GLP-1 Telehealth in the Southeast: FL, GA, NC and SC

The Southeast carries a disproportionate share of the country’s obesity burden. Four of the states in this region, including all four covered here, consistently rank in the top half of national obesity prevalence data, and the health consequences that follow, Type 2 diabetes, hypertension, cardiovascular disease, play out in emergency rooms and primary care offices across the region every day.

At the same time, the Southeast has some of the country’s most significant rural healthcare deserts, patchwork insurance coverage, and a long history of Medicaid non-expansion that has left millions of low-income adults without coverage. GLP-1 medications represent a genuine clinical breakthrough for this population, and telehealth is increasingly the most realistic way for Southeastern residents to access them.

What Are GLP-1 Medications and Who Qualifies

GLP-1 receptor agonists work by mimicking a naturally occurring gut hormone that regulates appetite, slows gastric emptying, and signals satiety to the brain. Semaglutide, the active ingredient in Wegovy and Ozempic, and tirzepatide, the active ingredient in Mounjaro and Zepbound, are the two most prescribed options for weight management.

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

How Telehealth GLP-1 Prescribing Works Across the Southeast

All four states covered here allow telehealth providers to prescribe medications following a clinically appropriate evaluation, which can take place through synchronous video or a detailed asynchronous intake. Through TrimRx, the process is the same across all four states. You complete an online health intake, a licensed provider reviews your information, and a prescription is issued if you qualify. Medication ships directly to your home from a compounding or retail pharmacy, with most patients receiving their first order within a few days.

TrimRx works with providers holding active licenses in Florida, Georgia, North Carolina, and South Carolina, so there’s no state-specific barrier to getting started regardless of where you live within the region. That consistency matters in a region where in-person access varies so dramatically between a Miami suburb and a rural county in the South Carolina Lowcountry.

State-by-State Telehealth and NP Practice Snapshot

The four states in this region have meaningfully different frameworks for nurse practitioner prescribing, which shapes how telehealth clinical teams are structured.

Florida is a supervised practice state, one of the more restrictive in the country for NPs. Florida NPs must practice under a protocol established with a supervising physician, and that relationship must be formally documented and maintained. This creates real structural challenges for telehealth platforms operating in Florida, though platforms like TrimRx build their clinical teams around these requirements. Florida has debated NP independence legislation repeatedly but has not passed it into law.

Georgia is also a restricted practice state, requiring NPs to have a physician delegation agreement to prescribe. As discussed in more detail in our how to get semaglutide in Georgia article, this affects how telehealth platforms structure their teams but doesn’t change what patients experience during the intake process.

North Carolina sits in a similar position, with NPs operating under reduced practice authority requiring a supervisory arrangement with a physician. Full practice authority legislation has been introduced in North Carolina but has not yet passed. The impact on rural communities in the western mountains and eastern coastal plain is significant, as finding a collaborating physician in these areas can be difficult.

South Carolina is a restricted practice state for NPs, requiring physician supervision for prescribing. South Carolina is among the more conservative states in the country on this issue, and there is limited legislative momentum toward full practice authority at present. Rural South Carolina, which covers a substantial portion of the state, feels the weight of this restriction more acutely than urban areas like Columbia and Charleston.

Insurance Coverage Across the Southeast

The Southeast’s insurance landscape is shaped heavily by the region’s historically mixed approach to Medicaid expansion and a commercial market that skews toward employer-sponsored plans in agriculture, manufacturing, hospitality, and retail, industries that don’t always offer comprehensive benefits.

Florida expanded Medicaid partially through a managed care waiver but has not pursued full ACA expansion, leaving a significant coverage gap for low-income adults. Florida Medicaid does not cover GLP-1 medications for weight loss. Commercial coverage varies widely, with larger employer plans in the Miami, Tampa, and Orlando metros sometimes including Wegovy coverage and smaller or part-time employer plans rarely doing so.

Georgia only began limited Medicaid expansion in 2023 through the Georgia Pathways program, which requires work or community engagement to qualify. Georgia Medicaid does not cover GLP-1s for weight management. The state’s high uninsured rate makes out-of-pocket telehealth access particularly relevant for a large share of the population.

North Carolina completed full Medicaid expansion in late 2023, extending coverage to hundreds of thousands of additional residents. However, North Carolina Medicaid does not currently cover GLP-1 medications for weight loss, meaning the expanded coverage population still faces out-of-pocket costs for these treatments. Commercial coverage in North Carolina varies by plan, with larger Research Triangle and Charlotte employers sometimes offering weight loss drug benefits.

South Carolina has not expanded Medicaid, leaving one of the largest coverage gaps in the region. South Carolina Medicaid does not cover GLP-1s for weight management. The state’s uninsured rate is among the higher ones in the Southeast, and rural communities in the Pee Dee region and the Lowcountry face compounding barriers of no coverage and no local providers.

For patients across all four states whose insurance doesn’t cover weight loss medications, compounded semaglutide or tirzepatide through a telehealth platform offers a predictable monthly cost that doesn’t depend on prior authorization or insurance approval.

Cost Comparison: GLP-1 Access Options in the Southeast

Practical Tips for Southeast Patients

Heat is the dominant shipping consideration across this entire region. The Southeast’s summers are long, humid, and genuinely hot from May through September across all four states. Florida’s heat is year-round. Semaglutide and tirzepatide are temperature-sensitive medications that should not sit in a mailbox, on a porch, or in a hot car for extended periods. Plan to be home for deliveries during warm months, or arrange for packages to be held at a pickup location. Most compounding pharmacies ship with cold packs, but reducing ambient heat exposure time is still worth the extra planning.

Military access is worth noting across this region. The Southeast has one of the highest concentrations of military installations in the country, including Fort Liberty in North Carolina, Fort Moore and Robins Air Force Base in Georgia, multiple installations in South Carolina including Fort Jackson and Shaw Air Force Base, and several Navy and Coast Guard facilities in Florida. Active duty service members and dependents using TRICARE should check their specific plan’s formulary for GLP-1 coverage, as benefits vary across TRICARE plan types.

The Southeast also has a substantial veteran population beyond active duty. VA facilities in Durham, Atlanta, Columbia, and throughout Florida have been expanding GLP-1 access for qualifying veterans in recent years. If you receive VA care, it’s worth asking your VA provider specifically about semaglutide or tirzepatide eligibility.

HSA and FSA funds can be applied toward semaglutide costs in many cases when the medication is prescribed for a qualifying medical condition. The Southeast’s cost of living varies considerably across the region, from expensive South Florida markets to more affordable rural communities, and that context affects how out-of-pocket medication costs land in your monthly budget.

For patients in the region’s most underserved areas, rural South Carolina’s Pee Dee and Lowcountry regions, Georgia’s coastal plain and Appalachian foothills, eastern North Carolina, and Florida’s rural northern counties, telehealth closes an access gap that in-person care simply cannot bridge. A patient in Orangeburg, South Carolina has the same telehealth options and the same delivery timeline as someone in Charlotte or Atlanta.

Where Access Challenges Are Most Acute

Among the four states, rural South Carolina presents the most layered access challenges. No Medicaid expansion, restricted NP practice authority, high uninsured rates, and thin specialist density in large portions of the state create compounding barriers. Telehealth is not just convenient there, it’s structurally essential for many patients.

Georgia’s situation is similar outside of Atlanta. The limited Medicaid expansion through Pathways covers a narrow population, and the state’s rural healthcare infrastructure is stretched. Florida’s restricted NP framework creates operational complexity for telehealth platforms even in urban markets. North Carolina is improving its access picture through full Medicaid expansion, but the coverage of medications hasn’t kept pace with coverage of people.

Getting Started

Whether you’re in Miami, Savannah, Raleigh, or a rural county that doesn’t make it onto most maps, the path through telehealth follows the same steps. Complete a health intake, connect with a licensed provider in your state, receive a prescription if you qualify, and have medication delivered to your address. The regional variations in NP authority and insurance coverage affect how platforms are structured, not what your experience looks like.

If you want to compare compounded tirzepatide as an alternative to semaglutide, the tirzepatide product page has details on dosing and pricing. And if you’re ready to find out whether you qualify for GLP-1 treatment, 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.