The bottom line: MedStands pays a recurring fixed marketing fee of $36 to $260 per active referred customer every month, set by the medication category, for as long as that customer keeps using the platform. Sesame runs a third-party affiliate program that pays a one-time CPA per booking or sale. One model pays you again every month a referral stays active; the other pays once, at the sale.
If you are choosing where to send GLP-1 and telehealth referrals, that structural difference matters more than any single headline number. Below is a factual, side-by-side look at how each program actually pays, drawn from MedStands program terms and from Sesame's publicly listed affiliate information.
At a glance
| MedStands | Sesame | |
|---|---|---|
| Payment model | Recurring fixed marketing fee, set by medication category (not a commission or percentage) | One-time CPA per booking or sale (third-party affiliate/publisher program) |
| When you are paid | Every month a referred customer stays active | Once, when the booking or sale is attributed |
| How much per referral | $36 to $260 per active customer per month, by category | FlexOffers lists $0.80 to $80 per sale depending on SKU and customer status; a flat ~$20 per consultation is reported by third parties, not officially confirmed |
| How long a referral counts | Tied to you for life (bound to your account at signup) | Cookie listed at 30 days on the FlexOffers network page |
| Cost to join | $0, no setup fee, no monthly fee, nothing to buy | Not publicly disclosed |
| Sign-up requirements | Self-serve, live the same day, no follower or audience minimum; admin reviews the account | Runs through affiliate networks (Impact, FlexOffers, Sovrn) |
| Referral cap | No cap on referrals or earnings | Not publicly disclosed |
| Who handles the clinical side | Licensed providers prescribe, licensed pharmacies fulfill; you do no clinical work and hold no inventory | A cash-pay telehealth marketplace that includes weight-loss and GLP-1 visits |
The math: recurring monthly vs one-time
The clearest way to see the difference is to follow one referred customer across a year.
Under a one-time CPA, you are paid once when the booking is attributed, and that is the end of it. Using Sesame's network figure, FlexOffers publicly lists a payout of $0.80 to $80 per sale "depending on the item SKU and customer status." Separately, aggregator roundups report a fixed rate of roughly $20 per consultation, though the brand does not publish a single official flat rate, so treat that $20 as reported by third parties and not officially confirmed. Whatever the exact amount, the payment happens one time. If that customer stays a loyal patient for twelve months, you are still paid for the first booking only.
Under the MedStands model, the same customer is paid on every month they stay active. The fee is a fixed dollar amount by medication category, between $36 and $260 per active customer per month. So a single referral who stays active is counted month after month, not once. Over a year, that is up to twelve monthly payments on the same person instead of a single payout.
An honest caveat: this is a per-customer monthly fee schedule, not a promise of a total. Your actual MedStands earnings depend on the medication category and on how many referred people qualify and stay active. Not everyone qualifies, every request is reviewed by a licensed provider, and people can stop at any time. What is fixed is the structure: a recurring monthly fee per active customer, versus a one-time payment at the sale.
Lifetime binding vs a listed cookie window
Attribution is the other place these programs diverge. With MedStands, a referred customer or business is bound to you for life. The link is stored on the account at signup, not tracked by a browser cookie that can expire or be cleared. Once someone signs up through your QR code or personal link, they stay tied to you.
Sesame's program, as listed on the FlexOffers network page, uses a cookie window listed at 30 days. Cookie-based attribution is standard for affiliate networks, but it depends on the same browser and device and resets after the window. If you want to understand why account-level binding behaves differently from a cookie, see How Telehealth Referral Attribution Works (Lifetime Tracking).
Cost and requirements to join
MedStands is free to join. There is no setup fee, no monthly fee, and nothing to buy. You get paid, you never pay. Sign-up is self-serve, your QR code and personal link are ready the same day you sign up, and an admin reviews the account. There is no follower count or audience-size minimum, so you do not need to be a large publisher to participate.
Sesame's affiliate program runs through third-party networks, including Impact, FlexOffers, and Sovrn. Any cost, approval bar, or eligibility requirement beyond the network's own is not publicly disclosed, so we will not state one here.
There is one more MedStands-specific detail worth knowing: affiliates can both sell directly on their own link and refer other businesses, and a referred business still earns its own fee in full. Nobody earns less because you referred them. If you are weighing individual versus business referrals, Partner vs Affiliate: Which MedStands Program Fits You? breaks down both tracks.
Who does the clinical work
With MedStands, you refer and you get paid, and that is the extent of your role. MedStands is not a medical practice and does not prescribe. Licensed providers do the prescribing, and licensed pharmacies handle fulfillment, refills, and shipping on a LegitScript-certified platform. You hold no inventory and do no clinical work. Every request is reviewed by a licensed provider, and not everyone qualifies. Sesame is a cash-pay telehealth marketplace that includes weight-loss and GLP-1 visits, and its providers deliver care through that marketplace.
Where Sesame might be a fit
If you are a publisher or creator who already works through affiliate networks like Impact, FlexOffers, or Sovrn, Sesame slots neatly into that existing workflow, and a one-time CPA can suit high-volume, one-and-done traffic. Its marketplace also spans many visit types beyond GLP-1, so it may fit a general-health audience rather than a weight-loss-focused one. If you prefer a single per-sale payout over managing a recurring relationship, that model has its appeal.
Common questions
Is the MedStands fee a commission or a percentage of sales?
No. It is a fixed marketing fee set by the medication category, a flat dollar amount between $36 and $260 per active customer per month. It is not a commission, a percentage, or a share of sales. For more on why that distinction matters, see Is a Telehealth Referral Fee a Commission?.
How and when does MedStands pay out?
Payouts are monthly, sent to your bank via Stripe Connect, with a US$25 minimum payout. If your balance is below that minimum in a given month, it rolls over to the next month.
Does Sesame pay recurring commissions?
Based on its publicly listed affiliate information, Sesame's program is a one-time CPA per booking or sale, and there is no evidence of a recurring commission. The FlexOffers network page lists a payout of $0.80 to $80 per sale, and third parties separately report a flat rate of about $20 per consultation, which is not officially confirmed.
Is there a cap on how much I can earn with MedStands?
No. There is no cap on the number of referrals or on total earnings. Your actual total still depends on the medication category and on how many referred people qualify and stay active.
Ready to earn a recurring monthly fee instead of a single per-booking payout? Learn how the MedStands affiliate program pays you every month a referral stays active, then sign up and get your link the same day.
Competitor program terms are as of July 2026 and come from each brand's published affiliate information. Programs change, so check their current terms.