Ask for a Good Faith Estimate: The Cash Pay Patient's Pricing Tool

A written estimate turns a phone conversation about money into a document you can read twice.

A good faith estimate is a written breakdown of the charges a provider expects for your care, given to you before treatment starts. Federal rules that took effect in 2022 let uninsured and self-pay patients request one. A useful estimate names every fee, says plainly what it does not cover, and arrives in writing before you hand over a card.

What is a good faith estimate?

It came out of the federal No Surprises Act. Most attention at the time went to surprise emergency room bills, and a quieter part of the same rule covers people who are uninsured or who choose not to run care through insurance. If you pay out of pocket, you can ask for a written estimate of expected charges before treatment begins.

It is not a contractor's bid, and it does not bind anyone to the penny. What it does is move the numbers out of a conversation and onto a page.

Spoken numbers are slippery, and that has nothing to do with anyone's honesty. You hear a price on a Tuesday afternoon while three other things are happening. I have rewritten our own price page twice after a patient read it back to me and it did not say what I thought it said.

Why written pricing matters more in cash pay care

GLP-1 care bought outside insurance is priced by the clinic rather than by a fee schedule, and what you are buying has parts that move: a physician fee, a medication cost, a dose that usually climbs over the first months, and sometimes labs, refill charges, delivery fees, or a membership renewing on a date nobody wrote down.

Brand GLP-1 medications list around $968 to $1,349 a month before manufacturer savings programs. Compounded options are priced lower. When the lower number lands, the work of explaining the rest belongs to whoever is quoting it, not to the person trying to think of the next question.

What belongs in a written estimate?

• The evaluation fee, marked one-time or recurring.
• The medication cost on its own line, with the medication named, the supply period, and the refill price.
• What happens at higher doses. Ask whether the price moves when the dose does.
• Follow-up visits. Included, extra, or unlimited.
• Labs. Ordered by the clinic, billed by an outside lab, or left for you to arrange.
• Shipping and pharmacy handling if medication fulfillment is available only if a prescription is approved and the dispensing pharmacy can fulfill it for the patient location, with packaging and shipping details confirmed by the pharmacy before fulfillment.
• Renewal terms. The date, the amount, and how a person cancels.
• Refund conditions if you are not approved, or if the pharmacy cannot fulfill for your address.

Ask for the itemized version. Two program prices can look comparable and contain completely different things.

The refund line most people skip

That last item is the one I would confirm first. Approval is not automatic and location matters, so if the answer turns out to be no, you want to already know what comes back to you and what does not.

Then check the far end of the timeline. An estimate covering the first 90 days is a real document and a partial one, and you can ask what month seven looks like at the dose you might actually be taking.

What if a clinic keeps the numbers verbal?

Usually it means something ordinary. A two-person office may have nobody whose job is producing documents, and whoever answers the phone is also rooming patients. Some clinics price after a clinical review and cannot honestly commit to a figure before they have read your history.

What you are left with is a gap between what is easy to say out loud and what is easy to put on paper. That gap may close the moment someone gets to a desk. I would still want to know it was there before I paid, and I would not start treatment on a number I only heard.

How do I ask without sounding difficult?

You are not being difficult. You are asking for something patients are entitled to request.

Try this wording: "I am a self-pay patient. Before my first visit, can you send me a good faith estimate in writing that includes the medication cost, what changes when my dose goes up, and what is refunded if I am not approved?"

Send it by email so a copy sits on your side too. If someone calls you back instead, that is fine; ask for the same figures in a follow-up message.

What does New Hope charge?

Our numbers, so you have something to compare against. The initial physician review is $119, one time, covering the doctor's review and the prescription if it is approved. Medication is billed separately. Compounded semaglutide runs $499 for 90 days, which works out to $166 a month, about $5.50 a day. For compounded tirzepatide the 90 day price starts at $699; per month that is $233, roughly $7.70 a day.

There is also a one-month introduction we call the Skeptic's Trial, $199, covering a physician evaluation plus, only if a prescription is approved and the dispensing pharmacy can fulfill it for the patient's location, one month of compounded semaglutide, with packaging and shipping details confirmed by the pharmacy before fulfillment. If the review finds someone is not a candidate, the medication portion is refunded and the evaluation fee covers the work performed.

Follow-up visits, labs, shipping and renewal terms are not in that price list, which is the same omission I just told you to watch for. Ask us for them in writing before you pay, at (657) 837-3342 in English or (213) 214-3325 on WhatsApp in Spanish, and ask the same of every clinic you are comparing. HSA and FSA funds are accepted, and financing is available through Cherry, Klarna and Affirm, with each provider setting and disclosing its own terms at application.

Compounded semaglutide and compounded tirzepatide are not FDA-approved and are not identical to the brand versions. State-state-licensed compounding pharmacies operating under section 503A dispense them after patient-specific and location-specific verification. Nothing ships until a prescription is approved, the pharmacy confirms it can fulfill for that patient's location, and packaging and shipping details are confirmed by the pharmacy before fulfillment. We are physically in Costa Mesa, California, and telehealth, prescribing and shipping depend on where the patient is, which gets confirmed before any treatment decision.

What an estimate cannot tell you

Whether the medicine will work for you. In STEP 1, published in the New England Journal of Medicine in 2021, semaglutide 2.4 mg averaged 14.9% body weight loss over 68 weeks alongside lifestyle changes, with about one in three participants reaching 20% or more. SURMOUNT-1, published in 2022, found tirzepatide at the highest studied dose averaged about 20.9% over 72 weeks. Those trials studied the FDA-approved brand products, not compounded preparations. They are averages under trial conditions, and results vary by individual.

It also cannot tell you how long you will stay on treatment, which is what really drives the cost across two or three years. We do not know yet how many people can taper off and hold their weight, or who those people turn out to be. The research there is still limited, and I would rather say that plainly.

So here is the line I would put in the email first: what is refunded if I am not approved, and how long does that take. Ask it in writing, before you pay, from us or from anybody else.

Notes. Ozempic and Wegovy are trademarks of Novo Nordisk. Mounjaro and Zepbound are trademarks of Eli Lilly. This clinic is not affiliated with or endorsed by either company. The trial figures cited in this article come from randomized trials of the FDA-approved brand products, not from compounded preparations. Compounded semaglutide and tirzepatide are not FDA-approved and not brand-identical, and individual results vary.

Frequently asked questions

This article is informational only and not medical advice. Speak with a licensed physician before starting or changing any GLP-1 therapy. Individual results vary. New Hope Weight Loss is a physician-supervised medical weight loss clinic in Costa Mesa, CA. Eligibility for treatment is determined during the medical consultation. Compounded semaglutide and compounded tirzepatide are not the same products as Wegovy®, Ozempic®, Mounjaro®, or Zepbound®.