If you live in Vermont and are looking into compounded semaglutide or compounded tirzepatide, this page is meant to save you a few hours of searching. It covers how telehealth access works here, the Vermont rules that actually affect you as a patient, what changed under federal law in 2025, what treatment costs at Gentle Health, and how other providers serving the state compare on their own published prices. One disclosure up front: this site is operated by Gentle Health, a telehealth practice that offers compounded GLP-1 treatment, so we have an interest in the subject. Gentle Health appears in the provider comparison below on the same terms as everyone else, every price links to the source it came from, and anything we could not verify is said to be unverified rather than guessed at.
How compounded GLP-1 access works in Vermont
Vermont does not require you to sit in a waiting room to be evaluated for a GLP-1 prescription. A physician-patient relationship can be established by telemedicine, and the visit is held to the same standard of care as an in-person one.
At Gentle Health, the process looks like this:
- Health intake. You complete a medical history online: current medications, prior conditions, relevant labs if you have them, and your goals.
- Medical evaluation. In Vermont, a licensed physician reviews your medical intake online and decides whether a video visit is needed. That physician is James Simmons, MD, who is licensed to practice medicine in Vermont (license 042.0040663-COMP, verifiable through the Vermont Board of Medical Practice). He reviews your intake and decides whether treatment is medically appropriate. Not everyone who applies is approved.
- Prescription and fulfillment. If treatment is appropriate, the prescription goes to a licensed compounding pharmacy and the medication ships to your Vermont address, whether that is Burlington, Rutland, Brattleboro, Montpelier or a mailbox at the end of a dirt road in the Northeast Kingdom.
- Ongoing care. Dosing is reviewed and adjusted over time, and you can reach out between refills with questions or side-effect concerns.
Eligibility details and license verification for Vermont are on our Vermont page. We use two workflows for an initial prescribing decision, an asynchronous clinician review or a scheduled video visit first, and how our initial prescribing process varies by state explains the difference between them in general terms.
The whole arrangement is cash-pay. There is no insurance paperwork because Gentle Health does not bill insurance.
Vermont rules worth knowing
Vermont regulates telehealth in a way most states do not, and the difference is worth understanding before you sign up with anyone, including us.
Vermont has a separate, capped license for out-of-state telehealth providers. Under 26 V.S.A. chapter 56, a clinician who is not otherwise licensed in Vermont but wants to treat Vermont patients remotely must obtain either a telehealth license or a telehealth registration. Those credentials come with hard limits written into the statute. Under 26 V.S.A. § 3054, a telehealth license covers up to 20 unique patients located in Vermont during its two-year term, and a telehealth registration runs no more than 120 consecutive days and covers up to 10 unique patients over that period. Both provisions are written for a professional “not otherwise licensed, certified, or registered to practice in Vermont,” so a clinician holding a full Vermont license is not subject to these particular telehealth caps. That is a narrow point about this chapter, not an exemption from Vermont law generally: a full licensee is bound by the same Vermont practice rules as any other Vermont physician.
That distinction is worth asking any online provider about directly. A practice operating under a capped telehealth credential is a different proposition from one whose prescriber holds a full Vermont license, and the difference is public: you can look up either in the Board’s own system. Dr. Simmons holds a full Vermont medical license, number 042.0040663-COMP. Vermont has participated in the Interstate Medical Licensure Compact since 2018, an agreement among member state boards that gives qualified physicians an expedited route to full licensure in participating states, and the “-COMP” suffix on that license number is Vermont’s designation for a license issued through it. A Compact license is a full, unrestricted Vermont medical license, not a limited permit.
Consent to telemedicine has to be obtained and documented. Under 18 V.S.A. § 9361, a provider must obtain and document a patient’s oral or written informed consent for the use of telemedicine before delivering services, including an explanation of the opportunities and limitations of care delivered this way.
Pharmacies shipping into Vermont need their own Vermont license. A pharmacy located outside the state that dispenses prescription drugs by mail, shipping or delivery to someone in Vermont is a nonresident drug outlet and must be licensed by the Vermont Board of Pharmacy, which sits within the Secretary of State’s Office of Professional Regulation. Wherever you get care, it is fair to ask which pharmacy fills the prescription and how it is licensed to ship into Vermont.
Both federal and Vermont requirements apply to a compounded GLP-1 prescription here. The federal conditions described in the next section govern what a pharmacy may compound. Vermont’s own requirements sit alongside them: the licensing rules above for the prescriber, nonresident drug outlet licensing for the pharmacy, documented consent to telemedicine, and the ordinary standard of care. If you want to know whether a Vermont board has said anything further about a specific product, the Board of Pharmacy and the Board of Medical Practice publish their own guidance and bulletins, and those are the places to look.
None of this is legal advice. The links above go to the primary sources so you can read them yourself.
What changed federally in 2025, and why it matters here
The rules governing compounded GLP-1s changed in 2025, and most summaries get the dates wrong.
For Section 503A’s essentially-a-copy analysis, while a drug sits on the FDA shortage list, it is not treated as commercially available, and the usual restriction on compounding copies of commercially available drugs does not apply. That is why compounded GLP-1s appeared at scale in 2023 and 2024. When the FDA determined the shortages resolved, it gave compounders wind-down periods, and tied their end to pending litigation: they ran to the announced date or the district court’s decision, whichever was longer. The court denied the preliminary injunction motions in Outsourcing Facilities Association v. FDA on March 5, 2025 for tirzepatide and April 24, 2025 for semaglutide. The FDA then stated that for a state-licensed pharmacy or physician compounding under Section 503A, “the period of enforcement discretion … has ended” as of those dates (FDA).
That did not close Section 503A compounding, and the courts did not change the law. What ended was the shortage-based enforcement discretion. Compounding under Section 503A continues, subject to the conditions the statute always imposed. The FDA describes those conditions plainly: the drug is compounded for an individual patient on receipt of a prescription, and the compounder does not compound, regularly or in inordinate amounts, products that are essentially copies of a commercially available drug.
Within that essentially-a-copy analysis there is one patient-specific pathway. A compounded product is not treated as an essential copy where the prescriber determines and documents that it contains a change producing a significant difference for an identified individual patient. That is one route through one condition, not the whole legal test, and every other Section 503A requirement continues to apply alongside it. The FDA has also said it does not currently intend to act against a compounder on the regularly-or-in-inordinate-amounts point where four or fewer prescriptions of that product are filled in a calendar month.
Read plainly: the weight moved off a supply designation and onto your prescriber, the record they keep, and the pharmacy’s compliance with the rest of Section 503A. In Vermont that federal framework applies alongside the state requirements described above.
Compounded semaglutide in Vermont
Semaglutide is a GLP-1 receptor agonist, a medication that mimics a gut hormone involved in appetite regulation and blood sugar control. Compounded semaglutide is a version of that molecule prepared by a licensed compounding pharmacy for an individual patient under a prescription, rather than manufactured by the brand’s maker.
Compounded medications are not FDA-approved. The FDA has not reviewed those specific preparations for safety, effectiveness or quality, and results from clinical trials of the FDA-approved semaglutide products should not be assumed to apply to them (FDA). Oversight comes instead from state boards of pharmacy and, for some facilities, federal registration. That is a real distinction rather than a technicality.
Gentle Health offers compounded semaglutide in two forms for Vermont patients:
- Oral compounded semaglutide: starting at $112 per month. Taken daily, no needles involved.
- Injectable compounded semaglutide: starting at $135 per month. A once-weekly subcutaneous injection.
Both prices are cash-pay and dose-tiered and include the medical care described above: the evaluation by James Simmons, MD, the prescription if treatment is appropriate, the medication itself, and ongoing dosing review. There is no separate membership fee and no intro rate that resets upward after the first month. As the provider comparison below shows, intro pricing and separate membership fees are common in this market, so it is worth reading any provider’s fine print, including ours.
Whether semaglutide is appropriate for you is a medical question. Side effects, most commonly gastrointestinal, are real, and treatment is subject to medical evaluation.
Compounded tirzepatide in Vermont
Tirzepatide works on two receptors rather than one, GLP-1 and GIP, a second gut hormone involved in metabolic regulation. It is the newer of the two molecules, and cash prices for it run higher than semaglutide almost everywhere it is offered.
Gentle Health offers injectable compounded tirzepatide starting at $169 per month for Vermont patients, cash-pay and dose-tiered, covering the evaluation, the prescription when appropriate, the compounded medication from a licensed pharmacy, and ongoing care. Once-weekly subcutaneous injection.
The same caveats apply and are worth repeating rather than burying. Compounded tirzepatide is not an FDA-approved product. It is compounded under Section 503A subject to that section’s conditions, including the patient-specific pathway through the essentially-a-copy analysis described above, where the prescriber determines and documents a change producing a significant difference for an identified patient. Trial data generated for the FDA-approved products describe those products, not compounded preparations. If you are weighing semaglutide against tirzepatide, that choice belongs in the medical evaluation, where your history, tolerability and budget can all be on the table at once.
Provider options in Vermont: provider comparison
Methodology: providers are listed alphabetically; prices were taken only from each provider’s own public pages on September 18, 2026, and where a provider does not publish a figure we write “See site” rather than estimating. Gentle Health operates this site and appears on the same terms as everyone else. No row is a recommendation.
Gentle Health
- Care model: Telehealth; care by James Simmons, MD
- Compounded semaglutide (cash/mo): From $112 (oral) / from $135 (injectable)
- Compounded tirzepatide (cash/mo): From $169 (injectable)
- Serves Vermont: Yes
- Insurance: Cash-pay only; insurance not billed
- Source: gentle.health (verified 2026-09-18)
Henry Meds
- Care model: Telehealth; GLP-1 program bundling provider visits, medication and supplies, priced from $179/mo across treatment plans
- Compounded semaglutide (cash/mo): Not published by molecule
- Compounded tirzepatide (cash/mo): Not published; page does not mention tirzepatide
- Serves Vermont: See site (states not listed on pricing page)
- Insurance: Not required; cash-pay
- Source: henrymeds.com (verified 2026-09-18)
Mochi Health
- Care model: Telehealth; membership plus medication billed separately
- Compounded semaglutide (cash/mo): From $60 medication + $79/mo membership
- Compounded tirzepatide (cash/mo): From $90 medication + $79/mo membership
- Serves Vermont: See site (“anywhere in the United States”; state list not published)
- Insurance: Insurance accepted for some services; coverage varies
- Source: joinmochi.com (verified 2026-09-18)
OrderlyMeds
- Care model: Telehealth; all-inclusive plans
- Compounded semaglutide (cash/mo): $149/mo ongoing; new-customer starter billed $149 for 2 months
- Compounded tirzepatide (cash/mo): $299/mo ongoing; new-customer starter billed $299 for 2 months
- Serves Vermont: Yes (site states all 50 states)
- Insurance: Not required; HSA/FSA accepted
- Source: orderlymeds.com (verified 2026-09-18)
Ozari Health
- Care model: Telehealth; clinician review before prescribing
- Compounded semaglutide (cash/mo): See site (not listed on its Vermont page)
- Compounded tirzepatide (cash/mo): $125/mo on a 3-month starter plan ($375 billed quarterly)
- Serves Vermont: Yes (states its clinicians hold active Vermont licenses)
- Insurance: Not required; HSA/FSA accepted
- Source: ozarihealth.com (verified 2026-09-18)
A few reading notes. OrderlyMeds’ starter offers are advertised as a monthly equivalent but billed as a single two-month charge, are limited to new customers, and reset to the ongoing rate afterwards, so the ongoing number is usually the one to budget around. Membership-model providers bill the membership whether or not medication ships that month. Quarterly billing changes the effective monthly figure and the amount you commit to at once. Some providers sell FDA-approved brand products at substantially higher cash prices, and at least one provider serving Vermont declines to prescribe compounded preparations at all and offers only brand products; those programs are out of scope for this comparison, which compares compounded programs. Prices change often. If you spot a stale number, the source links are there, and we will correct promptly.
We computed the whole annual bill for the major programs, every fee included, in compounded GLP-1 programs compared. The full list of states we practice in is on the states we serve.
Frequently asked questions
Is compounded semaglutide legal in Vermont? Compounded drugs are not FDA-approved, and whether a particular preparation is lawful depends on the compounder meeting every condition Section 503A imposes, not on any single fact. A valid prescription and a licensed pharmacy are necessary but not sufficient on their own. Since the shortage-based enforcement discretion ended in 2025, compounding continues under those statutory conditions, which include compounding for an individual patient on receipt of a prescription and not compounding essentially-copies regularly or in inordinate amounts, with the patient-specific significant-difference pathway described above running through that analysis. Vermont’s own licensing and standard-of-care rules apply on top. The practical takeaway: get care from a provider who conducts a real medical evaluation and uses a pharmacy licensed to ship into Vermont, and ask how the preparation complies with current rules.
Do I need an in-person visit to start treatment in Vermont? No. A physician-patient relationship may be established by telemedicine in Vermont, and the visit is held to the same standard of care as an in-person one. Vermont does require that your informed consent to telemedicine be obtained and documented before services are delivered. Separately, a prescriber who is not otherwise licensed in Vermont must hold a telehealth license or telehealth registration under 26 V.S.A. chapter 56, and those carry the statutory patient caps described above.
Who provides the medical care at Gentle Health for Vermont patients, and can I check the license? James Simmons, MD, who holds a full Vermont medical license, number 042.0040663-COMP, verifiable through the Vermont Board of Medical Practice. He conducts the evaluation, decides whether treatment is appropriate, prescribes when it is, and manages dosing over time. Board lookups are free and public, and a practice that will not tell you where to find its physician’s license is telling you something.
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 does not sell Ozempic, Wegovy, Mounjaro or Zepbound. We offer compounded semaglutide and tirzepatide, which are different products, and Gentle Health is not affiliated with or endorsed by Novo Nordisk or Eli Lilly.
By James Simmons, MD
Compounded medications are not FDA-approved. Treatment subject to medical evaluation.