If you live in Maryland and are looking into compounded GLP-1 medications, the practical questions are usually the same three: is this legal here, how does care actually work, and what does it cost. This page answers all three. It covers how telehealth prescribing works under Maryland’s rules, what the state expects of the pharmacies that ship compounded medication to Maryland addresses, and what real providers, both national telehealth services and Maryland clinics, currently charge. Prices in the comparison table come only from each provider’s own public pages, checked on the dates shown in the table.
One disclosure before anything else: this site is operated by Gentle Health, a telehealth provider of compounded semaglutide and tirzepatide. Gentle Health appears in the comparison below on the same terms as every other provider.
How compounded GLP-1 access works in Maryland
Maryland does not require an in-person visit before a physician can prescribe a non-controlled medication like semaglutide or tirzepatide. The state’s telehealth rules, discussed in detail below, require the same standard of care as an office visit, delivered by a physician who holds a Maryland license. Within that framework, the process at Gentle Health looks like this:
- You complete a health intake online. It covers your medical history, current medications, prior experience with GLP-1 therapy, and your goals for weight management.
- James Simmons, MD reviews your case. Dr. Simmons is licensed to practice in Maryland through the Interstate Medical Licensure Compact (license D0107726, state board record), an expedited licensing pathway for physicians practicing in multiple states. Maryland joined the Compact in 2019, and Compact licenses issued for Maryland are full Maryland medical licenses, according to the Maryland Board of Physicians. He evaluates whether treatment is appropriate for you, and not everyone qualifies.
- If treatment is appropriate, a prescription goes to a licensed compounding pharmacy. The pharmacy prepares the medication and ships it to your Maryland address, whether that is Baltimore, Silver Spring, Frederick, or the Eastern Shore.
- Follow-up continues by telehealth. Dose changes, side effect questions, and check-ins happen with Dr. Simmons, not a rotating cast of unnamed staff.
The plan is cash-pay, with pricing listed publicly further down this page. There is no insurance billing and no membership fee stacked on top of the medication cost.
Maryland rules worth knowing
Maryland regulates this category from two directions: rules for the prescriber and rules for the pharmacy. Federal rules sit on top of both.
Telehealth prescribing. The Maryland Board of Physicians publishes its telehealth rules in COMAR 10.32.05 and explains them in a plain-language FAQ. The essentials:
- Any physician treating a Maryland patient by telehealth must hold a Maryland license. There is no separate “telehealth license”; a standard Maryland license covers it.
- Before prescribing, the physician must perform a patient evaluation adequate to establish a diagnosis and identify contraindications. The standard of care is explicitly the same as for an in-person visit.
- The practitioner must verify the patient’s identity, disclose their name and license type, obtain the patient’s consent to telehealth, use a secure connection, and have an emergency protocol in place.
- Maryland permits all telehealth modalities, synchronous and asynchronous. The Board’s strictest telehealth prescribing limits apply to opioids for pain, which may generally not be prescribed by telehealth at all. Semaglutide and tirzepatide are not controlled substances, so those limits do not apply to them.
The pharmacy side. Most compounded GLP-1 prescriptions for Maryland patients are filled by out-of-state compounding pharmacies. Maryland regulates these directly: under COMAR 10.34.37.04, a nonresident pharmacy must hold a Maryland permit to dispense to Maryland residents, and one that ships compounded sterile preparations, which includes injectable GLP-1 vials, must also comply with Maryland’s sterile compounding chapter, COMAR 10.34.19, and USP standards. In short, the pharmacy filling your prescription has to answer to the Maryland Board of Pharmacy, not just its home state’s board. As of this writing (checked July 30, 2026), the Maryland Board of Pharmacy has not published guidance specific to compounded GLP-1s; the general compounding and nonresident-permit rules above are what govern.
The federal backdrop. The FDA resolved the tirzepatide shortage in December 2024 and the semaglutide shortage in February 2025, and has since clarified its policies for compounders as supply stabilized. Large-scale compounding of copies of commercially available products has wound down, and in 2026 the agency has moved to restrict bulk compounding of these ingredients by outsourcing facilities further, as reported by Pharmacy Times. What remains is traditional patient-specific compounding under Section 503A: a licensed prescriber writes a prescription for an individual patient based on that patient’s clinical needs, and a state-licensed pharmacy fills it. That is the pathway legitimate providers, Gentle Health included, operate under. Compounded medications are not FDA-approved, and any provider that glosses over that is not being straight with you.
Compounded semaglutide in Maryland
Semaglutide is a GLP-1 receptor agonist. It mimics a hormone your body produces after eating, which slows stomach emptying, moderates blood sugar, and reduces appetite. Compounded semaglutide is a patient-specific preparation made with semaglutide by a licensed compounding pharmacy, dispensed in a vial (for injection) or an oral form rather than a manufacturer’s fixed-dose pen. Compounded medications are not FDA-approved, and clinical trial results for brand-name products do not transfer to compounded versions.
For Maryland patients, Gentle Health offers compounded semaglutide in two forms:
- Oral semaglutide: starting at $112 per month. No needles. A daily form for people who want to start with the lower-cost option or simply prefer not to inject.
- Injectable semaglutide: starting at $135 per month. A once-weekly subcutaneous injection, shipped with supplies.
Both prices are cash-pay and dose-tiered. There is no membership fee, published prices for each prescribed dose tier, and no insurance paperwork, because insurance is not billed at all. Whether semaglutide is appropriate for you, and at what dose, is Dr. Simmons’s call after reviewing your health history. Treatment is subject to medical evaluation, and some patients, such as those with a personal or family history of medullary thyroid carcinoma, are not candidates.
Compounded tirzepatide in Maryland
Tirzepatide works on two receptors rather than one: GLP-1 and GIP, a second gut hormone involved in appetite and metabolism. Compounded tirzepatide, like compounded semaglutide, is prepared by a licensed compounding pharmacy for a specific patient under a physician’s prescription, and it is not FDA-approved.
Gentle Health offers injectable compounded tirzepatide starting at $169 per month, cash-pay, with the same structure as the semaglutide program: evaluation and ongoing care by James Simmons, MD, medication shipped from a licensed compounding pharmacy to your Maryland address, and no membership fee layered on top. Tirzepatide is typically the more expensive of the two medications across the market, as the comparison table below shows, so the practical question for many patients is whether to start with semaglutide and reassess. That is a conversation to have during your evaluation rather than a decision to make from a pricing page.
Provider options in Maryland: comparison table
Methodology: providers listed alphabetically; all prices taken from each provider’s own public pages, on the verification date shown in each row (July 27-30, 2026); where a price is not published, we write “See site” rather than guessing.
| Provider | Care model | Compounded semaglutide (cash/mo) | Compounded tirzepatide (cash/mo) | Serves Maryland | Insurance | Source |
|---|---|---|---|---|---|---|
| Gentle Health | Telehealth; care by James Simmons, MD | From $112 (oral) / From $135 (injectable) | From $169 (injectable) | Yes | Cash-pay only; insurance not billed | Gentle Health pricing (verified 2026-07-30) |
| Henry Meds | Telehealth; medication plus provider access | $247 after intro month (weekly injectable) | $349 after intro month (daily oral tablet) | See site | Not required; cash-pay | henrymeds.com (verified 2026-07-30) |
| Mochi Health | Telehealth; membership plus medication billed separately | From $99 medication + $79/mo membership ($39 first month) | From $199 medication + $79/mo membership | Yes (site Maryland page) | See site | joinmochi.com (verified 2026-07-27) |
| OrderlyMeds | Telehealth; all-inclusive plans | $149 after starter (from $74 starter) | $299 after starter (from $149 starter) | Yes (site states providers licensed in all 50 states) | Not required; cash-pay | orderlymeds.com (verified 2026-07-27) |
| Rivas Medical Weight Loss | In-person weekly clinic visits; 14 Maryland locations | $437 per 4-week package ($115/week pay-as-you-go); visit and medication included | $627 per 4-week package ($165/week); $195 initial visit fee for new patients (per Rivas’s tirzepatide page) | Yes (in person; clinics from Hagerstown to Waldorf) | Not processed; HSA/FSA accepted | rivasweightloss.com (verified 2026-07-30) |
A few honest notes on reading this table. The care models are genuinely different, not just differently priced. Rivas bundles a weekly in-person visit with the medication, which some people value and others do not need. Mochi separates the membership fee from the medication, so the monthly all-in cost is higher than the headline medication price. Henry Meds and OrderlyMeds use introductory pricing that steps up after the first period. Gentle Health’s numbers are dose-tiered monthly prices with no membership fee. None of these structures is objectively right; they suit different people, which is why we list them rather than rank them.
Maryland FAQ
Is compounded semaglutide legal in Maryland?
Yes, through the patient-specific pathway. A Maryland-licensed prescriber writes a prescription for an individual patient, and a compounding pharmacy that holds the appropriate Maryland permit fills it. Out-of-state pharmacies shipping to Maryland must hold a nonresident pharmacy permit under COMAR 10.34.37.04, and sterile preparations must meet Maryland’s sterile compounding standards. Compounded medications are not FDA-approved.
Can a doctor really prescribe this in Maryland without seeing me in person?
Yes. Maryland’s telehealth regulations (COMAR 10.32.05) allow prescribing by telehealth as long as the physician holds a Maryland license and performs an evaluation adequate to establish a diagnosis and rule out contraindications, at the same standard of care as an office visit. Maryland’s in-person telehealth prescribing restrictions target opioids for pain; semaglutide and tirzepatide are not controlled substances.
Who actually provides my care at Gentle Health if I’m in Maryland?
James Simmons, MD. He is licensed in Maryland through the Interstate Medical Licensure Compact, which Maryland has participated in since 2019. He performs the initial evaluation, writes the prescription if treatment is appropriate, and handles follow-up care and dose adjustments.
Will my insurance or Maryland Medicaid cover compounded GLP-1s?
Generally no. Insurance plans, including Maryland Medicaid, rarely cover compounded medications, which is why this market is almost entirely cash-pay. Gentle Health does not bill insurance; the listed figures are starting-tier prices; the dose-tier table below shows the full monthly cost at each prescribed dose. If you have coverage for brand-name GLP-1 therapy through your plan, that is worth exploring with your own physician and insurer, and it is a different product and pathway from anything on this page.
How does the medication get to me in Maryland?
After Dr. Simmons approves treatment, the prescription goes to a licensed compounding pharmacy holding a Maryland permit, which ships the medication and supplies to your address. Cold-chain packaging is standard for injectable peptides. Shipping timelines vary by pharmacy, typically within about a week of prescription approval. Plan details and current dose tiers are on our Maryland page, with local pages for Frederick, Gaithersburg and Ellicott City for readers who want to start from their own town. The shipping works the same from all of them.
I split time between Maryland and DC or Virginia. Does that matter?
It can. Telehealth rules generally attach to where the patient is physically located at the time of the visit, and each jurisdiction licenses separately. If you are usually in Maryland, do your visits from Maryland. If your situation is more complicated, raise it during your evaluation so care is set up correctly.
Why do Maryland prices range from around $112 to over $600 a month for what sounds like the same medication?
Because you are not just buying medication; you are buying a care structure. The high end of the range (Rivas) includes a weekly in-person clinic visit with the medication administered for you. The middle of the range often includes membership fees or post-introductory pricing. The low end, including Gentle Health’s $112 oral semaglutide, is telehealth care with medication shipped to you and no bundled extras. Compare what is actually included, not just the headline number.
Current Gentle Health dose tiers and pricing
Gentle Health pricing depends on the dose tier prescribed by your clinician. Current monthly prices are:
Oral compounded semaglutide
| Tier | Daily dose | Monthly price |
|---|---|---|
| Starting | 2-4 mg/day | $112/mo |
| Medium | >4-8 mg/day | $189/mo |
| High dose | >8-12 mg/day | $258/mo |
Injectable compounded semaglutide
| Tier | Weekly dose | Monthly price |
|---|---|---|
| Starting | 0.24-0.48 mg/wk | $135/mo |
| Medium | >0.48-1.2 mg/wk | $159/mo |
| High dose | >1.2-2.4 mg/wk | $199/mo |
Injectable compounded tirzepatide
| Tier | Weekly dose | Monthly price |
|---|---|---|
| Starting | 2.5-5 mg/wk | $169/mo |
| Medium | >5-10 mg/wk | $219/mo |
| High dose | >10-15 mg/wk | $269/mo |
Medication, the initial review by a licensed clinician, video visits and messaging, and overnight refrigerated shipping are included. There is no separate membership fee, and HSA and FSA cards are accepted. Your clinician determines the appropriate medication and dose; the monthly price changes if the prescribed dose moves into a different tier.
Gentle Health serves patients across a growing multistate footprint through clinicians licensed in each patient’s jurisdiction, including Maryland.
Reviewed by James Simmons, MD
Compounded medications are not FDA-approved. Treatment subject to medical evaluation.