California

No — California is asynchronous-first. A California-licensed provider can review your intake by secure message and, if appropriate, prescribe semaglutide without ever scheduling a video call, as long as the standard of care is met. A provider may ask for a brief video visit or additional labs if your history calls for it, but most patients complete everything asynchronously.

Yes — compounded semaglutide is available to eligible California residents through licensed telehealth. It is prepared per-patient by US-licensed compounding pharmacies under FDCA §503A, and a California-licensed clinician must prescribe it based on a documented, patient-specific clinical rationale. Pallas serves California with free shipping. FDA-approved brand-name options like Wegovy^® and Zepbound^® are also available through the same intake.

Medi-Cal covers FDA-approved GLP-1s for type 2 diabetes and, in some cases, for weight management with prior authorization and documentation of medical necessity. Compounded semaglutide and tirzepatide are not covered by Medi-Cal. Pallas is a cash-pay service, so Medi-Cal coverage does not apply to our prescriptions.

Yes. Compounded semaglutide prescribed by a licensed California provider and dispensed by a licensed compounding pharmacy is legal when prepared for an individual patient based on a specific clinical need. Pallas only works with U.S. state-licensed 503A and 503B compounding pharmacies that meet these requirements.

Pallas is a cash-pay telehealth service — there is no insurance to bill. Your Pallas Membership covers your clinician's review, ongoing check-ins, and care-team messaging; the medication is billed separately and ships free to your California address, only when a clinician prescribes it, typically arriving within 2–3 business days of the pharmacy filling your prescription. You see your full price during intake before you pay anything — no surprise renewal markups. The price is the same whether you are in Los Angeles, the Bay Area, or a rural California ZIP code.

Eligibility is always decided by a California-licensed clinician after reviewing your full intake, never by an automated quiz. In general, GLP-1 medications for weight management are considered for adults with a BMI of 30 or higher, or a BMI of 27 or higher together with a weight-related condition such as high blood pressure, type 2 diabetes, high cholesterol, or obstructive sleep apnea. Your clinician also reviews your medical history and current medications to confirm a GLP-1 is appropriate and safe for you, and will tell you if it is not.

Brand-name medications — Wegovy^® and Ozempic^® (semaglutide) and Zepbound^® and Mounjaro^® (tirzepatide) — are FDA-approved products from their manufacturers, offered cash-pay. Compounded semaglutide and tirzepatide are prepared on a per-patient basis by US-licensed compounding pharmacies, regulated under federal law (FDCA §503A) and by state boards of pharmacy, when a clinician documents a patient-specific clinical need. While these pharmacies are highly regulated, the compounded medications themselves are not FDA-approved, are not generic versions of brand-name drugs, and have not been evaluated by the FDA for safety, efficacy, or quality. Which option fits you is a clinical decision you make with your California-licensed provider.

Yes, many patients transfer their care to Pallas. During intake you tell your clinician which medication and dose you take now and how you have tolerated it. Your California-licensed provider reviews that history and, if appropriate, continues you at a comparable dose or adjusts your titration plan. Do not stop or change a prescription on your own — let your clinician guide any transition.

Most patients use a once-weekly injection with a very fine needle, but a compounded oral semaglutide tablet is available for people who would rather not inject. Both are prescribed only after a clinician confirms they are appropriate for you, and your provider can help you weigh which form fits your routine and goals.

The most common side effects are gastrointestinal — nausea, constipation, diarrhea, or reflux — and they are usually mildest when the dose is raised slowly, which is why clinicians titrate up gradually. GLP-1s are not right for everyone; they are avoided in people with a personal or family history of medullary thyroid carcinoma or MEN2, and during pregnancy. Your Pallas clinician screens for these before prescribing and stays available to help you manage any side effects.

You complete a detailed online intake in under five minutes, sharing your health history, goals, and current medications. A clinician licensed by the Medical Board of California reviews it asynchronously in most cases — no live video required — and may follow up by secure message or request labs if your history calls for it. If a GLP-1 is appropriate, your prescription goes to a licensed pharmacy that ships to any California address, usually within a few business days.

Pallas care is ongoing, not a one-time script. Your plan renews on a regular cadence so your medication arrives before you run out, and your clinician schedules check-ins to monitor your response, adjust your dose, and manage side effects. You can message your care team, change your plan, or cancel anytime from your patient portal — no phone calls or retention hoops.

Possibly — it depends on your full medication list and health history, so there is no way to answer in the abstract. During intake you list every prescription, over-the-counter medication, and supplement you currently take. Your California-licensed clinician reviews that list for interactions and contraindications before prescribing, and may follow up with questions about specific medications like insulin, other diabetes drugs, or blood thinners. Never stop or change an existing prescription on your own — let your clinician guide any adjustment.

Most patients start at a low dose so their body can adjust, and your California-licensed clinician plans a gradual increase over the following weeks based on how you respond. Mild gastrointestinal side effects — nausea, changes in appetite, occasional constipation — are common early on and typically ease as your dose stabilizes. Your care team checks in before any dose change and is reachable by secure message throughout, so you are never guessing whether what you're feeling is expected.

Compounded semaglutide injection through Pallas is $139 for your first month, then $597 every 12 weeks ($199/mo average). Cancel anytime. That one plan price includes your US-licensed provider, ongoing check-ins, dose adjustments, and unlimited care-team messaging — no separate membership fee. Medication ships free to any California address, only if a clinician prescribes it, and you are refunded in full if a clinician decides treatment isn't right for you.

Compounded tirzepatide injection through Pallas is $179 for your first month, then $897 every 12 weeks ($299/mo average). Cancel anytime. That one plan price includes your US-licensed provider, ongoing check-ins, dose adjustments, and unlimited care-team messaging — no separate membership fee. Medication ships free to any California address, only if a clinician prescribes it, and you are refunded in full if a clinician decides treatment isn't right for you.

Yes. FDA-approved Wegovy^® and Zepbound^® for chronic weight management — plus Ozempic^® and Mounjaro^® for type 2 diabetes — are available to California patients cash-pay from $1069/mo; insurance is not billed. Whether a brand-name or compounded medication is appropriate for you is determined by a clinician licensed in California during intake.

That is a decision you make with your clinician. Semaglutide activates the GLP-1 receptor; tirzepatide activates both the GLP-1 and GIP receptors. In the SURMOUNT-5 head-to-head trial of the FDA-approved products, Zepbound^® (tirzepatide) produced greater average weight loss than Wegovy^® (semaglutide) — about 20% versus 14% of body weight over 72 weeks. Clinical trial outcomes for the FDA-approved products have not been established for compounded preparations. Individual results vary. Semaglutide plans cost less and semaglutide has the longer post-market record; a clinician licensed in California weighs your history, goals, and budget to recommend a starting point.