GLP-1 Telehealth in the Midwest: IL, OH, MI and IN

The Midwest doesn’t get as much attention in conversations about obesity and healthcare access as the South does, but the numbers tell a sobering story.

Illinois, Ohio, Michigan, and Indiana all have obesity prevalence rates above the national average, and the industrial communities, small agricultural towns, and post-manufacturing cities that make up much of the region’s population face a particular combination of challenges: aging healthcare infrastructure, provider shortages outside major metros, insurance markets shaped by an eroding employer base, and a cultural tendency to push through health problems rather than seek treatment.

GLP-1 medications are changing outcomes for patients across this region, and telehealth is increasingly how those patients are getting access without waiting months for a specialist appointment or navigating a prior authorization process that can feel designed to discourage them.

What Are GLP-1 Medications and Who Qualifies

GLP-1 receptor agonists mimic a gut hormone that regulates appetite and slows gastric emptying, creating a sustained feeling of fullness that makes eating less feel natural rather than forced. Semaglutide, the active ingredient in Wegovy and Ozempic, and tirzepatide, the active ingredient in Mounjaro and Zepbound, are the two most widely prescribed options for weight management.

Eligibility for weight loss treatment generally requires a BMI of 30 or above, or 27 or above with at least one weight-related comorbidity such as high blood pressure, Type 2 diabetes, or elevated cholesterol. Telehealth providers assess eligibility through a health intake reviewing your medical history, current medications, and weight metrics. No specialist referral is required, and no prior in-person visit is needed to get started.

How Telehealth GLP-1 Prescribing Works Across the Midwest

All four states in this group allow telehealth providers to prescribe medications following a clinically appropriate evaluation conducted through synchronous video or a detailed asynchronous intake. Through TrimRx, the process is consistent across Illinois, Ohio, Michigan, and Indiana. You complete an online health intake, a licensed provider reviews your information, and a prescription is issued if you qualify. Medication ships from a compounding or retail pharmacy directly to your home, with most patients receiving their first order within a few days of approval.

TrimRx works with providers holding active licenses in all four states, so access is consistent whether you’re in Chicago, Columbus, Detroit, Indianapolis, or a small farming community in rural Indiana or southern Illinois.

One thing worth noting about the Midwest specifically is that the region’s manufacturing and industrial workforce has historically had strong employer-sponsored insurance. That’s changing as manufacturing employment shifts, but many patients in this region have more insurance options worth exploring before assuming they need to pay entirely out of pocket.

State-by-State Telehealth and NP Practice Snapshot

The four Midwestern states covered here have varying frameworks for nurse practitioner prescribing authority, and those differences have real implications for how telehealth platforms staff their clinical teams.

Illinois is a full practice authority state for nurse practitioners, meaning NPs can evaluate, diagnose, and prescribe independently without a required physician collaboration agreement. This is good for telehealth access, as it expands the pool of available prescribers and gives platforms more flexibility in how they structure clinical operations. Illinois made this transition in 2018, and it has meaningfully improved rural access in downstate communities where physician shortages are significant.

Ohio is a reduced practice state, requiring NPs to maintain a standard care arrangement with a collaborating physician. Ohio has considered full practice authority legislation in recent sessions but has not passed it. The practical impact is felt most in rural Ohio, particularly in Appalachian counties in the southeast part of the state where physician collaborators can be difficult to find, limiting the NP workforce that can practice independently in those communities.

Michigan is also a reduced practice state, with NPs required to maintain a collaborative practice agreement with a physician. As covered in detail in our how to get semaglutide in Michigan article, this affects clinical team structure for telehealth platforms but doesn’t change what patients experience during the intake and prescription process.

Indiana similarly requires NPs to maintain a collaborative agreement with a physician, and the state has been slow to move toward independence. Indiana’s large rural agricultural population feels this restriction most acutely, as rural NPs in the corn belt and river communities often struggle to find and maintain the physician relationships the law requires.

Insurance Coverage Across the Midwest

The Midwest’s insurance landscape reflects the region’s industrial history and its ongoing economic transition.

Illinois has a relatively strong commercial insurance market anchored by Chicago’s large employer base in finance, technology, healthcare, and professional services. Some Illinois employer plans cover Wegovy with appropriate documentation. Illinois Medicaid (called Illinois Medical Assistance) does not broadly cover GLP-1 medications for weight loss, though Ozempic may be available for members with Type 2 diabetes through prior authorization.

Ohio’s commercial market is shaped by a mix of large employers in healthcare, financial services, and remaining manufacturing. Some Ohio plans cover Wegovy for obesity with qualifying BMI and comorbidities. Ohio Medicaid does not cover GLP-1 medications for weight loss purposes. Ohio expanded Medicaid under the ACA in 2013, which has helped reduce the uninsured rate, but weight loss drug coverage hasn’t followed.

Michigan’s insurance landscape has historically been shaped by automotive industry employment and the UAW’s negotiated benefits. As covered in our semaglutide in Michigan article, UAW members and employees of major automakers or suppliers may have more comprehensive drug coverage than standard commercial plans. Michigan Medicaid (Healthy Michigan Plan) does not cover GLP-1s for weight management.

Indiana’s commercial market is influenced heavily by large manufacturing employers, pharmaceutical companies, and logistics firms. Some Indiana employer plans, particularly those connected to large manufacturers or Eli Lilly’s extensive Indianapolis-area workforce, include weight loss medication coverage. Indiana’s Healthy Indiana Plan (HIP) does not cover GLP-1 medications for weight loss. As detailed in our how to get semaglutide in Indiana article, the HIP’s consumer-driven model is notable but doesn’t extend to weight loss drug coverage.

For patients across all four states whose insurance doesn’t cover weight loss medications, or who want to avoid the prior authorization process, compounded semaglutide or tirzepatide through a telehealth platform offers a predictable monthly cost independent of insurance approval.

Cost Comparison: GLP-1 Access Options in the Midwest

Practical Tips for Midwest Patients

The Midwest’s climate creates shipping considerations that run in both directions. Summers in the Ohio River valley, the Chicago metro, and central Indiana can be genuinely hot and humid, with temperatures and heat indexes that can compromise medication left in a mailbox or on a porch. Plan deliveries carefully between June and August, and try to be home when shipments arrive or arrange a pickup alternative.

Winters are a different story. The Upper Peninsula of Michigan, northern Wisconsin border communities, and parts of northern Illinois and Indiana can see extreme cold and significant snowfall. Brief cold exposure during delivery is less damaging to semaglutide than heat exposure, but you still want to bring packages inside promptly and avoid leaving medication in a vehicle overnight in subfreezing temperatures.

The Midwest has a significant veteran population, with major VA facilities in Chicago, Indianapolis, Columbus, Detroit, and Cleveland. Veterans receiving VA care should ask their provider specifically about GLP-1 eligibility, as VA formularies have been expanding access to semaglutide and tirzepatide for qualifying patients.

The region’s cost of living is generally lower than the coasts, which means the out-of-pocket cost of compounded semaglutide represents a different budget proportion here than in New York or California. That said, the economic diversity within the Midwest is wide. A Chicago finance professional and a laid-off autoworker in Flint are both Midwestern patients, and the financial calculus looks very different for each.

If you have an HSA or FSA through your employer, those funds may be applicable toward semaglutide or tirzepatide costs when prescribed for a qualifying medical condition. The Midwest’s large manufacturing and professional workforce frequently has access to employer-sponsored HSA plans, making this worth investigating before assuming you’ll pay the full monthly rate out of pocket.

Where Access Challenges Are Most Acute

Among the four states, rural Ohio’s Appalachian southeast stands out as facing particularly layered challenges. The combination of restricted NP practice authority, high poverty rates, significant opioid crisis aftermath straining healthcare infrastructure, and limited specialist density creates compounding access barriers. Telehealth is structurally essential in communities like those in Lawrence, Scioto, and Meigs counties, not just convenient.

Rural Indiana and the southern Illinois counties below Interstate 64 face similar dynamics. These communities have aging populations, high rates of obesity-related chronic disease, and thin healthcare workforces. The Upper Peninsula of Michigan is geographically isolated in a way that makes in-person specialist access genuinely impractical for most residents.

Illinois benefits from full NP practice authority, which gives it a structural advantage over the other three states for telehealth access in rural communities. But even with that advantage, downstate Illinois has meaningful provider shortages that telehealth helps address.

Getting Started

Across all four Midwestern states, the telehealth path to GLP-1 treatment follows the same steps regardless of which state you’re in. Complete a health intake, connect with a licensed provider, receive a prescription if you qualify, and have medication delivered to your home. If you want to compare compounded semaglutide and tirzepatide options side by side, the semaglutide product page and tirzepatide product page have current pricing and dosing details for both.

When you’re ready to find out whether you qualify, start your assessment through TrimRx’s intake quiz and connect with a licensed provider covering your state.

This information is for educational purposes and is not medical advice. Consult with a healthcare provider before starting any medication. Individual results may vary.