What this plan is for, and what the example is
A business plan for a cash-pay telehealth brand in late 2026 is a short document: nine sections, ten to fifteen pages, and a spreadsheet behind it. The reader is a lender, an angel, a pharmacy or clinician partner, or your own medical director deciding whether to attach their license to your program. All of them skip to the same three places: who is legally practicing medicine, what one patient is worth per month, and how much cash you need before that number covers your costs.
Below is each section with what to put in it, followed by a worked example for Example Weight Co., a fictional brand invented for this post. It is illustrative. It has no patients, no customers and no history, and nobody should read it as a forecast for a real company. Its numbers come from the assumptions in our margin math post and from manufacturer cash prices published in 2026, and the math is shown so you can replace any line.
Section 1: the one-page summary
Write it last. One page, five facts: what you sell, to whom, at what price, under what clinical structure, and how much money you need for how long. A reader who stops here should be able to repeat your business in one sentence.
Example Weight Co. (fictional): A branded GLP-1 weight program for adults whose employer plan dropped weight-loss coverage for 2027, sold as a $149 monthly membership. The patient buys the medication from the manufacturer's cash channel (Wegovy at $349 a month from NovoCare, or the Wegovy pill from $149). Care is delivered by licensed clinicians through a professional corporation owned by a physician, with the brand operating as a management company. The plan needs about $25,000 of working capital to reach the month it stops consuming cash, and about $50,000 in the downside case.
Section 2: the patient, and why now
Name one patient group, how big it is, and what changed in the last year that sends them looking. Cite the sources. Avoid total-addressable-market slides with a trillion-dollar number in them; nobody who funds a small brand believes them.
Example: The Business Group on Health's August 2026 survey found 14% of employers have dropped or plan to drop GLP-1 weight-loss coverage in 2027, and the share of surveyed employers covering the drugs fell from 72% in 2025 to 60% in 2026. Mercer separately found 5% of large employers plan to drop it in 2027. These patients learn about the change during fall open enrollment and lose coverage on January 1. They are already on a dose, they already know the cash prices, and they want continuity more than a discount.
Section 3: the offer and the price the patient sees
Put the full monthly cost to the patient on one line, membership plus medication, because that is the number the patient compares.
| Route | Membership | Medication (manufacturer cash) | Patient pays per month |
|---|---|---|---|
| Injectable Wegovy | $149 | $349 (NovoCare) | $498 |
| Wegovy pill, starting dose | $149 | $149 | $298 |
What the membership buys has to be written in plain terms: provider review and dose changes, refill handling, messaging, side-effect triage, receipts and a letter of medical necessity for HSA and FSA use. If you cannot list what $149 buys, the reader will assume the answer is "a prescription", and the CVS $29 visit makes that hard to defend.
Novo Nordisk has announced a Wegovy list price of $675 from January 1, 2027. That mostly helps insured patients whose cost sharing tracks list price; the $349 cash price is already lower, so the example does not change its pricing for it.
Section 4: clinical and legal structure
This is the section a medical director and a payment processor read first. State who owns the professional entity in each state, who the medical director is, how providers are licensed in the states you serve, which pharmacy fills, and that you will apply for LegitScript certification before running paid ads. If you are not a clinician, explain the management services organization (MSO) and professional corporation (PC) arrangement and who drafted it. The MSO and friendly-PC explainer covers the structure; your counsel should write the documents. This is not legal advice.
Example: A physician-owned PC contracts with Example Weight Co.'s management company. The medical director is paid a fixed monthly fee inside the overhead line. Providers are routed by state license. LegitScript application ($975) and annual fee ($2,150) are budgeted in month one, per our LegitScript post.
Section 5: operations and the stack
Say what you build, what you buy, and what each costs per month. Readers are looking for one thing here: whether the founder plans to spend the first six months and most of the raise on engineering.
Example: Storefront, intake, provider routing, billing, pharmacy routing and the patient portal run on a white-label platform at a flat fee of $1,000 a month below 300 patients and $2,000 above it, which sits inside the published range in our pricing breakdown. Support is handled by the founder until 300 patients, then one coordinator at $4,500 a month.
This is where we would put Turbopills in a plan, so be skeptical in the right places. The platform ships the storefront, conditional intake, state-aware provider routing, billing that starts only after a provider approves, pharmacy routing, the branded portal and a mobile app as one system, and the founder still owns the PC, the medical director, the LegitScript application and marketing. We are in private beta and quote per program, so put our quote into this row at your own volume and check it against the flat fees others publish. Launch is weeks, not months; ask us in a demo what that means for your states.
Section 6: acquisition
Two numbers and where they come from: cost to acquire a paying patient, and new patients per month. Then the channel that produces them. "Paid social" is not a channel plan in a category where ad accounts require certification and where a founder on r/EntrepreneurRideAlong reported in April 2026, "Spent 7k in ad spend. 0 conversions."
Example: 60 new paying patients a month at $250 each, a $15,000 monthly acquisition budget, from employer-coverage-loss search terms, a spouse-and-coworker referral offer, and two benefits brokers. The $250 matches the margin post; Section 9 tests $400.
Section 7: unit economics
Show one patient-month. Every reader wants to check that the product makes money before anything else costs anything.
| Per patient per month | Amount | Derivation |
|---|---|---|
| Membership revenue | $149.00 | Price |
| Provider review | $20.00 | Blended async cost, margin post assumption |
| Card processing | $4.77 | 3.2% of $149 |
| Contribution before platform, support, overhead | $124.23 | $149 minus $24.77 |
| Expected lifetime | 12.5 months | 1 divided by 8% monthly churn |
| Lifetime contribution | about $1,550 | $124.23 times 12.5 |
| Acquisition cost | $250 | Section 6 |
Lifetime contribution is about six times acquisition cost before fixed costs. That ratio is the line investors underline, and it is also the line that falls apart fastest if month-two churn is worse than 8%, which is why the plan should say how you will measure it weekly.
Section 8: the 12-month forecast
Patients start at zero, add 60 a month, and lose 8% of the prior month's base. Revenue is billed after approval, so a patient counts in the month they start. Fixed costs: $3,000 a month overhead (medical director, insurance, legal, tools) and $1,000 platform below 300 patients; $6,000 and $2,000 above it, plus the coordinator. One-time setup: about $3,000 of legal work (the figure a founder quoted on Reddit in April 2026) plus the $975 LegitScript application.
| Month | Patients | Revenue | Costs incl. acquisition | Net | Cumulative cash |
|---|---|---|---|---|---|
| 1 | 60 | $8,940 | $22,636 | -$13,696 | -$17,671 |
| 2 | 115 | $17,135 | $21,848 | -$4,713 | -$22,384 |
| 3 | 166 | $24,734 | $23,111 | $1,623 | -$20,761 |
| 6 | 296 | $44,104 | $26,331 | $17,773 | $17,276 |
| 7 | 332 | $49,468 | $35,723 | $13,745 | $31,021 |
| 12 | 474 | $70,626 | $39,240 | $31,386 | $155,526 |
Month one costs include the $2,150 LegitScript annual fee. Month seven dips because support, the larger platform tier and the higher overhead all start when the base crosses 300. Year-one revenue is about $528,000.
The cash low point is month two, at about $22,400. Ask for more than that; the example asks for $25,000 and holds the rest as reserve against a processor hold.
Section 9: risks, and the downside case
Name the risks you cannot control and price at least two of them. Readers trust a plan more when it shows the version where things go badly.
| Case | Cash low point | Cumulative cash, month 12 |
|---|---|---|
| Base: $250 acquisition, 8% churn | -$22,384 (month 2) | $155,526 |
| Churn 12% | -$22,633 | $111,724 |
| Acquisition $400 | -$49,300 | $47,526 |
| Acquisition $400 and churn 12% | -$52,034 | $3,724 |
Acquisition cost moves the low point more than churn does in year one; churn does more damage in year two. For late 2026, the risks to list by name: the DEA telemedicine flexibilities expiring December 31 (irrelevant to GLP-1, relevant if you add testosterone later), the still-unpublished FDA 503B order on compounded semaglutide and tirzepatide, payment processor review in a category Stripe lists as restricted, and retail price pressure from CVS, Walgreens and Amazon One Medical. We do not know yet how many coverage-loss patients will go straight to NovoCare without a membership; the plan should say how fast you would cut acquisition spend if conversion comes in under target. The launch budget post lists the setup costs this example compresses into one line.
FAQ
What should a telehealth business plan include? A one-page summary, the patient group and why now, the offer with full monthly patient cost, the clinical and legal structure (PC, medical director, pharmacy, LegitScript), the operating stack and its costs, acquisition cost and channels, per-patient unit economics, a 12-month forecast with the cash low point, and a priced downside case.
How much money do you need to start a GLP-1 telehealth business? In our illustrative example, about $22,000 to $25,000 of working capital on a flat-fee platform with $250 acquisition cost, rising to about $50,000 if acquisition costs $400. A self-built stack adds $60,000 to $250,000 before the first patient.
How do you calculate unit economics for a telehealth subscription? Subtract variable costs (provider review, card processing) from the monthly membership, multiply by expected lifetime (1 divided by monthly churn), and compare the result with acquisition cost. At $149, $20 provider cost, 3.2% processing and 8% churn, lifetime contribution is about $1,550.
Is the example brand in this post real? No. Example Weight Co. is fictional and its numbers are illustrative, derived from stated assumptions and published 2026 prices.