A Washington overview of physician-supervised GLP-1 treatment through Astra, including local access context and the cities we cover. Every statistic on this page links to its source.
Roughly two-thirds of Washington adults carry excess weight: 31.5% have obesity and another 34.5% are classified overweight (CDC BRFSS 2024, n=22,905, 95% CI 30.7–32.2% for obesity) 1.
Adult obesity here climbed from 26.5% in 2011 to 31.5% in 2024 — a 5.0-point, roughly 19% increase over 13 years, with the steepest single jump, 28.8% to 31.7%, between 2021 and 2022 1.
Washington Apple Health (Medicaid) does not cover Wegovy, Zepbound, or Saxenda for weight loss. Both HCA medical policies say so verbatim, citing WAC 182-530-2100(1)(b)(i) and 42 U.S.C. §1396r-8(d)(2)(A) 34.
Coverage exists only through two narrow, non-weight-loss indications that happen to require obesity as an eligibility criterion. Wegovy is covered solely to reduce cardiovascular risk in adults with established heart disease — prior stroke, heart attack, or symptomatic coronary, carotid, or peripheral artery disease — and a BMI of 27 or higher, or for moderate-to-severe MASH/NASH with a cardiovascular risk factor; not for diabetes, which has its own separate policy 3. Zepbound is covered solely for moderate-to-severe obstructive sleep apnea (AHI/RDI of 15 or higher) with a BMI over 30, after PAP therapy has been tried or ruled out 4. Both require prior authorization, a 6-month initial approval, and 12-month reauthorization 34.
The order of the drugs matters here too. On Apple Health's Preferred Drug List, Zepbound is the preferred GLP-1 (PA policy 612525AA) and Wegovy is non-preferred (PA policy 612520AA), requiring documented failure of, or intolerance to, at least two preferred agents first 56. Saxenda is not covered at all, flatly excluded as a "weight loss product" 35. Net effect: an Apple Health enrollee who wants a GLP-1 specifically to lose weight has no Medicaid pathway — the only routes in are a cardiovascular, liver-disease, or sleep-apnea diagnosis that happens to overlap with obesity, each gated by its own strict criteria and prior authorization.
Astra's price in Washington is the price everywhere else we operate: $68 a month for compounded semaglutide and $118 a month for compounded tirzepatide, both on 12-month plans billed annually at $816 and $1,416, the same at every dose. There is no Washington price list, no regional surcharge, and no local discount.
6.5% of Washingtonians are uninsured and median household income is $99,389, per ACS 2024 1-year estimates 7. For the large share of readers whose only Apple Health route would be a diagnosis they don't have, a published flat price is the number that applies.
Washington's population reached 7,958,180 as of July 1, 2024, up 230,971 people (+3.0%) since 2020 — growth driven almost entirely by net migration, not births minus deaths, per the Census Bureau's own components-of-change data 2. More residents arriving into the same clinical capacity is part of why remote intake and follow-up matter here.
TODO — Washington's specific telehealth-prescribing rule has not been verified for this page, and we are not asserting a rule that hasn't been confirmed. In the meantime, the two authorities to read directly are the WA Medical Commission for physician licensing and telehealth, and the WA Pharmacy Quality Assurance Commission for compounding rules.
The federal frame is confirmed and applies in Washington the same as everywhere: FDA ended semaglutide/tirzepatide shortage-based compounding enforcement discretion in 2025, so 503A compounding is lawful only for an individual patient with a prescriber-documented, clinically significant difference from the FDA-approved product.
Astra serves patients in all 50 states, Washington included — Seattle, Spokane, and everywhere between, with no in-person visit required and no price change by county.
Astra treats patients in Washington through state-licensed physicians.
Spokane has its own page for city-level data and local access detail, under the same sourcing rules as this page.
Not for weight loss. Apple Health covers Wegovy only to lower cardiovascular risk in adults with established heart disease and a BMI of 27+, and Zepbound only for moderate-to-severe obstructive sleep apnea with a BMI over 30 -- both need prior authorization, and Zepbound must be tried first since Wegovy is non-preferred. Saxenda isn't covered at all. If your goal is weight loss itself, Apple Health has no pathway for it.
No -- and that's deliberate. Astra is a telehealth provider, not a local clinic chain, so the price is identical everywhere: $68/month for semaglutide, $118/month for tirzepatide, both on 12-month plans, every dose the same price. Washington doesn't get a markup or a discount.
Washington allows licensed providers to treat patients through telehealth under state law, but the specific rule text for this page is still being verified -- check the Washington Medical Commission and Pharmacy Quality Assurance Commission directly in the meantime. Separately, federal rules (FDA Section 503A) restrict compounded semaglutide and tirzepatide to patients with a documented, individual clinical need since the national shortages were declared resolved in 2025.
It's climbed steadily for over a decade -- from 26.5% of adults in 2011 to 31.5% in 2024, a 19% increase -- with the sharpest single jump, from 28.8% to 31.7%, between 2021 and 2022 (CDC BRFSS). Add the 34.5% of adults classified overweight and roughly two in three Washington adults carry excess weight today.
Yes -- Astra is licensed to treat patients throughout Washington state, including Spokane. Spokane's own page, with local clinic pricing and access data, is in progress; until then everything on this page -- coverage, pricing, and eligibility -- applies statewide.
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Educational information, not medical advice. Treatment requires evaluation by a licensed physician.