1st Optimal vs PlushCare
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 →
PlushCare
Best for: virtual primary care that can also prescribe GLP-1s
Visit PlushCare →1st Optimal and PlushCare 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 $149/mo, and PlushCare 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.
PlushCare
A cash-pay option of $149 per month, and it buys the 0.25 mg starting dose only — every maintenance dose is priced higher. Insurance is accepted separately.
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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
PlushCare
What the monthly price covers
Medication
Billed separately
Provider visits
Billed separately
Shipping
Not disclosed
Lab work
Billed separately
Coaching
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
PlushCare
7.0/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | PlushCare |
|---|---|---|
| Starting Price | ✓$99/mo | $149/mo |
| Features | 8 features | 8 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 PlushCare
Established virtual primary-care telehealth platform (subsidiary of Transcarent, Inc., a Delaware corporation, alongside Accolade, 2nd.MD, and 98point6 by Transcarent). PlushCare offers virtual visits with US board-certified physicians at $30 insured / $129 self-pay per appointment, with GLP-1 prescribing as a clinician-discretionary option within the broader primary-care relationship.
Read our full PlushCare 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
PlushCare
What we like
- Available in all 50 states
- Appointments with US board-certified physicians, not nurse practitioners only
- Virtual primary care — the same doctor can manage GLP-1s alongside other health needs
- Owned by Transcarent, a venture-backed health platform with a named corporate parent
Watch-outs
- Facing a California class action alleging deceptive subscription enrollment and unauthorized charges after cancellation
- GLP-1 prescribing is up to the clinician at the visit — not guaranteed at signup
- BBB complaints center on the membership cancellation process
Our Verdict
PlushCare edges out 1st Optimal with a higher overall score of 7.0/10 and is particularly strong for virtual primary care that can also prescribe GLP-1s. 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 PlushCare if…
You want virtual primary care that can also prescribe GLP-1s and a starting price around $149/mo.
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Sunlight
Compounded GLP-1 with unlimited telehealth visits and free shipping
From $88/mo
Get started →MadeMed
Compounded GLP-1 in both injection and oral forms
From $219/mo
Get started →Found
Mainstream telehealth GLP-1 access
From $99/mo
Get started →1st Optimal vs PlushCare: 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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