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The sticker price on an online weight-loss or hormone program is designed to be the number you remember. It is frequently not the number you pay. Telehealth companies increasingly split your bill into pieces — a membership fee, a “program” or “care” fee, and the medication itself — and only one of those pieces tends to appear in the ad. Here is what each piece actually buys, how the recurring billing works, and what the law does (and no longer does) to protect you.
What the fee actually covers
When a platform charges a monthly membership or program fee separate from the drug, that fee is nominally paying for the service wrapped around the prescription: the intake questionnaire, an asynchronous or video visit with a licensed clinician, message-based follow-up, dose adjustments, and shipping coordination. The medication is billed on top, either through the platform’s affiliated pharmacy or a compounding pharmacy.
That structure is why two programs advertising “$99” can cost wildly different amounts. One $99 may be all-in; another $99 is a membership that unlocks the right to then pay for the drug — pushing the real monthly total well past $200 or $300. When GoodRx entered this market in late 2025, for example, it launched a weight-loss telemedicine subscription with an introductory $39-per-month membership — rising to a standard $119 a month after the promotional period — that is explicitly the subscription fee, with medication priced separately on top. Neither the split-fee model nor an introductory rate is inherently a scam. The problem is when the split, or the jump from the intro price, is hidden until after you have handed over your card.
For the consumer how-to of choosing a GLP-1 program, see our sister publication MyGLPTalk; for compounded-drug pricing and shortage context, see our own reporting on compounded GLP-1s. This piece is strictly about the money and the fine print.
How recurring billing is supposed to work
Any online program that bills you again automatically is running a “negative option” — your silence counts as consent to the next charge. Under the Restore Online Shoppers’ Confidence Act (ROSCA), a 2010 federal statute that is very much still in force, a seller must do three things before and during those charges: clearly and conspicuously disclose all material terms before getting your billing information; obtain your express informed consent to the recurring charge; and provide a simple mechanism to stop it. A dark-pattern checkout that buries the membership fee, or a “cancel” flow that only works by phone during business hours, can violate ROSCA — enforced as an unfair or deceptive practice under Section 5 of the FTC Act.
The rule that was supposed to make this easier — and got struck down
In October 2024 the FTC finalized its Negative Option Rule, the “click-to-cancel” rule. It would have required that cancelling be at least as easy as signing up — cancel in the same medium you joined, with no forced chat with a live or virtual “retention” agent unless that is how you enrolled.
It never took effect. Days before the July 2025 compliance deadline, the U.S. Court of Appeals for the Eighth Circuit vacated the entire rule on procedural grounds, finding the FTC skipped a required preliminary regulatory analysis for a rule projected to exceed a $100 million annual economic impact. The FTC could pursue a fresh rulemaking to replace it — its Negative Option Rule page tracks the current status — but as of mid-2026 there is no click-to-cancel mandate in force. The baseline protections of ROSCA and the FTC Act remain; the sharper “as easy to cancel as to join” mandate does not.
How to avoid the trap
- Add it up before you enter a card. Ask, in writing, for the total monthly charge including membership and medication, and what happens after any introductory month ends.
- Screenshot the checkout. Capture the disclosed price, the consent box, and the stated cancellation method. If a fee later appears that you were never shown, that record is your ROSCA argument.
- Find the cancel path first. Legitimate providers let you cancel from the account dashboard or by email. If the only exit is a phone line or a chatbot that “retains” you, treat that as a red flag.
- Watch the trial-to-paid flip. Discounted first months that auto-convert to full price are the most common source of surprise charges.
- Use your card issuer. If a provider keeps billing after you cancel, dispute the charge and consider a stop-payment; then file a complaint at ReportFraud.ftc.gov.
None of this is medical advice, and none of it is a verdict on any one platform. It is the paperwork discipline that keeps a $99 headline from quietly becoming a $400 monthly habit you forgot you agreed to.