Getting a semaglutide prescription requires meeting clinical criteria and finding a provider willing to prescribe it. The criteria are defined by FDA approval: a BMI of 30 or higher, or 27 or higher with at least one weight-related condition. Meeting those criteria is the medical requirement. The practical barrier for most people is access and cost, not eligibility.

Route 1: Your Primary Care Doctor

A primary care physician (PCP) can prescribe semaglutide. This is the most straightforward route for patients who have an established relationship with a doctor and meet the BMI criteria.

What to bring to the appointment: your current weight, height, a list of current medications, and relevant medical history including any weight-related conditions (hypertension, prediabetes, sleep apnea, high cholesterol). Many PCPs are comfortable prescribing GLP-1 medications now that they have several years of post-market data and substantial prescribing experience among their colleagues.

If your PCP is unfamiliar with GLP-1 prescribing or hesitant, asking for a referral to an endocrinologist or a weight management specialist is a reasonable next step.

What to discuss: dose escalation schedule, insurance coverage before the prescription is written (prior authorization requirements vary by insurer), and a plan for monitoring response including follow-up weight checks and any labs your doctor wants to track.

Route 2: Endocrinologist or Bariatric Specialist

Endocrinologists specialize in hormonal and metabolic conditions, including obesity and diabetes. They typically have the most clinical experience with GLP-1 medications and can manage complex cases, patients with multiple comorbidities, those on other medications that interact with semaglutide, or patients who have previously tried and failed GLP-1 therapy.

Bariatric medicine specialists focus specifically on weight management. They may be physicians, nurse practitioners, or physician assistants with specialized training in obesity medicine. The American Board of Obesity Medicine (ABOM) certification identifies clinicians with specific obesity medicine training.

Wait times for specialist appointments are longer than for primary care. In many areas, the wait for a bariatric specialist can be four to eight weeks or more.

Route 3: Telehealth Programs

Telehealth platforms offer the fastest access to semaglutide for patients who qualify. The process typically involves an online intake form, asynchronous or synchronous clinician review, and a prescription issued the same day or within 24-48 hours of completing intake.

The clinician in a telehealth weight loss program is almost always a nurse practitioner or physician assistant, not an MD, in most programs. This is legally appropriate, NPs and PAs can prescribe controlled substances and GLP-1 medications in most states, but patients should understand who is reviewing their case.

The prescription issued by a telehealth program typically goes to their affiliated compounding pharmacy, meaning the medication dispensed is compounded semaglutide rather than brand-name Wegovy. This is a meaningful distinction in terms of quality oversight. The regulatory context is covered in Compounded Semaglutide vs. Brand-Name Ozempic: What Is the Actual Difference?

If brand-name Wegovy is important to you, for insurance reasons, quality assurance, or other considerations, confirm explicitly before signing up that the program dispenses brand-name product, not compounded semaglutide.

What varies between telehealth programs: the depth of clinical review, whether ongoing support is included in the monthly fee, the pharmacy used, and how escalation decisions are made. A comparison resource like ManyTreatments tracks what more than 20 programs include at their maintenance-dose pricing, which helps evaluate what you are actually buying beyond the first-month offer.

Route 4: Weight Loss Clinics

Brick-and-mortar weight management clinics exist in most metropolitan areas. These range from medically supervised programs associated with hospital systems to standalone private clinics. They typically offer a more intensive support model than telehealth, regular in-person weigh-ins, dietary counseling, and frequent clinical contact, at a higher cost and with less scheduling convenience.

For patients who want more structured support than telehealth provides but prefer in-person care, this route offers the most clinical oversight.

What Affects Whether You Qualify

BMI: BMI of 30 or above qualifies you for Wegovy regardless of other conditions. BMI of 27-29.9 qualifies if you have at least one comorbidity. Comorbidities recognized in the FDA label include hypertension, type 2 diabetes, dyslipidemia, and obstructive sleep apnea.

Prior treatment history: Most insurance plans require documented attempts at lifestyle modification before approving GLP-1 medications. Your PCP or specialist should document this in your chart before submitting prior authorization. Telehealth programs typically do not require this documentation for compounded semaglutide prescriptions.

Exclusions: Semaglutide is not appropriate for patients with a personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia type 2, or a history of pancreatitis. These exclusion criteria apply regardless of which provider you use.

Insurance Prior Authorization

Getting brand-name Wegovy covered requires prior authorization from most insurers. The PA process requires documentation of BMI, weight-related comorbidities, and in many cases a history of prior weight loss attempts. PA approval rates vary by insurer and have improved as more plans added GLP-1 coverage, but denial rates remain significant.

If denied, an appeal is possible. Your prescribing clinician can submit additional documentation supporting medical necessity. Patient advocacy organizations and the manufacturer’s patient services team can assist with appeals.

For a full breakdown of what semaglutide costs across every access route without insurance, see How Much Does Semaglutide Cost Without Insurance?