP-1s; LA, MS for Zepbound and Wegovy. Noom: AL, LA, MS. Rx.com’s tirzepatide: AK, LA, MS.

Important safety information

Compounded tirzepatide and semaglutide are not FDA-approved, and the FDA hasn’t reviewed them for safety, effectiveness or quality. A provider prescribes them only when they offer a significant difference for you compared with an FDA-approved product. Both medicines may cause thyroid tumors, including cancer: don’t use either if you or a family member has had medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2).

Read the full safety information

In studies with rodents, both medicines caused thyroid tumors; it isn’t known whether they cause them in people. Tell your provider if you notice a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath. Serious side effects can include inflammation of the pancreas (pancreatitis), gallbladder problems, low blood sugar (especially with insulin or sulfonylureas), kidney problems from dehydration, severe stomach problems, serious allergic reactions, vision changes in people with type 2 diabetes, and a faster heart rate. Tell your care team before any surgery or procedure that uses anesthesia or deep sedation. Don’t combine either medicine with other GLP-1 medicines.

Tirzepatide can make birth control pills less effective: switch to a non-oral method, or add a barrier method such as condoms, for 4 weeks after you start and for 4 weeks after each dose increase. Both medicines may harm an unborn baby. Semaglutide should be stopped at least 2 months before a planned pregnancy. Tell your provider right away if you’re pregnant, planning to be, or breastfeeding.

This is a summary, not the complete safety information. Read the full Prescribing Information for FDA-approved tirzepatide (Zepbound) and semaglutide (Wegovy), and talk with your provider. You can report side effects to the FDA at 1-800-FDA-1088 or fda.gov/medwatch.

† NexLife Price Match Guarantee: for new NexLife members switching from a licensed U.S. telehealth provider or clinic with an active prescription for compounded tirzepatide or semaglutide. We match your regular all-in monthly price there (medication plus any required membership, program or visit fee, on a month-to-month plan); first-month offers, coupons, referral credits and prepaid multi-month rates aren’t matched. Proof from the last 60 days required. A licensed provider must determine that treatment is right for you. Not open to people with Medicare, Medicaid or TRICARE coverage. Full terms.

About NexLife. NexLife is a telehealth and care-coordination platform. Care is delivered through affiliated, physician-owned medical groups, and licensed providers decide whether treatment is right for you. NexLife doesn’t make or compound medication: state-licensed partner pharmacies fill each prescription, and we coordinate the rest. NexLife is offered only in states where our affiliated providers are licensed.

“Generally, state boards of pharmacy have primary responsibility for the day-to-day oversight of state-licensed pharmacies that are not registered with FDA as outsourcing facilities.”

U.S. Food and Drug Administration, Compounding and the FDA: Questions and Answers

Who wrote and medically reviewed this page?

Adam Kennah, MDMedical Director, NexLife · Board-certified in emergency medicine (American Board of Emergency Medicine) · NPI 1144260043

Leads the NexLife Medical Team, which writes and medically reviews NexLife’s guides, including this one.

NexLife Medical TeamWrites and updates NexLife’s guides

Checked each state’s Medicaid, pharmacy and telehealth rules on November 1, 2026.

  • Every fact, sourced. Each price and rule links to the page it comes from.
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Compounded medications aren’t FDA-approved. A provider prescribes one only when it offers a significant difference for you.

Sources

  1. KFF. Medicaid coverage of and spending on GLP-1s (January 16, 2026). Checked November 1, 2026.
  2. Healthline. GLP-1 insurance coverage for weight loss: 2026 guide.
  3. KFF. What to know about the BALANCE Model and the Medicare GLP-1 Bridge (updated May 11, 2026).
  4. Texas State Board of Pharmacy. Non-resident (Class E and E-S) pharmacy requirements.
  5. California State Board of Pharmacy. Sterile compounding and nonresident sterile compounding licenses.
  6. The Florida Legislature. Florida Statutes §465.0158, nonresident sterile compounding permit.
  7. NexLife. Frequently asked questions.
  8. U.S. Food and Drug Administration. FDA’s concerns with unapproved GLP-1 drugs used for weight loss.
  9. Eli Lilly and Company. Zepbound (tirzepatide) prescribing information.
  10. Novo Nordisk. Wegovy (semaglutide) prescribing information.
  11. LegitScript. LegitScript certification record for NexLife.us.
  12. NexLife. Compounded tirzepatide plans.
  13. NexLife. Compounded semaglutide plans.
  14. Ro: weight loss program pricing. Checked November 1, 2026.
  15. Hims: Zepbound KwikPen. Checked November 1, 2026.
  16. Hims: Wegovy pill and pen, with membership. Checked November 1, 2026.
  17. Mochi Health: FAQs (membership and medication prices). Checked November 1, 2026.
  18. Embody: compounded tirzepatide, one-month supply. Checked November 1, 2026.
  19. Embody: compounded semaglutide, one-month supply. Checked November 1, 2026.
  20. Medi-Cal Rx: GLP-1 coverage changes for members (January 1, 2026). Checked November 1, 2026.
  21. CalPERS: board agenda item on GLP-1 coverage (June 17, 2026). Checked November 1, 2026.
  22. California State Board of Pharmacy: The Script, January 2026 (nonresident pharmacy rules). Checked November 1, 2026.
  23. Florida state employees: 2026 Weight Management Program notice. Checked October 21, 2026.
  24. Florida Board of Pharmacy: nonresident sterile compounding permits. Checked November 1, 2026.
  25. KFF: state Medicaid coverage of obesity drugs (data, status October 1, 2025). Checked October 21, 2026.
  26. Texas ERS: HealthSelect prescription drug program, plan year 2025–26. Checked November 1, 2026.
  27. Texas State Board of Pharmacy: new pharmacy applications (Class E and E-S). Checked November 1, 2026.
  28. New York State: Empire Plan preferred drug list, January 2026. Checked November 1, 2026.
  29. New York Office of the Professions: out-of-state pharmacy registration. Checked November 1, 2026.
  30. Ohio Department of Administrative Services: weight-loss resources for state employees. Checked November 1, 2026.
  31. Ohio Board of Pharmacy: compounding of GLP-1 drug products in Ohio (July 17, 2025). Checked November 1, 2026.
  32. NC Medicaid: coverage of GLP-1s for weight management reinstated (December 19, 2025). Checked November 1, 2026.
  33. Carolina Journal: NC Medicaid and State Health Plan diverge on GLP-1 coverage. Checked October 21, 2026.
  34. North Carolina Board of Pharmacy: pharmacy permits. Checked November 1, 2026.
  35. North Carolina Medical Board: telemedicine position statement. Checked November 1, 2026.
  36. Georgia State Health Benefit Plan: 9amHealth weight management program. Checked November 1, 2026.
  37. Georgia Board of Pharmacy rules, chapter 480-6 (nonresident pharmacy permits). Checked November 1, 2026.
  38. Illinois Central Management Services: state employee summary of benefits and coverage. Checked November 1, 2026.
  39. 68 Ill. Adm. Code 1330.550: nonresident special pharmacy registration. Checked November 1, 2026.
  40. Washington State Legislature: committee document on PEBB and SEBB coverage of obesity drugs. Checked November 1, 2026.
  41. Washington State Legislature: RCW 18.64.360, nonresident pharmacies. Checked November 1, 2026.
  42. Pennsylvania DHS: Medical Assistance Bulletin on GLP-1 coverage (November 24, 2025). Checked November 1, 2026.
  43. PEBTF: Summary Plan Description, 2026. Checked November 1, 2026.
  44. Pennsylvania Department of State: State Board of Pharmacy. Checked November 1, 2026.
  45. Ariz. Admin. Code R4-23-607: nonresident pharmacy permits. Checked November 1, 2026.
  46. Colorado Department of Personnel & Administration: state employee medical benefits. Checked November 1, 2026.
  47. Colorado Division of Professions and Occupations: pharmacy applications. Checked November 1, 2026.
  48. Maryland General Assembly: SB 496 (2026 session). Checked November 1, 2026.
  49. Maryland Department of Budget and Management: 2026 Health Benefits Guide. Checked November 1, 2026.
  50. Maryland Board of Pharmacy: nonresident pharmacy permit application. Checked November 1, 2026.
  51. MassHealth: pharmacy update on weight-loss drug coverage (May 2026). Checked November 1, 2026.
  52. Massachusetts Group Insurance Commission: June update on GLP-1 coverage. Checked November 1, 2026.
  53. Holland & Knight: Massachusetts to begin licensing nonresident pharmacies. Checked November 1, 2026.
  54. Priority Health: Michigan Medicaid GLP-1 coverage changes effective January 1, 2026. Checked November 1, 2026.
  55. Delaware State Employee Benefits Committee: state plans’ coverage of GLP-1s for weight loss (last updated December 10, 2025). Checked November 1, 2026.
  56. Michigan Legislature: MCL 333.17748. Checked November 1, 2026.
  57. New Jersey Monitor: panel approves deal on state worker health benefits (September 24, 2025). Checked October 21, 2026.
  58. N.J.A.C. 13:39-4.20: out-of-state pharmacy registration. Checked November 1, 2026.
  59. SEIU 503: PEBB 2027 plan changes (July 17, 2026). Checked November 1, 2026.
  60. Oregon Medical Board: telemedicine statement. Checked November 1, 2026.
  61. Select Health of South Carolina: prescription benefits. Checked November 1, 2026.
  62. South Carolina PEBA: weight management. Checked November 1, 2026.
  63. South Carolina Board of Pharmacy: permits. Checked November 1, 2026.
  64. TennCare: provider notice on weight management updates (December 1, 2025). Checked November 1, 2026.
  65. Tennessee Partners for Health: pharmacy benefits. Checked November 1, 2026.
  66. Tenn. Comp. R. & Regs. 1140-01-.08: out-of-state pharmacies. Checked November 1, 2026.
  67. Wisconsin ForwardHealth Update 2026-15: weight-loss drugs. Checked November 1, 2026.
  68. Wisconsin ETF: Group Insurance Board approves GLP-1 cost sharing for 2027. Checked November 1, 2026.
  69. Wisconsin DSPS: Pharmacy (Out-of-State) license. Checked November 1, 2026.
  70. Wis. Admin. Code Med 24.07: telemedicine standards. Checked November 1, 2026.
  71. Center for Connected Health Policy: online prescribing laws by state. Checked November 1, 2026.
  72. AHCCCS fee-for-service provider manual, Chapter 12: Pharmacy (exclusions). Read November 1, 2026.
  73. A.R.S. 36-3606: interstate telehealth services, registration. Checked November 1, 2026.
  74. Health First Colorado: pharmacy benefits (drugs not covered for any reason). Checked November 1, 2026.
  75. Office of the Governor of Indiana: Indiana Medicaid to cover GLP-1 treatments through the BALANCE model, July 30, 2026. Read November 1, 2026.
  76. Indiana Medicaid: IHCP bulletins (checked through BT2026179, October 22, 2026). Read November 1, 2026.
  77. Indiana State Personnel Department: prescription coverage, GLP-1 drugs for weight loss. Read November 1, 2026.
  78. Indiana Code 25-26-17-3: nonresident pharmacy registration. Read November 1, 2026.
  79. KMAP General Bulletin 23255: anti-obesity medication coverage (KanCare). Read October 25, 2026.
  80. KDHE: anti-obesity medications, prior-authorization criteria (reviewed August 19, 2026). Read October 25, 2026.
  81. Kansas State Employee Health Plan: GLP-1 coverage. Read November 1, 2026.
  82. K.S.A. 65-1657: nonresident pharmacy registration. Read November 1, 2026.
  83. K.S.A. 65-28,135: telemedicine waivers for out-of-state physicians. Read November 1, 2026.
  84. 907 KAR 23:010, Kentucky Medicaid outpatient pharmacy program (Section 5, exclusions). Read November 1, 2026.
  85. Kentucky General Assembly: Senate Bill 65 (2026), record and veto override. Read November 1, 2026.
  86. Kentucky Employees’ Health Plan: 2026 Benefits Selection Guide. Read November 1, 2026.
  87. KRS 315.0351: out-of-state pharmacy permits. Read November 1, 2026.
  88. Maryland Department of Health: Wegovy or Zepbound prior authorization form (December 2025). Read November 1, 2026.
  89. COMAR 10.32.05.05: telehealth patient evaluation (Maryland Board of Physicians). Checked November 1, 2026.
  90. COMAR 10.32.05.06: standards related to telehealth. Checked November 1, 2026.
  91. Md. Code, Health Occupations § 12-403: nonresident pharmacies. Read November 1, 2026.
  92. MassHealth Pharmacy Facts 276 (May 13, 2026, corrected): changes to management of anti-obesity medications. Checked November 1, 2026.
  93. 247 CMR 6.00: licensure of pharmacies (Massachusetts Board of Registration in Pharmacy). Checked November 1, 2026.
  94. MDHHS Medicaid Letter L 25-73: pharmacy coverage for treatment of obesity (December 8, 2025). Read November 1, 2026.
  95. Michigan Medicaid Single PDL criteria: anti-obesity GLP-1s (January 1, 2026). Read October 19, 2026; confirmed again October 25, 2026.
  96. Minnesota DHS: Anti-Obesity Medications prior authorization criteria, August 2026. Read November 1, 2026.
  97. SEGIP: 2026 Summary of Benefits, Minnesota Advantage Health Plan. Read November 1, 2026.
  98. Minnesota Statutes 151.19: pharmacy licensure requirements. Read November 1, 2026.
  99. MO HealthNet: GLP-1 receptor agonists prior authorization form 2575-053, April 2026. Read October 25, 2026.
  100. 20 CSR 2220-2.025: nonresident pharmacies (Missouri Board of Pharmacy rule). Read October 25, 2026.
  101. Nevada Medicaid Services Manual, Chapter 1200: Prescribed Drugs (version effective October 5, 2026). Read October 25, 2026.
  102. Nevada PEBP: CDHP plan document, plan year 2027. Read November 1, 2026.
  103. Nevada PEBP: Low Deductible PPO plan document, plan year 2027. Read October 25, 2026.
  104. Nevada PEBP: EPO plan document, plan year 2027. Read November 1, 2026.
  105. Nevada Revised Statutes, chapter 639: NRS 639.2328 and 639.23286 (pharmacies outside Nevada). Read October 25, 2026.
  106. New Jersey Division of Medical Assistance and Health Services: GLP-1 coverage memo. Read October 19, 2026; reviewed again October 25, 2026.
  107. New Jersey SHBP Plan Design Committee: resolution of September 24, 2025 (GLP-1 copays). Read October 19, 2026; reviewed again November 1, 2026.
  108. Oregon Health Plan: weight management drugs, prior authorization criteria (March 2026). Read November 1, 2026.
  109. Oregon Board of Pharmacy: OAR 855-183-0001, drug compounding (Division 183, effective June 17, 2026). Read November 1, 2026.
  110. S.C. Code § 40-43-83: pharmacy permits. Read November 1, 2026.
  111. TennCare: pharmacy coverage of obesity management agents (August 1, 2025). Read November 1, 2026.
  112. TennCare: Clinical Criteria, Step Therapy and Quantity Limits for the Preferred Drug List (November 1, 2026). Checked November 1, 2026.
  113. State of Tennessee Benefits Administration: obesity medication costs in 2026. Read November 1, 2026.
  114. Wisconsin ForwardHealth Online Handbook: weight management agents (topic #24303). Checked November 1, 2026.
  115. Wisconsin ETF: 2027 Insurance Benefits Decision Guide for state employees (ET-2107, August 27, 2026). Checked November 1, 2026.
  116. Wis. Stat. § 450.065: out-of-state pharmacies, licensure. Read November 1, 2026.
  117. 8 NYCRR 63.8: registration of nonresident establishments (New York; the exception for isolated transactions). Read November 1, 2026.
  118. Indiana Code 25-1-9.5-6: what counts as telehealth. Read November 1, 2026.
  119. Centers for Medicare & Medicaid Services. Medicare GLP-1 Bridge. Read November 2, 2026.
  120. NOAA Regional Climate Centers (ACIS). Daily maximum temperatures, June 1 to September 30, 2026, at the weather station for each region of our state guides; our count. Read November 3, 2026.