How to Qualify for Semaglutide: Requirements to Meet

Semaglutide (the active ingredient in Ozempic^®, Wegovy^®, and Rybelsus^®) is a prescription drug, meaning a healthcare provider will determine if it’s right for you.

There are a few eligibility criteria to meet. So, how do you qualify for semaglutide?

To qualify for semaglutide for weight loss, you’ll need a body mass index (BMI) of 30 or higher or 27 or more with at least one weight-related health condition, like type 2 diabetes, hypertension, or high cholesterol.

There are a few more things to think about, like if you have any health conditions that mean you can’t take semaglutide.

In this guide, we’ll discuss how to qualify for semaglutide, who qualifies for semaglutide, and who can’t take the medication.

Semaglutide is the active ingredient in a few different medications, which have different eligibility criteria.

One thing to keep in mind is that even if you meet these criteria, a healthcare provider still needs to determine if the medication is right for you. If so, they’ll have to write you a prescription in order to access it.

Here’s a rundown of how to qualify for semaglutide medications.

Who Qualifies for Ozempic^®?

Ozempic^® is approved by the U.S. Food and Drug Administration (FDA) for type 2 diabetes. To qualify, you’ll need a type 2 diabetes diagnosis.

The medication is sometimes prescribed off-label for weight loss and chronic weight management. This is when a healthcare provider prescribes a drug to treat a condition outside of its approved use — a common and legal practice.

To qualify for Ozempic^® for weight loss, your provider will probably look at your BMI and overall health status. They may use Wegovy^®’s prescribing guidelines to help determine if Ozempic^® is right for you.

Who Qualifies for Wegovy^®?

Wegovy^® is FDA-approved to help people with overweight and obesity lose excess weight.

To qualify for Wegovy^®, you’ll typically need to have a:

• BMI of 30 or more (obesity)

• BMI of 27 or more (overweight) and at least one weight-related condition

You can use our BMI calculator to input your current body weight and height and find out your number.

Weight-related conditions include:

• Hypertension (high blood pressure)

• Dyslipidemia (which includes high cholesterol)

• Sleep apnea

• Type 2 diabetes

• Heart disease

Wegovy^® is also FDA-approved to reduce the risk of adverse cardiovascular events — like heart attack and stroke — in those with heart disease and overweight or obesity.

We’ve covered more on Wegovy^® versus Ozempic^® on our blog.

Who Qualifies for Rybelsus^®?

Rybelsus^® is FDA-approved to help people with type 2 diabetes manage their blood sugar levels. Ozempic^® and Wegovy^® are semaglutide injections, whereas Rybelsus^® is a pill.

You’ll need to have type 2 diabetes to qualify for Rybelsus^®.

This medication is sometimes prescribed off-label for weight loss. There’s no strict eligibility criteria in those cases, but your healthcare provider will likely look at your BMI and consider whether you have any health conditions to see if it’s right for you.

Who Qualifies for Compounded Semaglutide? 

A healthcare provider may prescribe compounded semaglutide if you have a unique need that brand-name versions of the drug can’t meet. For instance, you might need a personalized dose or an allergen removed.

Since compounded semaglutide* isn’t FDA-approved, there are no official eligibility criteria. A healthcare provider may look to Wegovy’s prescribing guidelines to determine if compounded semaglutide is right for you.

So, to qualify, you may need a certain BMI and (sometimes) a weight-related health condition, as well as a unique need that means you can’t use Ozempic^®, Wegovy^®, or Rybelsus^®.

Through Weight Loss by Hims, eligible customers can access compounded semaglutide starting from $199 a month with a 6-month plan, paid upfront in full.**

There are also 2- and 4-month subscription options, so you can find a plan that works for your lifestyle, health goals, and budget.

Check out our guide to compounded GLP-1s to learn more.

*Compounded drug products are not approved or evaluated for safety, effectiveness, or quality by the FDA. Prescription required.

**Actual price depends on product and plan purchased.

There are no official guidelines for how long you can stay on semaglutide. It all depends on how your body reacts to the medication and when you reach your weight loss goals.

In general, though, you may be able to stay on semaglutide long-term to help maintain your weight. This is because semaglutide was originally designed for long-term use as a diabetes medication.

Research backs that up. A 2022 review found that Wegovy^® was safe and effective over two years of use.

If you’re taking the medication for weight loss, semaglutide isn’t usually covered by insurance companies — even if you have a qualifying BMI.

It’s worth checking your policy just in case, but most people need to pay out of pocket for Ozempic^® or Wegovy^® for weight loss.

Our guide to weight loss drugs and insurance coverage goes into more detail.

Semaglutide isn’t right for everyone, even if you meet the BMI requirements. Your healthcare provider will go over your medical history and any medications you’re currently taking to make sure semaglutide is safe for you.

You shouldn’t take semaglutide if you:

• Have a personal or family history of medullary thyroid carcinoma (MTC), a type of thyroid cancer

• Have multiple endocrine neoplasia syndrome type 2 (MEN2), a rare, inherited condition that causes tumors

• Have an allergy to any of the ingredients in semaglutide drugs

• Are taking another semaglutide medication or glucagon-like peptide-1 (GLP-1) receptor agonist (like liraglutide, for example)

Let your healthcare provider know about any health problems you currently have (or previously had), including:

• Type 2 diabetes and a history of diabetic retinopathy (an eye condition)

• Depression, suicidal thoughts, or any other mental health issue

• Problems with your kidneys, gallbladder, or pancreas, such as gallbladder disease or a history of pancreatitis

Some of these things won’t automatically disqualify you from getting semaglutide, but a healthcare professional may want to keep a closer eye on you throughout your treatment.

You might have read about all the good semaglutide can do for your health, and now you’re wondering, Can I take semaglutide? A healthcare provider can answer that question, taking into account your BMI, overall health, and medical history.

Here are the key takeaways on qualifying for semaglutide for medical weight loss or to treat other health conditions:

• BMI is key. Semaglutide BMI requirements are usually 30 or more or 27 or more with at least one weight-related health condition. Related medical conditions include type 2 diabetes, sleep apnea, high blood pressure, high cholesterol, and heart disease.

• Your medical history is important. Let your healthcare provider know about any health conditions you have (or have had in the past) and any medication you’re on. They can determine if semaglutide is safe for you.

• Alternatives are available if you don’t qualify. Depending on why you don’t qualify for semaglutide, or if you have a higher risk of experiencing side effects, you may be eligible for other weight loss medications like tirzepatide (Mounjaro^® and Zepbound^®), liraglutide, or metformin. 

If you’re interested in getting semaglutide medication through Hims, a licensed healthcare provider can go over all the eligibility criteria and, if suitable, write you a prescription so you can start your weight loss and wellness journey.

Ozempic^® and Wegovy^® are registered trademarks of Novo Nordisk A/S. Hims, Inc. is not affiliated with or endorsed by Novo Nordisk A/S.