[they handle it for you]
This is important for anyone who wants to get safe/high-purity longevity drugs [estriol, acarbose, canagliflozin, nexlizet] without going through possibly unreliable international suppliers!! Which is many people in this forum
I checked with them and they also do SGLT2’s!
they’re SF based. they negotiated special rates for tirzepatide
Only serving California, Texas and Florida. Rest of the country and the world are SOL.
Is it confirmed they have alpha estradiol? And if so, what kind of formulation?
I live on east coast (my state isn’t listed) and contacted Them. They told me they would try to find a doctor that could prescribe for me - so maybe ??
I will say for my “standard RX” (telamersin, statin, etemzibe), my PCP was fine RX-ing it, and insurance covers most if not all). They were OK with me being on SLGT2 and acarbose , but didn’t feel comfortable prescribing because I am not diabetic.
I did the online longevity clinic route initially (getHealthspan), and then used Push health and showed evidence that I was on SLGT2i and acarbose (from another provider), and was able to get an ongoing RX for both. 90 days of generic
Dapagliflozin was like 14 bucks on Amazon pharmacy (no insurance).
Only downside is you have to pay for a $70 consult every six months to get refills. And there is a risk I need to find a new provider each time, etc. But this is a more legal and safest option than relaying on overseas pharmacies.
At some point if I prove to my PCP that I don’t croak from SLGT2s he will probably be Ok taking over RX.
They’re very new and very willing to look into others!
just had a video call - I really enjoyed it!!! They use AI - they’re way smarter than other doctors! [maybe this is what working at ambiencehealth does to people!]
“Temi is live in California, Florida, Ohio, and Texas. Everywhere else, joining the waitlist is a vote for your state. The more votes, the sooner we launch there.”
[historically they specialize in weight management so the weight management ones are easiest]
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tirzepatide is so good for the planet (less area needed to grow crops => more area that can be released for biodiversity]
[josh did work with nikhil buduma and were housemates at cresta/the ambiencehealthcare grouphouse, who really did a lot to make the medical system suck less]. and it shows in the transcripts of the doctor call with you + medical records
(they even looked at my posts ON THIS FORUM for my medical record!!)
they might be able to order Ion panel tests and how to order them and biotek too
My tirzepatide arrived today!
So grateful for this
Wouldn’t have happened if not for the Elliott Roth biopunk party
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https://www.costplusdrugs.com/medications/acarbose-100mg-tablet/
^acarbose is possible!
https://www.costplusdrugs.com/medications/finasteride-1mg-tablet/
https://www.costplusdrugs.com/medications/dapagliflozin-propanediol-10mg-tablet-farxiga/
https://www.costplusdrugs.com/medications/nebivololhcl-10mg-tablet/
https://www.costplusdrugs.com/medications/ezetimibe-10mg-tablet/
https://www.costplusdrugs.com/medications/selegiline-hcl-5mg-capsule-eldepryl/
https://www.costplusdrugs.com/medications/ondansetron-4mg-orallydisintegratingtablet-odt/ (for glp nausea)
https://www.costplusdrugs.com/medications/tadalafil-10mg-tablet/
no nexlizet, no empagliflozin, canagliflozin super-expensive, no pure estriol [though there’s variants] but if dapagliflozin is almost as good?
and acarbose arrived 07/19/2026 (it can send Rx to walgreens!)
Thanks, I will look into Temi. How do their prices compare to Indian suppliers? Its in the US, so I would expect their prices to be much higher for rx such as rapamycin.
I got my SLGT2 prescribed because of my GFR kidney score. 55. Okay … but starting of possibly kidney disease. I take 25 mg Jardiance nightly. I think it’s good… foamy piss tells me salt is being flushed out. Cost $10 per month.
GFR (Glomerular Filtration Rate) measures how well your kidneys filter blood.
Did you use eGFR calculation via creatinine or via Cystatin C ?
If creatinine based your eGFR is likely being underestimated, as you are likely supplementing creatine.
Yeah, it is creatinine based… why I am not worried about it. Works for getting my SLGT2 prescription. I think Jardiance is a great addition for longevity.
you can always visit CA and have them order to a pharmacy in your state (or mail order) - you just technically have to be in CA when you fill the form…
Good news for some who are looking for GLPs for weight loss, but don’t have type II diabetes.
The Medicare GLP-1 Bridge, a temporary nationwide program run by the Centers for Medicare & Medicaid Services (CMS) that operates from July 1, 2026, through December 31, 2027
If you have Medicare Part D or a Medicare Advantage plan that includes drug coverage.
This program is for those who do not have type II diabetes
Standard Medicare Part D plans cover GLP-1 medications for treating Type 2 diabetes, but federal law currently prohibits them from covering drugs prescribed solely for weight loss. The Bridge program was created specifically to bypass this restriction to provide access for weight management.
To qualify, a doctor must submit a prior authorization proving you meet these clinical criteria:
Age: 18 or older.
BMI Requirements: BMI of 35 or higher. Or a BMI of 30 or higher with specific conditions (e.g., uncontrolled high blood pressure, heart failure, chronic kidney disease).
OR BMI of 27 or higher with other risks (e.g., pre-diabetes, previous heart attack, stroke).
Drug Coverage and Cost
Under the Bridge program, the cost is a flat $50 per monthly supply.
However, there is an important detail regarding Ozempic: Ozempic is the brand name for the drug semaglutide when it is specifically prescribed for Type 2 diabetes. Because the Bridge program only covers GLP-1s prescribed for weight loss, it covers the weight-management branding of these medications.
Instead of Ozempic, your doctor will need to prescribe one of the medications officially covered under the Bridge program:
Wegovy (which contains the exact same active ingredient as Ozempic but is branded and dosed for weight loss), Zepbound (tirzepatide), or Foundayo.
How does a doctor submit a prior authorization for the Medicare GLP-1 Bridge program?
The doctor writes the prescription for one of the covered medications, such as Wegovy or Zepbound KwikPen. Crucially, the doctor should include an obesity diagnosis code and specifically write “SEND TO BRIDGE FOR WEIGHT MANAGEMENT” on the prescription. This stops the pharmacy from accidentally billing her regular Part D plan.
The pharmacy bills the prescription directly to the Bridge program’s central processor using special routing numbers, not her Part D plan. The system will intentionally reject this initial claim to establish an eligibility record and officially flag that a PA is required. The pharmacy then sends the PA request form to the doctor, typically within 24 to 72 hours.
3.The Doctor Submits the Prior Authorization:
Her doctor submits the PA directly to Humana (the Bridge program’s central processor) via fax or an electronic portal like CoverMyMeds. The doctor must medically attest that the medication is for weight management alongside diet and exercise, verify your qualifying BMI and health conditions, and confirm that you do not have Type 2 diabetes.
Addenda:
Zepbound (tirzepatide) generally results in significantly greater weight loss than Wegovy (semaglutide). Clinical data shows that Zepbound helps patients lose an average of 20% or more of their body weight, compared to roughly 13% to 15% body weight loss with Wegovy. [1, 2, 3]
Key Differences at a Glance
| Feature | Zepbound (tirzepatide) | Wegovy (semaglutide) |
|---|---|---|
| Average Weight Loss | ~20.2% of body weight (at 72 weeks) | ~13.7% to 15% of body weight (at 68–72 weeks) |
| Hormones Targeted | Dual Agonist: GLP-1 and GIP | Single Agonist: GLP-1 only |
| Administration | Weekly injection | Weekly injection (and a pill version) |
| Age Approval | Adults only | Adults and children ages 12+ |
| Extra Benefits | Obstructive sleep apnea | Cardiovascular risk and fatty liver reduction |
I just asked for sirolimus and metformin! (though really, did I have to ask about sirolimus?)
[on the form i was honest about saying this is safer than ordering from india because I would otherwise get them from india, and I have had them from India for years, though it’s not fully known for me to tell if they are having metabolic effects on me - unlike tirzepatide which is obvious]. and i mentioned matt kaeberlein being important for rapamycin advocacy and safety.
[but even then, i did so later, sirolimus/metformin are not as important as SGLT2s/tirzepatide/nebivolol]
alfatradiol might be worth someone trying
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FYI: a lot of physicians are not willing to prescribe sirolimus, it’s a “threshold” of unknown-ness that goes beyond the standard diabetic drugs]
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my insurance covered for all the diabetes drugs from temi!!! (dapagliflozin/empagliflozin/ezetimibe/metformin/acarbose require no PA). nebivolol and beta blockers also don’t require PA.
nexlizet/canagliflozin require PA
I have documented past LDL results of 138/110 which make PA easier for nexlizet
Medication PA status Selegiline capsule/tablet No PA, A90 Selegiline patch/Emsam PA Sirolimus oral tablet/solution No PA, A90; brand Rapamune requires PA when a generic equivalent is available Acarbose No PA, M90 Metformin standard tablets No PA, M90 Pioglitazone No PA, M90 Aspirin 81 mg No PA, generic OTC covered Canagliflozin/Invokana PA Captopril PA, although X may automatically approve it when claims show an accepted diagnosis and prior ACE-inhibitor use Tadalafil/Cialis PA Mounjaro or Zepbound tirzepatide PA Ozempic/Wegovy semaglutide PA PCSK9 inhibitors such as Repatha/Praluent PA