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Telehealth Graded
Buyer guide

What “starting at” is really buying you

Across 74 priced plans we have read first-hand, 21 of them advertise a monthly figure lower than the one that actually recurs — 13 of 28 sellers. The widest single gap on our roster is $400.00000000000006 a month — on that plan the real price is 2.4 times the advertised one. This is how that gets built.

Evidence read September 2026. Every source below is listed so you can check it yourself.

What this comes down to

  • 21 of 74 priced plans on our roster advertise less than they charge in month two.
  • There are only four mechanics, and every headline in this market is one of them: the prepaid year divided by twelve, the first-month promotion, the fee billed separately from the drug, and the price you only see after an intake.
  • Of the 28 sellers we have written up, 14 publish a month-to-month price for everything they sell.
  • The 2024 “click-to-cancel” rule is not in force. The FTC revised it to conform to federal court decisions and reopened the rulemaking in March 2026.
Plans advertising below what recurs
21 of 74
Sellers doing it
13 of 28
Widest monthly gap
$400.00000000000006
Sellers publishing a month-to-month price
14 of 28

The four mechanics, and how to spot each one

1. The prepaid year, divided by twelve

The most common one and the hardest to see. A company prints a monthly figure that only exists if you buy twelve months upfront, then puts the condition in small type below the number or in a footnote further down the page. Nothing about it is false. The number is real for somebody. It just isn't real for you unless you hand over a year's money before you know whether the drug agrees with you.

The tell is a phrase like “based on a 12-month plan paid in full,” usually set smaller than the price and often several hundred pixels below it. Scroll to the bottom of a pricing page before you read the top of it.

2. The first-month promotion

A low entry price for month one, then the real rate. This one is comparatively honest, because the second number usually appears somewhere. What makes it work anyway is that the low figure goes in the ad, the headline and the price comparison, and the real one goes in a FAQ.

3. The fee billed separately from the drug

Membership here, medication there, two charges on the card. A seller can then advertise whichever half is smaller. Adding them is the reader's job, and a comparison table that lists one company's medication price beside another's all-in price is comparing nothing.

4. The price that only exists after an intake

No published figure at all, or a figure so hedged it means nothing, and the real number arrives after a questionnaire, a phone call, or a card on file. “No published price” is almost never a fact about a company. It is a fact about how far somebody looked — so we finish the intake ourselves with dummy details and no payment, and record how many steps in the number appeared.

That has produced 8 of the 150 price records on this site, the deepest 30 steps into a signup. The rules behind each record are on how we verify prices.

Direct Meds is the one on this roster that publishes no price at all until you are inside the signup. We finished it and came back with the number.

What the gap looks like on a real roster

We read every price on this site off the seller's own page and stamp it with the day we read it[3]. Counted across that record right now: 21 of 74 priced plans advertise below what recurs, spread over 13 of 28 companies. The widest is $400.00000000000006 a month. Those numbers move whenever a price does, because they are counted rather than written down.

The widest one on our roster right now is TeleWellnessMD: $279.95 a month advertised against $679.95 that actually recurs, on the same tirzepatide plan. Our read of it names the page that figure came off and the day we read it.

The one that should bother you most is the third state

A seller that publishes a month-to-month price for semaglutide and not for tirzepatide isn't transparent and isn't opaque — it's selective, and a yes-or-no badge can't describe it. Of 28 sellers written up here, 14 publish a month-to-month price across everything they sell, 11 publish one for nothing, and 3 do it for some drugs and not others.

What the regulators actually require

Less than most people assume. The FTC finalized a “click-to-cancel” rule in October 2024 that would have tightened how recurring subscriptions are sold and canceled. It is not in force. In February 2026 the Commission published a Federal Register notice revising the Negative Option Rule to conform it to federal court decisions, and in March 2026 it opened a fresh advance notice of proposed rulemaking asking the public what the rule should say[1]. So the specific protections that rule contained are not currently law.

The FDA's contribution is narrower and worth reading anyway, because it is written for exactly this market. Its list of telehealth red flags for consumers includes a company that “offers medicine at deep discounts or prices that seem too good to be true,” alongside a company that does not require a screening and prescription from a licensed doctor before sending medicine[2]. The whole list is short and we walk it in how a telehealth prescription actually happens.

Five questions that settle it before you pay

  1. What do I pay in month two if I cancel after month one? Ask it in those words — it is the only phrasing all four mechanics answer honestly.
  2. Is the medication price the whole price, or is there a membership fee on a separate line?
  3. Does the advertised figure assume a plan term? Which one?
  4. What happens to money already paid if I stop? Is there a refund, or is a prepaid year gone?
  5. Which pharmacy compounds it, and is it a state-licensed pharmacy or a registered outsourcing facility? Not a price question, but the FDA notes that buyers on telehealth platforms often have no idea who made their drug[4] — see compounded versus brand.

We publish the month-two number for every company we grade, and show the advertised figure beside it rather than instead of it. The full graded roster is here, and the letter itself is explained on how we grade.

Questions people actually ask

Why is the price I see in an ad never the price I pay?

Usually because the advertised figure is a prepaid annual rate divided by twelve, or a first-month promotion, or the medication price with a separate membership fee left out of it. All three are legal as long as the condition is disclosed somewhere, and the condition is generally disclosed in smaller type than the number.

Is it legal to advertise a price that requires prepaying a year?

Yes, provided the condition is disclosed. What the FTC's 2024 click-to-cancel rule would have tightened was the cancellation side of this, and that rule is not currently in force — the Commission revised it to conform to court decisions and reopened the rulemaking in 2026.

What does “month to month” mean on this site?

What you pay in month two if you never commit to a longer plan and never take a promotion. It is the only figure that compares cleanly between two sellers, so it is the one we publish and the one the grade is built on.

How do you get a price that a company does not publish?

We complete the intake ourselves with dummy details, no card and no order placed, until the screen that states what you would owe. Each of those records notes how many steps in the figure appeared, so the claim is checkable rather than a boast.

Sources

Every source here was fetched and read for this article, with the identifier taken off the record that came back and the claim it supports written down beside it.

  1. Negative Option Rule. U.S. Federal Trade Commission, 2026. Source · Read September 2026
    The FTC announced a final click-to-cancel rule in October 2024; a February 12, 2026 Federal Register notice revises the Negative Option Rule to conform it to federal court decisions; a March 13, 2026 advance notice of proposed rulemaking reopens the question of what the rule should require.
  2. FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss. U.S. Food and Drug Administration, 2026. Source · Document dated September 2026; read September 2026
    The FDA's telehealth red flags for consumers include a company that offers medicine at deep discounts or prices that seem too good to be true, and a company that does not require a screening and prescription by a licensed doctor before providing medicine.
  3. The Telehealth Graded price record. Telehealth Graded, 2026. Source · Read September 2026
    Every count of priced plans, advertised-versus-actual gaps and month-to-month disclosure in this article is computed at build time from the site's own price records, each of which carries the page it was read on, the sentence it came from and the day it was read.
  4. Compounding and the FDA: Questions and Answers. U.S. Food and Drug Administration, 2025. Source · Document dated September 2025; read September 2026
    Consumers who buy compounded drugs through online pharmacies and telehealth platforms may not know the identity of the compounder that produced the drug, including whether it is appropriately licensed and regulated.