How to Qualify for GLP-1s: BMI and Eligibility for Tirzepatide and Semaglutide

GLP-1
How to Qualify for GLP-1s: BMI and Eligibility for Tirzepatide and Semaglutide
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If your BMI is 25 or higher, you'll usually qualify for tirzepatide or semaglutide. With a BMI between 23 and 24.9, you'll also need a condition like high blood pressure, and a licensed clinician reviews every intake before anything is prescribed.

Your BMI and health history help a clinician decide whether tirzepatide or semaglutide is right for you. This guide explains the BMI ranges, which health conditions count and what else a clinician checks before prescribing.

You don't need an existing prescription to apply through HealthiCare's online GLP-1 weight loss program.

First, work out your BMI:

BMI formula

BMI=weight in pounds × 703height in inches2

GLP-1 BMI Requirements at a Glance

Your BMIWeight-related condition needed?Where you stand
25 or higherNoIn range
23 to 24.9Yes, at least oneIn range with a condition
Under 23Doesn't applyBelow the usual range

Tirzepatide and semaglutide use these same numbers.

What Weight Is a BMI of 23 or 25?

Don't want to do the math? Find your height below. If you weigh at least the number shown, you're at or above that BMI.

HeightBMI 23BMI 25
5'0"118 lbs129 lbs
5'2"126 lbs137 lbs
5'4"135 lbs146 lbs
5'6"143 lbs155 lbs
5'8"152 lbs165 lbs
5'10"161 lbs175 lbs
6'0"170 lbs185 lbs
6'2"180 lbs195 lbs
6'4"189 lbs206 lbs

At 5'6" (66 inches) and 150 pounds, that's 150 × 703 ÷ (66 × 66), or 24.2. That's in the 23 to 24.9 band, so you'd also need a condition like high blood pressure to be eligible for a GLP-1 treatment.

Who Is a Candidate for GLP-1 Treatment at a BMI of 23 to 24.9

At a BMI of 23 to 24.9, you also need at least one weight-related health condition to be a candidate for GLP-1 treatment, such as:

  • High blood pressure
  • High cholesterol or triglycerides
  • Type 2 diabetes
  • Sleep apnea
  • Heart disease

Taking medicine for blood pressure or cholesterol? List it on your intake, along with everything you've been diagnosed with. Your clinician decides what counts.

GLP-1 BMI Checker

Check Where Your BMI Falls

Add your height, your weight and any conditions a doctor has diagnosed.

Diagnosed conditions

Enter your height and weight to see your BMI.

When BMI Doesn't Tell the Whole Story

BMI can't see body fat. It only knows your height and weight.

A 5'10" man who lifts weights and weighs 175 pounds has a BMI of 25, even with little body fat. A woman with little muscle can have a normal BMI and still carry extra fat around her waist.

If you're close to 23 or 25, grab a tape measure and add your waist size to your intake.

How to Get Prescribed Tirzepatide or Semaglutide Through HealthiCare

  1. Complete the online intake

    Answer questions about your height, weight, health history and medications.

  2. A clinician reviews it

    A licensed clinician reviews your answers and meets with you by telehealth. They may also order screening tests.

  3. Get your prescription

    If treatment is right for you, you're prescribed personalized tirzepatide, personalized semaglutide or the Wegovy pill.

  4. Receive your medication

    Most orders arrive 5 to 7 days after your prescription is issued, and refills ship every month. Your personalized tirzepatide or semaglutide comes in a vial, with small insulin-style syringes for your injections.

If you already take a GLP-1 through another provider, moving your care to HealthiCare is simple. Put your current medication and dose on your intake, and if it's appropriate, the clinician will prescribe a treatment that picks up from there.

Completing the intake doesn't guarantee a prescription.

To compare the two medications, see personalized tirzepatide and personalized semaglutide.

What a Clinician Reviews Besides Your BMI

The clinician also looks at conditions and medications that can change your dose or which medication fits you. None of these rules you out on its own.

Include on your intakeWhy it matters
Pancreatitis or gallbladder problemsBoth are possible side effects, so your history matters
Insulin or a sulfonylurea for diabetesYour clinician may lower these doses so your blood sugar doesn't drop too far
Diabetic eye disease (retinopathy)Your eyes will need checking during treatment
Kidney problemsEarly stomach side effects can dehydrate you and strain your kidneys
Birth control pillsOn tirzepatide, use a backup method for 4 weeks after you start and after each dose increase
Upcoming surgery or sedationYour surgical team needs to know you're on a GLP-1 before anesthesia or sedation
Your weight loss goals and past attemptsThey help your clinician set up a plan that fits you

Qualifying for a GLP-1 vs. Getting Insurance to Pay

Meeting these BMI ranges means a clinician can prescribe a GLP-1. It doesn't mean your insurance will pay for it. Plenty of plans add their own hoops, like prior authorization, proof you've tried dieting first or a higher BMI.

HealthiCare works differently. If a clinician prescribes personalized tirzepatide or semaglutide, you pay the plan price listed below.

What GLP-1 Treatment Costs Once You Qualify

TreatmentThree-month planMonthly plan
Personalized semaglutide$107.10 a month, billed $321.30 every three months$126.00
Personalized tirzepatide$122.40 a month, billed $367.20 every three months$144.00
Wegovy pillMonthly billing only$268.68 for 1.5 mg and 4 mg, $448.79 for 9 mg and 25 mg

These prices apply in the states where our partner pharmacy is licensed. See the state list below.

There's no membership fee, and personalized semaglutide and tirzepatide cost the same at every dose, so your bill doesn't go up when your dose does. Every plan includes unlimited support from our medical team and coaches, plus the Healthi app, so you get personal care along with your medication. Cancel whenever you like, and HSA and FSA cards work. For the full yearly cost, see the cost of GLP-1 treatment.

GLP-1 Eligibility by State

Our partner pharmacy isn't licensed in California, Delaware, Massachusetts, Mississippi, Nevada, New Hampshire, New Jersey, North Carolina, Texas or West Virginia. If you live in one of those states, get in touch before you pick a plan and we'll tell you what's available to you.

Who Shouldn't Take Tirzepatide or Semaglutide

Ruled out

Tirzepatide and semaglutide aren't prescribed if you or anyone in your family has had medullary thyroid carcinoma, a rare thyroid cancer. The same goes if you have multiple endocrine neoplasia syndrome type 2 (MEN 2), an inherited condition that causes tumors in hormone glands, or if you've had a serious allergic reaction to tirzepatide or semaglutide before.

Pregnancy

You'll need to stop if you get pregnant, and the Wegovy label says to stop at least two months before you start trying. Let us know on your intake if you're pregnant, trying to get pregnant or breastfeeding.

Warning signs

Once you're on treatment, call your doctor right away about a lump in your neck, trouble swallowing, shortness of breath or hoarseness that doesn't go away.

Not Sure You Qualify? Ask a Clinician.

The online intake is quick. A licensed clinician reviews it and tells you whether GLP-1 treatment is right for you.

Start Your Intake
  • No membership fees
  • Same price every dose
  • Cancel anytime
Smiling woman on a sunny hiking trail

Frequently Asked Questions

Can I get a GLP-1 with a BMI of 21 or 22?

Usually not. A BMI under 23 is below the range these medications are prescribed for.

Do I need diabetes to qualify for a GLP-1?

No. Tirzepatide and semaglutide are approved for weight loss in people without diabetes. Type 2 diabetes is one of the conditions that counts at a BMI of 23 to 24.9.

Why won't my doctor prescribe a GLP-1?

Usually your BMI is below the range, or you're between 23 and 24.9 without a weight-related condition. Something in your history can also rule it out, like a family history of medullary thyroid carcinoma.

What if my BMI is below the range?

Then a GLP-1 usually isn't prescribed for weight loss right now. That can change. If your BMI moves into the range or you're diagnosed with a weight-related condition, you'd be in range then.

Can sleep apnea or heart disease qualify me?

Yes. Both count as weight-related conditions at a BMI of 23 to 24.9. Zepbound is also approved to treat moderate to severe obstructive sleep apnea in adults with obesity, and Wegovy to lower the risk of heart attack and stroke in adults with heart disease and obesity or overweight.

What should I tell the clinician to get a GLP-1?

Tell them everything, accurately. Include your current height and weight, every diagnosis, all your medications, any GLP-1 you've taken before and what you want from treatment. There's no script that gets you approved. The clinician decides from your actual history.

Do I need lab work before I apply?

Your clinician reviews your intake first and may order tests if they're needed.

How old do you have to be?

You need to be 18 or older to sign up.

Sources: Zepbound label and Wegovy label on DailyMed

Updated on:

October 30, 2026