1st Optimal vs Midi Health
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: GLP-1 therapy within a lab-driven functional-medicine program
Visit 1st Optimal →
Midi Health
Best for: menopause-focused care with GLP-1 as a metabolic adjunct
Visit Midi Health →1st Optimal and Midi Health are both GLP-1 Providers competing for the same patients, but they make different trade-offs on price, coverage, and what's included. In our scoring, 1st Optimal starts lower at $99/mo versus $164/mo, and Midi Health edges ahead overall (7.0 vs 6.7 out of 10). Below we break down pricing, what each plan covers, the six-dimension score, pros and cons, and exactly who should pick which.
Pricing
1st Optimal
Care membership only — the GLP-1 medication is billed separately and is not priced.
Midi Health
Per-visit self-pay fee, NOT a monthly medication price; GLP-1 medication billed separately or through insurance. UPDATED 2026-08-15: the earlier claim that no compounded medication price is published is NO LONGER TRUE — see the ladder rows below, from /glp1-pricing.
Per-visit self-pay fee; medication not included. Under insurance you instead pay your standard copay + deductible.
From /glp1-pricing, headed 'No membership fees. No surprises.' ⚠ EVERY table is labelled '4-week supply', NOT a calendar month, so this is 13 cycles a year and must never be restated as '/mo'. Ladder runs $165.90 (0.1–0.5 mg) to $355.00 (2.5 mg).
4-week supply, not a month. Ladder runs $210.00 (1.25–2.5 mg) to $434.00 (13.75–15 mg).
4-week supply, not a month. Ladder runs $164.00 (0.075 mg) to $275.00 (0.8 mg).
4-week supply, not a month. Ladder runs $209.00 (1 mg) to $460.00 (7 mg).
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What’s included
1st Optimal
What the monthly price covers
Medication
Not disclosed
Provider visits
Included
Shipping
Included
Lab work
Not disclosed
Coaching
Included
Midi Health
Inclusions not disclosed.
Score breakdown
Both providers are scored on the same six-dimension framework. The gradient bar marks the stronger side on each dimension.
1st Optimal
6.7/10
Midi Health
7.0/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Midi Health |
|---|---|---|
| Starting Price | ✓$99/mo | $164/mo |
| Features | ✓8 features | 5 features |
| States Available | Not disclosed | 50 |
| Compounded | — | ✓ Yes |
| Brand Name | ✓ Yes | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
About 1st Optimal
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. Its model pairs prescription GLP-1 therapy with at-home lab testing, blood-work interpretation, unlimited coaching, and personalized protocols framed around long-term weight loss and longevity. Care is delivered virtually by credentialed providers, and treatments ship to the home with no long-term contracts. The site does not publish monthly pricing or a state list.
Read our full 1st Optimal review →About Midi Health
Midi Health is a nationwide 50-state menopause and perimenopause telehealth platform. GLP-1 prescribing is offered as a clinician-discretionary metabolic-health adjunct within the menopause care framework — not as a standalone weight-loss product. Accepts commercial insurance but does NOT accept Medicare, Medicaid, or Medi-Cal.
Read our full Midi Health review →Pros & Cons
1st Optimal
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
Watch-outs
- 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
Midi Health
What we like
- Available in all 50 states
- Accepts commercial insurance — a differentiator vs cash-pay-only GLP-1 telehealth
- Menopause + metabolic-health focus suits women where GLP-1 efficacy and weight regulation overlap most
- Transparent self-pay visit fees ($250 initial, $150 follow-up); GLP-1 can also be billed through commercial insurance (copay + deductible)
Watch-outs
- Does not accept Medicare, Medicaid, or Medi-Cal
- GLP-1 is prescribed at clinician discretion within a menopause plan, not guaranteed at intake
- Menopause-focused — not the right fit for men or younger women whose main goal is weight loss
Our Verdict
Midi Health edges out 1st Optimal with a higher overall score of 7.0/10 and is particularly strong for menopause-focused care with GLP-1 as a metabolic adjunct. 1st Optimal remains a solid alternative, especially if you're looking for GLP-1 therapy within a lab-driven functional-medicine program.
Choose 1st Optimal if…
You want GLP-1 therapy within a lab-driven functional-medicine program and a starting price around $99/mo.
Choose Midi Health if…
You want menopause-focused care with GLP-1 as a metabolic adjunct and a starting price around $164/mo.
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Get started →1st Optimal vs Midi Health: FAQ
Key terms, explained
New to GLP-1s? Tap any term for a quick, plain-English definition.
- Semaglutide · Drugs and brands
- Tirzepatide · Drugs and brands
- Compounded GLP-1 · Pharmacy and drug forms
- 503A pharmacy · Pharmacy and drug forms
- PCAB accreditation · Pharmacy and drug forms
- Prior authorization (PA) · Insurance and regulatory
- Off-label use · Insurance and regulatory
- FDA Drug Shortage List · Insurance and regulatory
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