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Ranked #489 of 497 · Grade C

1st Optimal review

1st Optimal is a Michigan-based telehealth and functional-medicine platform offering GLP-1 weight loss medications, including semaglutide and tirzepatide, as once-weekly injections or daily oral tablets.

Visit 1st Optimal Or see your best match We may earn a commission if you start care through some of these links, at no extra cost to you. What we write about a provider is the same either way, and every Match Score is computed from the six published factor sub-scores. See our disclosure.

1st Optimal earns a Match Score of 45/100 (grade C) and sits #489 of 497 on our board under the balanced default weighting.

Semaglutide
Not disclosed
Tirzepatide
Not disclosed
Coverage
Coverage not published
Brand-name
Compounded only
Oral option
Yes
Verification
Not independently listed

Best for: Patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

MatchScript's take: Our #489 pick of 497 — one of the few with a non-injection route, scored on the same six factors as everyone else.

The factor breakdown

1st Optimal on the six Match Score factors — the same sub-scores the quiz reweights to your priorities. See the methodology.

Budget Fit48/100

Its lowest tier isn't clearly disclosed puts Budget Fit at a below-par 48 — above the budget tiers.

Speed to Start33/100

Limited or undisclosed state coverage can slow your start, for a below-par 33 on Speed to Start.

Formulary Match51/100

1st Optimal adds an oral/sublingual route on top of injectables, for a below-par 51 on Formulary Match.

Support Level82/100

Support lands at a solid 82 — solid, standard support.

Flexibility37/100

Flexibility scores a below-par 37 — fewer levers to flex your plan.

Transparency20/100

Disclosure here is thinner than the top of the board give a below-par 20 on Transparency.

Pricing in context

How 1st Optimal's monthly price sits against the category median and the cheapest provider we track.

Monthly priceSemaglutideTirzepatide
1st Optimalthis providerVisit Not disclosedNot disclosed
Category median353 tracked$179/mo$249/mo
Cheapest trackedTelos RxVisit $49/mo$99/mo

What we like

  • Offers both semaglutide and tirzepatide with injectable and oral formats
  • Functional-medicine approach with at-home labs and blood-work interpretation
  • Unlimited coaching and ongoing support included
  • No long-term contracts
  • Board-certified doctors and nurse practitioners referenced

The caveats

  • No public monthly pricing disclosed
  • No published state availability list
  • Compounded vs branded sourcing not clarified on site
  • Pricing only revealed after quiz or consultation

Who it's for — and who should skip it

Choose 1st Optimal if patients wanting GLP-1 therapy within a lab-driven functional-medicine program.

Skip it if that doesn't sound like you. A closer fit may be Blue Haven RX (Match Score 46) — or take the quiz to see where 1st Optimal lands for your priorities.

See every alternative to 1st Optimal.

How it compares to CoreAge Rx & the closest scorer

1st Optimal against our #1 overall pick and the provider that scores closest to it. Green marks the row leader.

How it compares1st Optimalthis providerCoreAge Rxour #1Blue Haven RXclosest scorer
Sema priceNot disclosed$149/moNot disclosed
CoverageCoverage not publishedAll 50 statesCoverage not published
FormularyInjectable + oralInjectableInjectable
Match Score45 · C91 · A−46 · C

1st Optimal, answered

Is 1st Optimal legit?

1st Optimal is a real, operating GLP-1 telehealth program, but we don't find it on the LegitScript registry, so it carries less third-party verification than the certified providers on our board. It dispenses compounded medication, which isn't FDA-approved. Vet the prescriber and pharmacy before you commit.

How much does 1st Optimal cost?

1st Optimal doesn't publish a clear compounded-semaglutide price up front. You'll typically see full pricing after the intake questionnaire. Get the all-in monthly number in writing before you pay.

Does 1st Optimal ship to my state?

1st Optimal operates in a limited set of states (Coverage not published). If yours isn't on that list, you'll need a nationwide provider instead.

1st Optimal vs CoreAge Rx — which is better?

Both are on our board. 1st Optimal scores 45/100; CoreAge Rx leads our default ranking at 91/100 for its flat nationwide pricing on both molecules and easy cancellation. 1st Optimal can still win for you if its strengths match your priorities — best for: Patients wanting GLP-1 therapy within a lab-driven functional-medicine program. Run the quiz to see which comes out ahead for you.

Pricing & state data last verified July 2026 from 1st Optimal's public site and our master provider matrix. The Match Score and its sub-scores are our editorial judgment per the methodology. Commercial facts only — prices change, so confirm on 1st Optimal's site. Not medical advice; see our disclosure.

Verdict · Grade C · 45/100

1st Optimal earns a Match Score of 45/100 (grade C) and sits #489 of 497 on our board under the balanced default weighting. 1st Optimal is a Michigan-based telehealth and functional-medicine platform offering GLP-1 weight loss medications, including semaglutide and tirzepatide, as once-weekly injections or daily oral tablets. Best for: Patients wanting GLP-1 therapy within a lab-driven functional-medicine program. If it isn't the right fit, Blue Haven RX is a sensible alternative to weigh next.

Compare with other providers

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