1st Optimal vs SurpassMD
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 →
SurpassMD
Best for: budget-conscious GLP-1 shoppers wanting broad state coverage
Visit SurpassMD →1st Optimal and SurpassMD 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, SurpassMD starts at $124/mo, and SurpassMD edges ahead overall (7.3 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
Pricing not publicly listed.
SurpassMD
Homepage/FAQ: 'Semaglutide starts as low as $124/m ... for eligible patients. Actual pricing depends on medication, dose, and provider approval.'
Homepage/FAQ: 'tirzepatide starts as low as $184/m ... for eligible patients. Actual pricing depends on medication, dose, and provider approval.'
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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
SurpassMD
What the monthly price covers
Medication
Included
Provider visits
Included
Shipping
Not disclosed
Lab work
Not disclosed
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
SurpassMD
7.3/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | SurpassMD |
|---|---|---|
| Starting Price | — | $124/mo |
| Features | 8 features | 8 features |
| States Available | Not disclosed | 51 |
| Compounded | — | ✓ Yes |
| Brand Name | — | — |
| FSA/HSA Accepted | — | ✓ Yes |
| 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 SurpassMD
SurpassMD is an online GLP-1 weight loss platform operated by Life Vitality LLC that connects patients with independent licensed providers for compounded semaglutide and tirzepatide, dispensed by 503A pharmacies with cold-chain shipping. Its clinical intake and consent flow runs on OpenLoop's telehealth platform. Pricing starts as low as $124/month for semaglutide and $184/month for tirzepatide for eligible patients, cash-pay only, with HSA/FSA and Klarna-style financing accepted.
Read our full SurpassMD 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
SurpassMD
What we like
- Transparent starting prices published: $124/mo semaglutide, $184/mo tirzepatide
- Compounded through 503A pharmacies with cold-chain shipping
- Broad coverage: licensed to operate in all 50 states plus DC
- HSA/FSA and Klarna-style buy-now-pay-later accepted
- Free assessment with no payment required to see if you qualify
- Full refund if disqualified by the medical provider
Watch-outs
- Specific compounding pharmacy partner is not named on the site
- LegitScript Certified badge shown, but no verifiable LegitScript record found
- Cancellation & Refund Policy page conflicts with the Terms of Use on refund eligibility
- Billing begins at intake submission, before provider approval
- Exact per-dose pricing beyond the 'starting at' figures is not published
- Refund policy requires 72 hours' notice before your next billing date to cancel
Our Verdict
SurpassMD edges out 1st Optimal with a higher overall score of 7.3/10 and is particularly strong for budget-conscious GLP-1 shoppers wanting broad state coverage. 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.
Choose SurpassMD if…
You want budget-conscious GLP-1 shoppers wanting broad state coverage and a starting price around $124/mo.
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Get started →1st Optimal vs SurpassMD: 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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