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Telehealth prescriber directory — by state and medication

TomTeleRx Sat, Jun 6, 2026 at 2:33 PM 8 replies 172 viewsPage 1 of 2
TomTeleRx
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Feb 2025
Delaware
Jun 6, 2026 at 2:33 PM#1

Writing this once so I can stop repeating it across threads. It is about cost and coverage, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

Denials are usually procedural rather than clinical, and the order that works reflects that. Get the denial reason in writing, because it names the criterion you failed. Then supply the documentation that criterion asks for — usually documented BMI with a comorbidity, or a failed prior therapy. Then appeal, and ask for a peer-to-peer review, because a prescriber talking to a reviewing clinician resolves a large fraction of denials that written appeals do not. Manufacturer copay assistance is separate and applies mainly to commercial insurance, and patient assistance programmes are means-tested rather than a discount.

The condition it depends on

Coverage criteria are plan-specific rather than insurer-specific. Two people with the same insurer and different employers have different rules, which is why "my insurer covers it" is not transferable information.

What I am not sure about

What I actually want to know is what actually works on a prior-authorisation denial, as opposed to the list of things that sound like they should work. I would rather have one careful answer than five confident ones.

— TomTeleRx · corrections welcome and will be edited into this post with credit
21 16pete_manc_UK, anna.melb_AU, mark_tokyo and 18 others
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Dr.BariatricHTX
Senior Member
1,456
7,234
Feb 2024
Houston, TX
Jun 6, 2026 at 2:58 PM#2
TomTeleRx said:
Denials are usually procedural rather than clinical, and the order that works reflects that.
TomTeleRx said:
...compounded vs brand cost and coverage...

This debate comes up weekly and I think both sides have valid points:

Pro-brand: FDA-approved, manufacturing standards guaranteed, clinical trial data directly applicable

Pro-compounded: 10x cost savings, same active molecule, independent testing available, accessibility

My position: if you can afford brand or have insurance coverage, that's the gold standard. If not, properly tested compounded from a 503B pharmacy is a reasonable alternative. Neither side should shame the other.

Last edited: Jun 6, 2026 at 8:58 PM
20 15pete_RVA, CarlaRPh_TPA, steph_laguna and 17 others
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DataDave
Senior Member
1,678
8,901
Apr 2024
Washington
Online
Jun 6, 2026 at 3:23 PM#3
TomTeleRx said:
Denials are usually procedural rather than clinical, and the order that works reflects that.

I read this differently from TomTeleRx, on substance rather than tone. The affordability discussion here usually stops at individual tactics. At list price this class is out of reach for most of the people who would benefit, and no amount of appeal strategy changes that — it is a pricing problem wearing a paperwork costume.

19 14LondonLisa, mike_nyc, VendorMark and 16 others
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Dr.MetabolicMD
VIP Member
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Jan 2024
Rochester, MN
Jun 6, 2026 at 3:48 PM#4
DataDave said:
The affordability discussion here usually stops at individual tactics.

Telehealth prescriber review for cost and coverage: I've used 4 different telehealth platforms to get my GLP-1 prescription. Comparison:

FeaturePlatform APlatform BPlatform C
Initial Consult$50$90$0
Monthly Follow-up$40Included$50
Prescription SpeedSame day24-48 hoursSame day
Lab MonitoringRequiredOptionalRequired

I settled on the one that required labs — it shows they care about safety, not just prescribing volume.

18 13Dr.ObesityMed, HealthEcon_DC, PedsEndoPhilly and 15 others
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sean_dublin
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Nov 2024
Dublin, IE
Jun 6, 2026 at 6:02 PM#5
Dr.BariatricHTX said:
TomTeleRx said: ...compounded vs brand cost and coverage...

This matches mine closely enough to be worth saying so out loud. The detail I would add is minor and it is already implied above.

17 12quinn_sf, NurseLeah_Nash, gary_naperville and 14 others
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