Does Aetna Cover Lantus

Discover if Aetna covers Lantus, reasons for denial, tips for obtaining coverage, costs without insurance, and FAQs in our comprehensive guide.
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Does Aetna Cover Lantus?

 

  • Aetna typically covers Lantus under its prescription drug plans, but coverage can vary based on your specific plan.
  •  

  • You may need prior authorization. This means Aetna must approve the prescription before coverage applies.
  •  

  • Coverage might require a co-payment or co-insurance, depending on your plan's specifics such as formulary tier.
  •  

  • Your doctor may need to verify that Lantus is medically necessary and provide evidence that alternative medications were ineffective or unsuitable.
  •  

  • Verify your coverage by reviewing your benefits documents or contacting Aetna customer support.

 

 

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Dr. Neeta Ogden, MD

Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

Dr. Ravi Patel, VP Telemedicine

At Curex, our mission is to help people improve their health and quality of life by understanding their allergies and treating them at their source.We provide more than individualized prescription treatments; we provide individualized care.

Jill Hamburg, PA - C

Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

Dr. Chet Tharpe, Medical Director

Curex has set the standard for the virtual allergy experience. From the comfort of their home, patients nationwide are able to receive a personalized treatment plan from an experienced clinician, aimed at treating the source of their allergies, not just the symptoms.

Kayla Mardaga, NP

Curex offers convenient at-home allergy testing options. Our goal is to determine if a patient would benefit from immunotherapy and then customize a treatment plan that can reduce both the symptoms and the reliance on allergy medications.

How to Get Lantus Coverage with Aetna

 

Check Your Aetna Plan Details

 

  • Review your Aetna health insurance plan documents to understand what prescription drug coverage is offered. Look for details related to your plan's formulary, which lists covered medications.
  •  

  • Identify the tier or status of Lantus (insulin glargine) within the formulary. Some plans may designate it as preferred, non-preferred, or may require prior authorization.

 

Consult with Your Doctor

 

  • Discuss your prescription needs with your healthcare provider. Ensure they are aware of your insurance requirements and that Lantus is a medically necessary part of your treatment plan.
  •  

  • If alternative medications or insulin formulations are available, discuss them with your doctor to understand the best option for your health and insurance coverage.

 

Contact Aetna Customer Service

 

  • Reach out to Aetna's customer service to confirm the specifics of Lantus coverage under your plan. They can provide information on any required approvals, such as prior authorizations or step therapy requirements.
  •  

  • Inquire about your deductible, co-payment, or co-insurance responsibilities for Lantus.

 

Obtain Prior Authorization if Needed

 

  • If your plan requires prior authorization for Lantus, work with your doctor to submit a request to Aetna. Provide any necessary medical documentation or rationale for using Lantus over other alternatives.
  •  

  • Follow up with both your healthcare provider and Aetna to ensure the prior authorization process is progressing and be ready to provide additional information if requested.

 

Use In-Network Pharmacies

 

  • Locate pharmacies within Aetna's network to fill your Lantus prescription. Using these pharmacies can often lower your co-payment and streamline the coverage process.
  •  

  • Contact the pharmacy ahead of time to verify they have Lantus in stock and can process your prescription with Aetna's coverage terms.

 

Review Cost Assistance Options

 

  • Explore any cost assistance programs offered by the manufacturer of Lantus or nonprofit organizations that support individuals with diabetes. These programs may provide coupons, discounts, or financial assistance.
  •  

  • Discuss with your doctor or pharmacist about combining any cost assistance with your insurance benefits to minimize out-of-pocket costs.

 

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FAQs

Does Aetna Cover Lantus

Discover if Aetna covers Lantus, reasons for denial, tips for obtaining coverage, costs without insurance, and FAQs in our comprehensive guide.
Curex allergy drops unboxing

Is Lantus Covered by Aetna

 

Does Aetna Cover Lantus?

 

  • Aetna typically covers Lantus under its prescription drug plans, but coverage can vary based on your specific plan.
  •  

  • You may need prior authorization. This means Aetna must approve the prescription before coverage applies.
  •  

  • Coverage might require a co-payment or co-insurance, depending on your plan's specifics such as formulary tier.
  •  

  • Your doctor may need to verify that Lantus is medically necessary and provide evidence that alternative medications were ineffective or unsuitable.
  •  

  • Verify your coverage by reviewing your benefits documents or contacting Aetna customer support.

 

 

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Aetna's Approved Criteria for Lantus Coverage

 

Criteria for Lantus Coverage

 

  • The member has a diagnosis of diabetes mellitus (either Type 1 or Type 2) requiring long-acting insulin, confirmed by a healthcare provider.
  •  

  • Lantus is prescribed as part of a comprehensive diabetes treatment plan, including diet, exercise, and possibly other pharmacologic interventions.
  •  

  • The member has tried and had inadequate response or contraindication to other long-acting insulins (such as Levemir) or evidence supports the use of Lantus over other insulins based on patient-specific factors.
  •  

  • Lantus is prescribed by or in consultation with an endocrinologist, or a healthcare provider specializing in diabetes care, to ensure specialist input into management.
  •  

  • Documentation of regular monitoring of blood glucose levels by the member to ensure effectiveness and safe management of diabetes while using Lantus.
  •  

  • The healthcare provider has outlined documentation of member-specific goals for treatment and ongoing assessment of response to Lantus.

 

Additional Criteria

 

  • For pediatric members under age 18, Lantus may be approved when necessary for achieving adequate glycemic control where clinically indicated.
  •  

  • Coverage may include provision for necessary diabetes education and support to maximize the benefits of Lantus therapy.
  •  

  • Lantus may be approved as part of a combination therapy when multiple insulin products are necessary for optimal management of diabetes.
  •  

 

Why Aetna Might Deny Lantus Coverage

 

When Aetna Might Deny Lantus Coverage

 

  • If Lantus is not deemed medically necessary based on the clinical criteria set by Aetna medical policies.
  •  

  • When there are less costly alternatives that are considered therapeutically equivalent to Lantus.
  •  

  • If prescribed for an off-label use that is not supported by sufficient clinical evidence according to Aetna's guidelines.
  •  

  • In situations where the patient’s medical history does not demonstrate an inability to control blood sugar levels with other medications.
  •  

  • When the prescribing physician fails to provide adequate documentation or justification meeting Aetna’s criteria for Lantus use.
  •  

  • For patients who do not meet age or usage restrictions as specified in Aetna's coverage policy for Lantus.
  •  

  • If the patient has not adhered to previous treatment plans or medication regimens without adequate justification.
  •  

  • When Lantus is excluded from the plan's formulary and no exception process is applicable.

 

Together with our partners we have changed the lives of over 300,000 patients.

How Much Does Lantus Cost without Insurance?

 

Cost of Lantus Without Insurance

 

  • The price of Lantus (insulin glargine) without insurance can vary based on factors such as the pharmacy, location, and available discounts. Typically, the retail price ranges between $250 and $350 for a 10ml vial at a retail pharmacy.
  •  

  • For the Lantus SoloStar pen, which is a more convenient option for some, the price is generally similar, ranging from $400 to $500 for a pack of five pens.
  •  

  • Prices can fluctuate slightly, so it is advisable to check with local pharmacies or online services for the most current prices and potential savings options.
  •  

  • Consider exploring patient assistance programs offered by the manufacturer or third-party organizations, which might offer Lantus at reduced prices or even for free if you qualify based on income.

 

Our team is here to help!

Dr. Neeta Ogden, MD

Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

Dr. Ravi Patel, VP Telemedicine

At Curex, our mission is to help people improve their health and quality of life by understanding their allergies and treating them at their source.We provide more than individualized prescription treatments; we provide individualized care.

Jill Hamburg, PA - C

Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

Dr. Chet Tharpe, Medical Director

Curex has set the standard for the virtual allergy experience. From the comfort of their home, patients nationwide are able to receive a personalized treatment plan from an experienced clinician, aimed at treating the source of their allergies, not just the symptoms.

Kayla Mardaga, NP

Curex offers convenient at-home allergy testing options. Our goal is to determine if a patient would benefit from immunotherapy and then customize a treatment plan that can reduce both the symptoms and the reliance on allergy medications.

How to Get Lantus Coverage with Aetna

 

Check Your Aetna Plan Details

 

  • Review your Aetna health insurance plan documents to understand what prescription drug coverage is offered. Look for details related to your plan's formulary, which lists covered medications.
  •  

  • Identify the tier or status of Lantus (insulin glargine) within the formulary. Some plans may designate it as preferred, non-preferred, or may require prior authorization.

 

Consult with Your Doctor

 

  • Discuss your prescription needs with your healthcare provider. Ensure they are aware of your insurance requirements and that Lantus is a medically necessary part of your treatment plan.
  •  

  • If alternative medications or insulin formulations are available, discuss them with your doctor to understand the best option for your health and insurance coverage.

 

Contact Aetna Customer Service

 

  • Reach out to Aetna's customer service to confirm the specifics of Lantus coverage under your plan. They can provide information on any required approvals, such as prior authorizations or step therapy requirements.
  •  

  • Inquire about your deductible, co-payment, or co-insurance responsibilities for Lantus.

 

Obtain Prior Authorization if Needed

 

  • If your plan requires prior authorization for Lantus, work with your doctor to submit a request to Aetna. Provide any necessary medical documentation or rationale for using Lantus over other alternatives.
  •  

  • Follow up with both your healthcare provider and Aetna to ensure the prior authorization process is progressing and be ready to provide additional information if requested.

 

Use In-Network Pharmacies

 

  • Locate pharmacies within Aetna's network to fill your Lantus prescription. Using these pharmacies can often lower your co-payment and streamline the coverage process.
  •  

  • Contact the pharmacy ahead of time to verify they have Lantus in stock and can process your prescription with Aetna's coverage terms.

 

Review Cost Assistance Options

 

  • Explore any cost assistance programs offered by the manufacturer of Lantus or nonprofit organizations that support individuals with diabetes. These programs may provide coupons, discounts, or financial assistance.
  •  

  • Discuss with your doctor or pharmacist about combining any cost assistance with your insurance benefits to minimize out-of-pocket costs.

 

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Lantus FAQ

What is Lantus used for?

 

What is Lantus Used For?

 

  • Lantus is primarily used to manage blood sugar levels in individuals with type 1 and type 2 diabetes.
  •  

  • It is a long-acting insulin, providing a steady release of insulin over a 24-hour period with no pronounced peak, mimicking natural insulin secretion.
  •  

  • It's taken once daily, often at the same time each day, helping to maintain consistent blood glucose control.
  •  

  • Beneficial for patients requiring basal insulin to prevent hyperglycemia between meals and overnight.
  •  

  • Alongside diet and exercise, Lantus is vital for comprehensive diabetes management.

 

How does Lantus work in the body?

 

How Lantus Works

 

  • Lantus is a long-acting insulin, also known as insulin glargine. It provides a stable and continuous release of insulin to control blood sugar levels.
  •  

  • The formulation of Lantus enables it to dissolve slowly upon injection, creating a slow and steady insulin level that lasts up to 24 hours.
  •  

  • This minimizes the risk of blood sugar peaks and troughs, providing more consistent blood glucose management.
  •  

  • Lantus mimics the basal level of insulin production in the pancreas, thus helping to maintain glucose balance between meals and overnight.
  •  

  • It binds to insulin receptors, facilitating glucose uptake into muscle and fat tissues, while inhibiting hepatic glucose production.

 

What are the side effects of Lantus?

 

Common Side Effects

 

  • Injection site reactions such as redness, swelling, or itching can occur.
  • Hypoglycemia, or low blood sugar, is a frequent side effect.
  • Weight gain may happen due to improved glucose utilization.

 

Less Common Side Effects

 

  • Allergic reactions like rash or itching may occur but are rare.
  • Systemic reactions such as swelling of hands/feet can occur.
  • Visual changes might be experienced during initial treatment.

 

Serious Side Effects

 

  • Severe hypoglycemia requiring intervention.
  • Signs of allergic reactions like difficulty breathing, require immediate attention.
  • Hypokalemia may develop, leading to muscle weakness or cramps.

 

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Initial Dosage

Your initial medication and dosage are carefully determined by doctors, taking into account your unique health profile. This ensures a personalized and safe treatment plan tailored to your specific needs.

Titration

We gradually adjust your dosage to reach the optimal therapeutic level, ensuring maximum effectiveness while minimizing potential side effects.

Additional Treatments

Our providers may also recommend medications such as metformin or supplements such as vitamin B12. We recognize the importance of managing side effects, so your care plan may include medication to alleviate them.

Got questions? We have answers.

Do your plans include prescriptions and medications?

Curex plans cover everything from reviewing your medical intake to providing prescription medications, with free shipping included. There are no extra or hidden charges. Prescriptions are issued only after a medical provider reviews your information to confirm that the medication is suitable for you. Our service includes continuous support and regular follow-ups to ensure your treatment stays on track.

Our clinicians may order labs and additional medications for you, which would not be covered by the plan but for which you can use your insurance.

Please note: Compounded medications are tailored to individual needs or used in case of shortages, but they are not FDA-approved for safety or effectiveness. A prescription is required. Results may vary from person to person.

What medications do your providers prescribe?

We prioritize a personalized approach to your health. If your medical provider prescribes medication, options may include GLP-1 treatments such as compounded semaglutide (the active ingredient in Wegovy®* and Ozempic®*). Our providers prescribe only combination treatments not available at your local pharmacy that may include vitamin B12, etc. to help you achieve your goals faster.

Depending on your treatment goals, other medications such as metformin may also be considered. We recognize the importance of managing side effects, so your care plan might include medication to ease symptoms like nausea. Your well-being is always our top priority!

Please note that compounded medications are customized to meet individual patient needs and are not FDA-approved for safety or effectiveness. A prescription is necessary. Results may vary from person to person.

Curex and its pharmacy partners do not have any association with Novo Nordisk.

Will I be prescribed semaglutide if I sign up?

Your health journey is unique, and we tailor our care to match. Any prescriptions, including semaglutide, will be based on the expert assessment of the medical provider matched with you through our platform. You can trust that your treatment plan will be personalized to fit your specific needs. And if semaglutide is not prescribed, we will provide a full refund.

What is compounded medication?

Compounding involves creating customized medications to meet the specific needs of individual patients. For instance, a patient may require a liquid version of a medication that is only available in tablet form. Pharmacies can also compound medications using FDA-approved drugs that are on the FDA’s shortage list.

These compounded medications are made by state-licensed pharmacies that follow both federal and state regulations, including quality standards. However, when compounded in accordance with these laws, these medications are not subject to FDA approval and are not evaluated for safety or effectiveness.

Is compounded medication the same as generic medication?

Compounded medications differ from generic drugs. Generics require FDA approval by demonstrating bio-equivalence to the brand-name drug. In contrast, compounded medications are not FDA-approved. They are made based on a personalized prescription that may not be commercially available elsewhere or when a drug appears on the FDA’s shortage list. Compounding pharmacies must have the proper licensed facilities and comply with state and federal regulations before dispensing these medications.

Is insurance required?

No, Curex doesn’t require insurance. We offer clear and simple pricing, along with affordable medication options, making it easy and accessible to take care of your health.

Can I pay with an FSA or HSA card?

Yes! You can pay with your HSA or FSA card.

How much does treatment cost?

Semaglutide Injections:

Prices for semaglutide start at only $149 per month for weekly doses of 0.25mg and 0.5mg. You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 1mg, 1.7mg and 2.4mg of semaglutide for an additional $50 per month for each plan.

Tirzepatide Injections:

Prices for tirzepatide start at only $249 per month for weekly doses of 2.5mg and 5mg of tirzepatide.You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 7.5mg, 10mg and 12.5mg of tirzepatide for an additional $100 per month for each plan.

Semaglutide Tablets:

Prices for semaglutide tablets start at only $149 per month for daily doses of 2mg. You can cancel anytime. Some people experience weight loss at this dose and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 4mg and 8mg of semaglutide daily for an additional $50 per month for each plan.

Tirzepatide Tablets:

Prices for tirzepatide start at only $199 per month for daily dosees of 3mg of tirzepatide. You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 6mg and 12 mg of tirzepatide daily for an additional $100 per month for each plan.

Can you prescribe Ozempic®* or Wegovy®*?

Our providers focus on personalized medications and dosages that aren’t commercially available at your local pharmacy. While we don’t prescribe Ozempic®* or Wegovy®* directly, we may prescribe treatments containing the same active ingredient. These medications are specially compounded for you by a licensed pharmacy to meet your specific needs.

Are video visits with a provider required?

Our providers will review your information 100% online. Depending on where you live and the specifics of your medical history, our providers may require you to have a video visit or asynchronous visit via text message. If prescribed, you’ll get unlimited online access to message your provider as needed for follow-ups, adjustments, and answers to your questions.

What states do you serve?

Currently, we do not serve Arkansas, Connecticut, and New Mexico. However, we are always working to expand our reach, so stay in touch with us at hi@getcurex.com.

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