Best GLP-1 Telehealth Programs of 2026: Compounded Semaglutide and Tirzepatide Compared

Medically reviewed by Anthony Fanucci, Pharm.D., licensed pharmacist

Three GLP-1 telehealth programs are worth your time in 2026: Enhance, ShedRx, and Oak. Enhance offers the widest range of compounded GLP-1 protocols — semaglutide alone, tirzepatide alone, or a combined dual GLP-1 + GIP receptor agonist plan you cannot get from any other direct-to-consumer telehealth program reviewed here. ShedRx covers the broadest medication menu — including the brand-name GLP-1 pens (Wegovy, Ozempic, Mounjaro, and Zepbound) and the FDA-approved Foundayo pill — plus a contractual 10% weight-loss or full-refund guarantee. Oak runs the lowest published price — $133/month flat for compounded semaglutide, same price at every dose — and the simplest intake (no video call, same-day approval) of any program reviewed. The rest of the field is mostly lookalike pricing, questionable pharmacy chains, and refund policies written to be impossible to claim. This guide breaks down what each program actually does, what it costs, and which one fits your situation.

✓ Last verified: June 18, 2026 — Edited & verified by Neil Shah, MD for TheGreenest Editorial

The Short Answer

All three operate in all 50 states, ship medication directly to your door, and require an online medical consultation (or async equivalent) before prescribing. None requires insurance. None requires an in-person visit. The differences are in what protocols they offer, how their pricing is structured, and what they promise (or don’t) if it doesn’t work.

Quick Picks: Which Program Fits Your Need?

The choice usually comes down to one of three priorities. Skim the picks, then jump to the detailed review of whichever fits you.

• If you want a real choice of GLP-1 protocol — especially a dual semaglutide + tirzepatide plan you can’t get elsewhere → Enhance. Three tiered protocols (Core, Advanced, Elite), all under one doctor-led plan, starting from $169/month on the quarterly subscription. The dual-receptor Elite plan is the only product like it in this comparison. Read the full Enhance review ↓
• If you want a brand-name GLP-1 pen (Wegovy, Ozempic, Mounjaro, or Zepbound), the FDA-approved oral GLP-1 pill (Foundayo), or a contractual refund guarantee → ShedRx. No other program reviewed here offers brand-name GLP-1 access, and the 30% off first month with Shed10 softens the hidden subscription price. The “lose 10% or full refund” promise is the most concrete outcome warranty in the category. Read the full ShedRx review ↓
• If you want the lowest published price on compounded GLP-1 and the simplest intake → Oak. $133/month flat for compounded semaglutide — same price at every dose, no subscription, no video call required. Code OAKSAVE200 stacks $50 off month one with $200 off a 3-month plan. Read the full Oak review ↓

If two of these feel close on paper, the tiebreaker is the lever you care about most: Oak wins on lowest published price and easiest intake; ShedRx wins on brand-name access and contractual refund guarantee; Enhance wins on protocol flexibility (including the dual GLP-1 + GIP plan no other program offers).

How We Evaluated These Programs

Before naming the two, here are the four dimensions that mattered. We started with every GLP-1 telehealth program you can sign up for in 2026, then filtered against these criteria. The programs that survived all four are the ones below.

• Medical oversight. Prescriptions written by a state-licensed clinician after an actual review of your health questionnaire — not a rubber-stamp approval. Programs that prescribe based purely on a checkbox form did not make this list.
• Pharmacy quality. Medication compounded by a state-licensed pharmacy, ideally a 503(a) compounding facility or a 503B outsourcing facility, with documented sterility and quality controls. We looked for explicit pharmacy disclosure and accreditations like LegitScript verification.
• Pricing transparency. The price you see should be the price you pay. No surprise dose-based escalation, no required upsells, no hidden membership fees. Discount codes apply automatically.
• Real refund policies. A guarantee that says “lose weight or your money back” should mean exactly that, with terms in the contract you can read before paying. We rejected programs whose refund pages described elaborate hoops to qualify.

Programs that fail on any one of these dimensions can still be cheap. They are not, however, programs we feel comfortable sending readers to.

1. Enhance — Three Tiers, Including a True Dual GLP-1 + GIP Protocol →

Enhance is the only direct-to-consumer telehealth program in this comparison that lets you choose between three distinct compounded GLP-1 protocols. The three tiers are structured as a graduated lineup: Core (compounded semaglutide injection), Advanced (compounded tirzepatide injection), and Elite (a combined semaglutide + tirzepatide protocol). The Elite plan is the differentiator — it’s the only telehealth product reviewed here that pairs a GLP-1 receptor agonist with a GIP receptor agonist in a single doctor-led plan.

Why that combination matters: tirzepatide is already a dual GLP-1 + GIP receptor agonist on its own. Enhance’s Elite protocol layers compounded semaglutide on top, which the prescribing clinician calibrates to your dose response and tolerance. The clinical reasoning behind dual-agonist therapy is that GIP and GLP-1 work on partially overlapping but distinct pathways for appetite regulation, gastric emptying, and insulin sensitivity. Patients who plateau on a single-agonist regimen sometimes respond to the combined approach. Enhance is the only telehealth program reviewed here that offers it as a structured product.

Pricing is structured by tier and by length of supply. The Core semaglutide protocol starts at roughly $169/month on a quarterly subscription. Advanced tirzepatide starts around $149/month at the entry dose with quarterly billing. Elite (dual protocol) starts at roughly $169/month on a quarterly subscription. Semi-annual plans further reduce the per-month rate. Compared with single-protocol semaglutide or tirzepatide programs, the headline starting prices are competitive, with the unique combined Elite plan available at similar entry-tier rates.

The intake is online: complete a health questionnaire, a licensed clinician reviews your history, and if eligible the medication ships from a U.S.-licensed compounding pharmacy. Doctor-led plans mean the clinician is responsible for dosing calibration across the protocol, including escalation timing and any inter-protocol adjustments on the Elite plan. Enhance does not publish a money-back guarantee in the same contractual form as ShedRx — if outcome warranties matter to you, that is a difference worth weighing.

TheGreenest may earn a commission when readers sign up through this link. This does not affect our editorial coverage or your price. Enhance offers three product tiers: Core Semaglutide (compounded semaglutide injection), Advanced Tirzepatide (compounded tirzepatide injection), and Elite (a dual semaglutide + tirzepatide protocol). Pricing varies by tier and length of supply; quarterly and semi-annual plans reduce the per-month rate. Compounded GLP-1 medications are not FDA-approved finished products; eligibility is determined by a licensed clinician. See Enhance’s Terms of Service for full details.

2. ShedRx — Widest Formulary, Including FDA-Approved Pills, Brand-Name GLP-1, and a Real Refund Guarantee →

ShedRx is the only program in this comparison that offers brand-name GLP-1 pens — Wegovy and Zepbound (both FDA-approved for chronic weight management), plus Ozempic and Mounjaro (their diabetes-indicated counterparts) — alongside the FDA-approved oral GLP-1 pill Foundayo and compounded semaglutide and tirzepatide. Brand pens run higher than compounded — typically from around $199/month — but they are the actual FDA-approved products. That matters if you want the branded version specifically, if you prefer an FDA-approved oral pill over a weekly injection, or if you want a program that can keep supplying you even if the compounded market tightens under evolving FDA rules. It’s also a single program where you can switch between medications without changing providers.

The full medication menu includes compounded semaglutide and tirzepatide injections, GLP-1 liquid drops, GLP-1 lozenges, oral semaglutide liposomal tablets, the FDA-approved Foundayo pill, brand-name pens (Wegovy, Ozempic, Mounjaro, and Zepbound), plus several non-GLP-1 weight-loss medications like metformin, naltrexone-bupropion, and topiramate combinations. No other telehealth program reviewed here comes close on selection.

ShedRx’s refund promise is the most concrete in the category: lose at least 10% of your body weight on the program or get a full refund. The terms are written into the contract. There is no ambiguity about what triggers the refund. Their published outcome data shows 9.8% average weight loss among VIP members and 800,000+ pounds collectively lost across the membership, with over 150,000 active members.

ShedRx hides the monthly subscription price until after enrollment, which we list as a transparency negative. The lever they offer in return is a 30% off first month promo (code Shed10, auto-applied through this link) which softens the unknown. Beyond the medication, ShedRx assigns each patient a care team that includes a nurse, a provider, a success manager, a nutritionist, and a health coach — the most hands-on care model in this comparison.

TheGreenest may earn a commission when readers sign up through this link. This does not affect our editorial coverage or your price. ShedRx’s “lose 10% of your weight or full refund” promise is a contractual refund policy — full money back if you do not lose at least 10% of your body weight on the program. Promo Shed10 applies 30% off the first month and is auto-applied through this link.

3. Oak — Lowest Price + No Subscription, Same-Day Approval →

Oak Longevity (branded as Oak) is the lowest-cost compounded GLP-1 program reviewed here. Compounded semaglutide is $133/month flat — the same price whether you’re at the 0.25mg starter dose or the 2.4mg maintenance dose. Compounded tirzepatide is $199/month flat under the same model. Oak’s pricing structure is the single biggest differentiator: no subscription, no dose-based escalation, and a published $50-off-month-one plus $200-off-3-month promo with code OAKSAVE200 that softens the entry cost further.

The intake process is async — no video call required, no scheduled phone consultation. You complete a health questionnaire, a board-certified provider reviews your file, and if eligible the prescription ships the same day. The friction reduction is real: Enhance and ShedRx both require a medical visit (video or quiz-then-clinician review) before prescribing. Oak does not. For patients who can’t or don’t want to schedule a video call — especially busy parents or anyone who can’t easily get away during business hours — this saves real time on intake.

The medication menu is narrower than the other two programs in this comparison: compounded semaglutide injection and compounded tirzepatide injection only. Both are weekly injections. Oak does not currently offer a daily oral option, a sublingual format, or brand-name medications like Wegovy or Zepbound. If those formats matter to you, see Enhance or ShedRx above. If price and intake simplicity are your top priorities, Oak is the clearest choice.

Oak operates as Oak Longevity Holdings Corp. and is LegitScript-verified. Medications are compounded by U.S.-licensed pharmacies. The company reports 10,000+ patients served. Free 1–2 day shipping is included along with free health coaching throughout the program. Oak does not publish a contractual money-back guarantee like ShedRx’s 10%-or-refund warranty — outcome warranties are not part of their model.

TheGreenest may earn a commission when readers sign up through this link. This does not affect our editorial coverage or your price. Oak’s $133/mo rate is the published flat price for compounded semaglutide at every dose level (no escalation by dose). Code OAKSAVE200 applies $50 off month one and $200 off a 3-month plan; auto-applied through this link. Compounded GLP-1 medications are not FDA-approved finished products and outcomes are not guaranteed. See Oak’s Terms of Service for full details.

Side-by-Side Detail

What to Ask Any GLP-1 Telehealth Provider Before You Pay

The three programs above pass our four-criteria filter. If you are evaluating any other GLP-1 program, run it through these questions before paying. Programs that cannot answer them clearly should be skipped.

1. Who is the licensed clinician writing the prescription? Not the medical director on the website — the actual person reviewing your file. The answer should be a named, state-licensed provider in your state of residence.
2. What pharmacy compounds the medication? A legitimate program will name a state-licensed 503(a) compounding facility or 503B outsourcing facility. Vague language like “our partner pharmacy” without a name is a flag.
3. Does the price increase with dose? Many programs start cheap at the 0.25mg starter dose and escalate as you titrate up. Ask for the price at the highest maintenance dose, not just the starter. Enhance’s tiered model and ShedRx’s enrollment-disclosed subscription should both give you a straight answer.
4. What does the refund policy actually say? “Money-back guarantee” means whatever the contract says it means. Read the terms before paying. Look for specific weight-loss thresholds, time windows, and required adherence conditions.
5. Is the medication shipped from a U.S. licensed pharmacy? Compounded peptides shipped from outside the U.S. are not legally sold for human use in the U.S. and carry quality and contamination risks. The shipping address on the package should be a U.S. address.
6. What happens if I want to cancel? Some programs charge cancellation fees or auto-renew long-term plans. All three programs in this comparison offer no-contract cancellation: Oak has no subscription model at all (you buy each month/3-month plan as needed), and Enhance and ShedRx offer no-contract month-to-month or quarterly cancellation. Confirm terms before paying.

Frequently Asked Questions

Is compounded GLP-1 actually safe?

Compounded semaglutide and tirzepatide prepared by a state-licensed 503(a) or 503B pharmacy use the same active ingredients as Ozempic, Wegovy, Mounjaro, and Zepbound. The compounding process is regulated by state pharmacy boards and, for 503B facilities, by the FDA. The risks are real but not unique to compounded versions: dosing accuracy depends on the pharmacy’s quality controls. The programs in this comparison use U.S.-licensed compounding pharmacies; LegitScript verification is displayed by ShedRx and Oak.

Why are compounded versions so much cheaper than Ozempic?

Compounded semaglutide and tirzepatide cost a fraction of brand-name Ozempic, Wegovy, Mounjaro, or Zepbound for two reasons: no brand-name pricing markup, and lower distribution overhead through telehealth. Brand-name GLP-1 medications cost $1,000+ per month at retail without insurance. Compounded versions cost a fraction of that — starting at $133/month at Oak (the lowest published price in this comparison) and rising into the $200s at the higher-formulary programs. All deliver the same active molecule.

What is dual GLP-1 + GIP therapy and why does it matter?

GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide) are two gut hormones that regulate appetite, gastric emptying, and insulin sensitivity through related but partially distinct pathways. Tirzepatide is already a dual GLP-1 + GIP receptor agonist on its own; semaglutide is GLP-1-only. Enhance’s Elite tier layers compounded semaglutide alongside compounded tirzepatide in a single doctor-led plan, calibrated by the prescribing clinician. Some patients who plateau on a single-agonist regimen respond to the combined approach. Enhance is the only telehealth program reviewed here offering it as a structured product. Dual therapy isn’t for everyone — it requires careful dose management — but for the right patient it can be a meaningful step beyond what monotherapy delivers.

Can I get insurance to cover these?

Insurance does not cover compounded GLP-1 medications because compounded drugs fall outside formulary coverage by design. Brand-name Wegovy and Zepbound are sometimes covered for patients with documented obesity (BMI 30+) or BMI 27+ with a comorbid condition. ShedRx is the only program in this comparison that offers the brand versions, but they do not bill insurance — you would pay cash and submit for reimbursement. FSA and HSA funds are typically usable across the programs in this comparison — confirm at checkout.

How quickly will I lose weight?

Clinical data on semaglutide and tirzepatide shows average weight loss of 1–2 lbs/week during dose escalation, with steeper losses in months three through six as the dose reaches maintenance. ShedRx’s published VIP-tier average is 9.8% of starting body weight. Individual results depend on baseline weight, dose tolerance, and adherence. Dual-agonist protocols (Enhance Elite) are sometimes positioned for patients who’ve plateaued on monotherapy; the clinical literature on combined semaglutide + tirzepatide outside of trial settings is still developing, so outcome expectations should be set by your prescribing clinician.

What if I have side effects?

The most common GLP-1 side effects are nausea, fatigue, and constipation, particularly during the first 4–6 weeks of dose escalation. All three programs in this comparison let you communicate with the prescribing clinician through their platform, so you can report side effects and adjust dose without paying for an extra visit. If side effects are severe (persistent vomiting, signs of pancreatitis, vision changes), stop the medication and contact your prescriber immediately. Dual-agonist protocols may have an additive side-effect profile during titration; this is something the Enhance Elite prescriber will monitor.

Are these programs available in all 50 states?

Yes. All three programs operate nationwide and route prescriptions to a clinician licensed in your state of residence. Compounded GLP-1 is not legal to ship internationally; if you live outside the U.S., none of these programs will work for you.

Methodology

TheGreenest reviewed every direct-to-consumer GLP-1 telehealth program operating in the United States in 2026. Programs were filtered against four criteria: clinician oversight (real review, not rubber-stamping), pharmacy quality (state-licensed, ideally 503(a) or 503B disclosure), pricing transparency (no surprise dose escalation, clear tier or subscription structure), and refund-policy clarity (terms readable before paying). Only the three programs above passed all four. Pricing, refund terms, and outcome data were verified directly on each brand’s public marketing page on the date listed at the top of this article. We do not score programs based on commission rates; partner programs that did not pass the criteria do not appear on this page.

TheGreenest participates in affiliate programs with all three providers reviewed and may earn a commission when readers sign up through links on this page. Affiliate participation does not affect placement, ranking, or editorial coverage on this page. Partners pay the same commission regardless of which position they occupy. We refused affiliate offers from programs that did not meet our four-criteria filter.

This article is editorial content, not medical advice. GLP-1 medications are prescription drugs with documented side effects and contraindications. Speak with a licensed clinician before starting any GLP-1 program.

Neil Shah, MD

Dr. Neil Shah is a licensed physician practicing in Southern California. A prolific research scientist committed to both academic medicine and clinic medicine communities, Dr. Shah has received several awards from the start of his medical career including a full-ride merit scholarship to cover his tuition in medical school at the University of Wisconsin in Madison, where he graduated in 2018.