1st Optimal vs Midi Health
An in-depth comparison of two leading GLP-1 Providers
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1st Optimal
Best for: coaching bundled into the price rather than sold separately
Visit 1st Optimal →
Midi Health
Best for: coverage in all 50 states, which most of the register will not confirm
Visit Midi Health →Two GLP-1 Providers chasing the same patients, trading off price, geography and what lands in the box differently. On our scoring, Midi Health starts at $150/mo, and Midi Health finishes ahead, 4.6 to 3.9. What follows: the prices, what each plan actually covers, the six-dimension score, where each one is weak, and who should pick which.
Pricing
1st Optimal
Pricing not publicly listed.
Midi Health
Per-visit self-pay fee, NOT a monthly medication price; GLP-1 medication billed separately or through insurance. No compounded medication price is published on the current site.
Per-visit self-pay fee; medication not included. Under insurance you instead pay your standard copay + deductible.
What’s included
1st Optimal
Covered by the monthly price
Medication
Not stated
Clinician visits
In the price
Shipping
In the price
Lab work
Not stated
Coaching
In the price
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
3.9/10
Midi Health
4.6/10
Value25%
Effectiveness25%
User Experience15%
Trust & Safety15%
Accessibility10%
Support10%
Features & Coverage
| Feature | 1st Optimal | Midi Health |
|---|---|---|
| Starting Price | — | $150/mo |
| Features | ✓8 features | 5 features |
| States Available | Not disclosed | 50 |
| Compounded | — | — |
| Brand Name | — | — |
| FSA/HSA Accepted | — | — |
| FDA Warnings | None | None |
About 1st Optimal
Neither a monthly price nor a list of states is published. 1st Optimal operates out of Michigan across telehealth and functional medicine, writing the GLP-1s semaglutide and tirzepatide either as a weekly injection or as a daily oral tablet. Around the prescription it stacks at-home lab testing, interpretation of the blood work, coaching without limit and protocols built individually, all framed as long-term weight loss and longevity. Credentialed providers work virtually, treatment goes to the home, and nothing binds you to a long contract.
Read our full 1st Optimal review →About Midi Health
Medicare, Medicaid, and Medi-Cal are all refused at Midi Health, though commercial insurance is taken. The platform covers menopause and perimenopause nationwide, in 50 states. GLP-1s are not sold here as a standalone weight-loss product; a clinician may add one at their discretion, a metabolic-health adjunct inside the menopause care framework.
Read our full Midi Health review →Pros & Cons
1st Optimal
What we like
- The monthly figure covers consult, shipping, coaching
- No FDA warning letter matched this operator when we searched our enforcement register
- A live video visit with a clinician is required before a prescription, which is slower than a form and is the more careful intake
- Baseline bloodwork is required before a prescription
Watch-outs
- No price appears until the medical intake is complete, so the cost cannot be compared before health information is submitted
- No state list is on record here, so whether it serves your state cannot be confirmed from this page
- No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
Midi Health
What we like
- Coverage is published for all 50 states
- No FDA warning letter matched this operator when we searched our enforcement register
- A live video visit with a clinician is required before a prescription, which is slower than a form and is the more careful intake
Watch-outs
- No price appears until the medical intake is complete, so the cost cannot be compared before health information is submitted
- No dispensing pharmacy is named in our record, so its accreditation cannot be looked up from here
Our Verdict
Midi Health takes it, 4.6 against 3.9, and it is especially strong on coverage in all 50 states, which most of the register will not confirm. 1st Optimal is no weak second and may fit you better on coaching bundled into the price rather than sold separately.
Choose 1st Optimal if…
You want coaching bundled into the price rather than sold separately.
Choose Midi Health if…
You want coverage in all 50 states, which most of the register will not confirm and an opening price near $150 a month.
Ready to start? Vetted GLP-1 providers
Vetted telehealth providers that prescribe GLP-1 online.
No insurance needed · vetted by our editors
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SkinnyRx
Starting below a standard dose, with microdose tiers
From $149.25/mo
Get started →YourEra
Semaglutide at $99/month, 63% under the register median
From $99/mo
Get started →Gala
Moving between compounded and brand without changing seller
From $129/mo
Get started →1st Optimal vs Midi Health: FAQ
Glossary
The words sellers use, defined. Tap any term.
- 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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Or see the full category ranking.
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