GLP-1 and Weight-Loss Telehealth: How to Get and Keep a Merchant Account in 2026
A clinician reviewing patient records on a tablet
Director of Sales at Adaptiv Payments | More
We set up merchant accounts for licensed telehealth providers and medical practices, and a clinic that prescribes semaglutide or tirzepatide can get a stable GLP-1 merchant account. The catch is that it won't come from Stripe, Square or PayPal, and underwriting will look closely at things most clinics never think about: your website copy, your pharmacy labels and how you describe a subscription charge.
Can your GLP-1 telehealth business get a stable merchant account?
Yes, if your prescribers are licensed, your pharmacy partner is a properly licensed 503A pharmacy or 503B outsourcing facility, and your marketing doesn't call compounded products "generic Wegovy." What you need is a dedicated high-risk telemedicine merchant account set up for card-not-present payments.
Don't run GLP-1 payment processing through Stripe, Square or PayPal. All three restrict or prohibit online prescription sales, and accounts that break those rules get frozen or closed, sometimes with funds held for months.
When we review telehealth applications, the trouble is usually marketing, labels or a missing certification like LegitScript, not the prescribing. This article covers how to set up pricing, marketing, consent and subscription billing so a bank can approve the account and keep it open.
Who can't get a GLP-1 merchant account
No legitimate payment processor can take payments for "research use only" peptides, non-prescription semaglutide or tirzepatide, or GLP-1 products sold outside a real prescriber-patient relationship. If your site sells GLP-1 powders, peptides like BPC-157, or "not for human consumption" products to consumers, expect every bank to decline you.
Licensed telehealth businesses get declined too when they label drugs as "FDA-approved generics" or use pharmacies that aren't licensed in the states they ship to. A high-risk business is fine with us. A business model that breaks FDA rules isn't, and no merchant account can fix that.
This article is for licensed telehealth providers and medical practices. It isn't legal or medical advice. Have a healthcare regulatory attorney review your business model before you apply.
Why Stripe, Square and PayPal shut down GLP-1 telehealth
Stripe, Square and PayPal put many small businesses under one account with their banks. From what we see, a clinic on these platforms sits in the same pool as coffee shops and Etsy sellers, under the same automated checks. When the system flags prescription drug sales, the platform closes the account first and asks questions later.
Stripe prohibits card-not-present sales of prescription-only products and requires pre-approval for telemedicine and online pharmacies. Without that approval, Stripe can close a GLP-1 account at any time. We've written more about why Stripe shuts accounts down.
Square doesn't allow card-not-present prescription sales and may deactivate sellers who mainly sell prescription products online.
PayPal requires pre-approval for prescription items and telemedicine services. Without it, expect frozen balances and holds.
Recurring billing and a high average ticket are exactly what their risk systems look for. A GLP-1 program has both.
What the FDA changed in 2026
These are the dates underwriters have in mind when they review a GLP-1 business.
The FDA declared the tirzepatide shortage resolved on December 19, 2024. The grace period for 503A pharmacies ended February 18, 2025, and for 503B facilities on March 19, 2025. The semaglutide shortage was declared resolved on February 21, 2025, with the 503A period ending April 22, 2025 and the 503B period ending May 22, 2025.
Compounded GLP-1s aren't banned. A 503A pharmacy can still compound for an individual patient when the prescriber decides and documents a change that makes a significant difference for that patient. What's prohibited is regularly making copies of an approved drug. The FDA has said that adding B12 to semaglutide can still count as "essentially a copy."
On February 6, 2026, the FDA announced steps to restrict GLP-1 ingredients used in unapproved compounded drugs that are mass-marketed as alternatives to approved drugs, and named Hims & Hers. Hims had launched a compounded semaglutide pill on February 5 and pulled it on February 7. HHS's general counsel said he would refer Hims to the DOJ. A referral was announced; no charges have been filed.
On April 30, 2026, the FDA proposed leaving semaglutide, tirzepatide and liraglutide off the 503B bulks list. That's still a proposal, not a final rule.
Then came the warning letters. On March 3, 2026, the FDA sent them to 30 telehealth companies, and on June 16, 2026, to 25 more. The problems cited included calling compounded products "generic Zepbound," claiming "FDA approved ingredients," calling products or pharmacies "FDA-approved," and putting the telehealth brand on labels without saying who compounded the drug. Underwriters now screen new GLP-1 applicants for these same problems.
How Visa, Mastercard and acquiring banks treat GLP-1 telehealth
Visa treats card-not-present drug and pharmacy sales (merchant category codes 5122 and 5912) as high-integrity-risk under its Visa Integrity Risk Program, and the acquiring bank has to register these merchants with Visa. If your telehealth platform ships GLP-1 medication, that bank is responsible for monitoring you.
Mastercard requires anyone selling prescription drugs without a face-to-face visit to be registered and verified by a recognized third party, such as LegitScript or the National Association of Boards of Pharmacy.
If you bill only for consultations and not for the medication, LegitScript isn't a universal card network rule. In practice, most acquiring banks ask GLP-1 telehealth merchants for LegitScript Healthcare Merchant Certification anyway, especially when the medication is in the price. No LegitScript yet? Expect the question.
What underwriters check for a GLP-1 telemedicine merchant account
Business documents. Articles of incorporation, EIN, a business bank account, your platform URL, your refund policy, cancellation policy and privacy policy, and processing statements from any previous accounts.
Prescribers. Every prescriber licensed in each state where they treat patients. Prescriptions based on a real clinical evaluation, not a questionnaire alone. Semaglutide and tirzepatide aren't controlled substances, so DEA telemedicine rules and the Ryan Haight Act don't apply, but state licensure and standard-of-care rules do.
The pharmacy. A state-licensed 503A pharmacy or a registered 503B outsourcing facility, licensed in every state it ships to. Labels must name the pharmacy that compounded the drug, not just your brand.
Data security. Your platform needs HIPAA compliance for patient records, and card data falls under PCI DSS. Use a payment setup that keeps card numbers off your own systems.
Processing details. Expected monthly transaction volume, average and largest ticket, chargeback and refund history, and any other telehealth accounts you've had. Expect an underwriter to read your website by hand. Before clinics apply, we usually tell them to remove any claim that their medication is generic or FDA-approved.
To get your paperwork in order, use our telehealth merchant account opening checklist.
Marketing language that gets GLP-1 merchants declined
Plenty of 2026 warning letters and bank declines start with website copy. Fix these before you apply, everywhere they appear: your site, ads, funnels, texts and labels.
| Risky phrase | Why it's a problem |
|---|---|
| "Generic Zepbound" or "generic Wegovy" | Compounded drugs aren't generics. The FDA cited claims like this in its 2026 warning letters. |
| "Contains the active ingredient in Wegovy/Zepbound" | Implies the compounded product is the same as an approved drug. |
| "FDA approved ingredients" | Suggests the compounded product is FDA-approved. |
| "FDA-approved compounded semaglutide" | Compounded drugs are never FDA-approved. |
| "FDA-approved pharmacy" or "FDA-licensed pharmacy" | Pharmacies are licensed by states. |
Labels and patient materials should name the 503A or 503B pharmacy that compounded the drug. Weight-loss claims should describe a medically supervised program, not guaranteed pounds lost or promised timelines.
A person reviewing website copy on a laptop
Credit: Adaptiv Payments
Pricing and subscriptions that keep the account open
A confusing monthly charge becomes a dispute. Spell out what the monthly fee covers: the medication, the visit, a membership, monitoring, or a combination. If the pharmacy charges separately, say so.
In December 2025, the FTC finalized an order against telehealth provider NextMed over prices that left out the drug cost, fake reviews, unsupported weight-loss claims and subscriptions that were hard to cancel. That's the pattern that draws both regulators and banks.
Every recurring charge needs clear consent, a confirmation email, and terms that match your checkout page and card statement descriptor. The FTC's click-to-cancel rule was struck down by the Eighth Circuit on July 8, 2025, but ROSCA and state auto-renewal laws still apply, so offer easy online cancellation. More on subscription merchant accounts.
Use a card statement descriptor patients will recognize, matching the brand in your ads. For higher-priced programs, send a reminder before each rebill, especially in the first 90 days.
Consultation-only vs. medication-included billing
How you split billing between the visit and the medication affects your merchant category code, how comfortable the underwriter is, and whether you'll need pharmacy registration and LegitScript.
Consultation only. You charge for the medical service (evaluation, follow-ups, coaching) and the patient pays the pharmacy separately. This usually means less pharmacy-related scrutiny, but you still have to follow FDA and state rules.
Medication included. You charge one price that covers the visits and the GLP-1 medication. Banks are more likely to treat this as online pharmacy activity under Visa and Mastercard rules, which means more likely LegitScript requirements, pharmacy documents and closer monitoring of volume and chargebacks.
Decide who the merchant of record is for each part of the program, your platform or the pharmacy, and don't hide separate charges behind vague descriptors. When you apply, tell your processor which billing model you use so the account is set up to match.
Subscription billing that holds up to chargebacks
In weight-loss payment processing, most disputes come from subscriptions: a patient wants a refund after lab results, has side effects, sees slower results than expected, or is confused about a refill.
- Use an enrollment checkbox that says plainly the patient will be billed each month
- Show first-month pricing separately from the ongoing price when they differ
- Put cancellation in the patient portal where it's easy to find
- Explain titration, refill timing, and how to pause or delay a shipment
Link each clinical visit and prescription in your EHR to the transaction record, so you can point to a real consultation when you answer a dispute. When a patient asks for a refund, we suggest refunding within 24 hours, which often stops a chargeback before it's filed.
Visa's monitoring program flags merchants whose fraud reports and disputes reach 1.5% of card-not-present sales, and VAMP fines add up quickly for subscription businesses. Use chargeback prevention tools for alerts and to track why patients dispute. For high-priced programs, AVS, CVV checks and 3-D Secure on the first charge cut down on stolen-card fraud.
A card terminal next to medical supplies on a clinic counter
Credit: Adaptiv Payments
How Adaptiv Payments works with GLP-1 telehealth and weight-loss clinics
We set up high-risk merchant accounts for licensed telehealth providers and medical practices, and we handle recurring billing for subscription programs.
- HIPAA-compliant payment processing
- Apply in about 60 seconds, with no setup fees
- Next-day funding
- Chargeback and fraud tools
See our telehealth merchant account page for more.
FAQ: GLP-1 merchant accounts
Not safely. Stripe prohibits card-not-present sales of prescription-only products and requires pre-approval for telemedicine, and an account it approves can still be closed after a later review.
Apply for a GLP-1 telemedicine merchant account
Licensed telehealth providers and weight-loss clinics can still run GLP-1 programs on stable telemedicine merchant accounts. It comes down to what the FDA and the card networks check in 2026: licensed prescribers, a licensed pharmacy, marketing that doesn't overclaim, and billing patients understand.
Before you apply, check your website copy, subscription terms, pharmacy relationships and labels against this article and the opening checklist.
When you're ready, apply with Adaptiv Payments. It takes about 60 seconds, with no setup fees.
This article is for information only and isn't legal, regulatory or medical advice. Work with a healthcare regulatory attorney on your business model before you go live.
