Does Amerigroup Cover Lantus

Discover if Amerigroup covers Lantus, learn how to secure coverage, understand the costs without insurance, and find answers in our Lantus FAQ section.
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Amerigroup Lantus Coverage

 

  • Amerigroup typically covers Lantus for individuals with diabetes who require insulin for blood sugar management. Coverage may depend on the specific health plan and any state-specific Medicaid guidelines.
  •  

  • To have Lantus covered, patients often need a prescription from a healthcare provider. Prior authorization might be required to approve the medication based on medical necessity.
  •  

  • It's important for patients to verify their coverage details, co-pays, and any possible restrictions, such as using a preferred brand or generic substitutions.
  •  

  • Patients might need to show a history of managing diabetes with other medications before Lantus is covered. This can be a part of step therapy protocols common in insurance policies.
  •  

  • Consult with a healthcare provider or the Amerigroup customer service to understand the specific criteria and ensure that all documentation is properly submitted.

 

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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 Amerigroup

 

Get Started with Amerigroup

 

  • Contact Amerigroup to verify if you have a health plan that covers prescription medications. You can do this by reviewing your plan documents or calling their customer service line.
  •  

  • Ensure that your plan includes coverage for diabetes medications like Lantus, as formulary lists may vary by plan and state.

 

Consult Your Healthcare Provider

 

  • Set up an appointment with your healthcare provider to discuss your need for Lantus. Ensure that they understand your medical history and current health needs for prescribing Lantus.
  •  

  • Ask your provider for a prescription for Lantus. Discuss any medical documentation or justification needed to support your request for coverage under Amerigroup.

 

Submit a Prior Authorization Request

 

  • Check if a prior authorization is needed for Lantus under your Amerigroup plan, as some plans require approval before covering specific medications.
  •  

  • Work with your provider to submit the necessary prior authorization forms. This might include your prescription, your medical history, and any additional documentation provided by your healthcare provider.

 

Utilize Amerigroup's Pharmacy Network

 

  • Identify a participating pharmacy within Amerigroup's network where you can fill your Lantus prescription. Using an in-network pharmacy can help minimize out-of-pocket costs.
  •  

  • Present your Amerigroup insurance card when picking up your prescription to ensure the coverage is applied correctly at the pharmacy.

 

Explore Financial Assistance Options

 

  • If there are any additional costs that your insurance does not cover, investigate financial assistance programs that may be available for Lantus users. Many pharmaceutical companies offer patient assistance programs.
  •  

  • Contact Lantus directly or search online for Lantus savings programs, discounts, or copay cards that might reduce the cost further.

 

Follow Up with Amerigroup

 

  • If your prior authorization has been denied or if there are issues with your coverage, contact Amerigroup for more details. Be proactive in addressing any documentation or additional information they might need.
  •  

  • Work with your healthcare provider to appeal any denied requests or to provide further justification if necessary.

 

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Apply treatments in minutes from the comfort of your own home with under-the-tongue applications instead of shots or pills

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Potential for results in as few as 6 months

Individual results vary but some users have reported a noticeable difference in as few as 6-12 months since starting treatments

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FAQs

Does Amerigroup Cover Lantus

Discover if Amerigroup covers Lantus, learn how to secure coverage, understand the costs without insurance, and find answers in our Lantus FAQ section.
Curex allergy drops unboxing

Is Lantus Covered by Amerigroup

 

Amerigroup Lantus Coverage

 

  • Amerigroup typically covers Lantus for individuals with diabetes who require insulin for blood sugar management. Coverage may depend on the specific health plan and any state-specific Medicaid guidelines.
  •  

  • To have Lantus covered, patients often need a prescription from a healthcare provider. Prior authorization might be required to approve the medication based on medical necessity.
  •  

  • It's important for patients to verify their coverage details, co-pays, and any possible restrictions, such as using a preferred brand or generic substitutions.
  •  

  • Patients might need to show a history of managing diabetes with other medications before Lantus is covered. This can be a part of step therapy protocols common in insurance policies.
  •  

  • Consult with a healthcare provider or the Amerigroup customer service to understand the specific criteria and ensure that all documentation is properly submitted.

 

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Amerigroup's Approved Criteria for Lantus Coverage

 

Amerigroup Coverage Criteria for Lantus

 

  • Patients must have a documented diagnosis of diabetes mellitus, demonstrating a need for insulin therapy to manage blood sugar levels effectively.
  •  

  • There should be documentation of prior treatment with an appropriate trial of other antidiabetic medications that did not result in adequate blood sugar control or where such medications are contraindicated or not tolerated.
  •  

  • Lantus coverage is applicable when used for both Type 1 and Type 2 diabetes, provided that it helps in achieving the target glycemic control as part of a comprehensive management plan.
  •  

  • In the case of pediatric patients, authorization for Lantus may require confirmation that the child is 6 years or older, given its approved usage age.
  •  

  • Lantus is covered when prescribed by an endocrinologist or a healthcare provider who coordinates with a team-based management plan, ensuring comprehensive diabetes care.
  •  

  • Confirmation that Lantus is being used in conjunction with regular monitoring of blood glucose levels and ongoing evaluations to determine its effectiveness and safety for the individual patient.
  •  

  • Coverage is provided when Lantus is not being used in combination with other long-acting insulin, unless specifically approved due to unique clinical circumstances.
  •  

 

Why Amerigroup Might Deny Lantus Coverage

 

When Amerigroup Might Deny Lantus Coverage

 

  • The prescribed dosage does not align with Amerigroup's coverage guidelines or established clinical protocols.
  •  

  • No prior authorization obtained, which is a requirement for certain insurance plans before proceeding with specific medications.
  •  

  • Lack of proper documentation or justification for the medical necessity of Lantus, especially if alternative treatments are available.
  •  

  • The patient is not within the approved age range or demographic for Lantus coverage according to Amerigroup policies.
  •  

  • Medications are being sought for off-label uses not approved by the FDA, which may not be covered by Amerigroup policies.
  •  

  • Duplicate therapy situations where alternative insulin products are already covered and in use by the patient.
  •  

  • Previous claims or coverage history indicates non-compliance with prescribed diabetes management, leading to a denial of further claims.

 

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 Amerigroup

 

Get Started with Amerigroup

 

  • Contact Amerigroup to verify if you have a health plan that covers prescription medications. You can do this by reviewing your plan documents or calling their customer service line.
  •  

  • Ensure that your plan includes coverage for diabetes medications like Lantus, as formulary lists may vary by plan and state.

 

Consult Your Healthcare Provider

 

  • Set up an appointment with your healthcare provider to discuss your need for Lantus. Ensure that they understand your medical history and current health needs for prescribing Lantus.
  •  

  • Ask your provider for a prescription for Lantus. Discuss any medical documentation or justification needed to support your request for coverage under Amerigroup.

 

Submit a Prior Authorization Request

 

  • Check if a prior authorization is needed for Lantus under your Amerigroup plan, as some plans require approval before covering specific medications.
  •  

  • Work with your provider to submit the necessary prior authorization forms. This might include your prescription, your medical history, and any additional documentation provided by your healthcare provider.

 

Utilize Amerigroup's Pharmacy Network

 

  • Identify a participating pharmacy within Amerigroup's network where you can fill your Lantus prescription. Using an in-network pharmacy can help minimize out-of-pocket costs.
  •  

  • Present your Amerigroup insurance card when picking up your prescription to ensure the coverage is applied correctly at the pharmacy.

 

Explore Financial Assistance Options

 

  • If there are any additional costs that your insurance does not cover, investigate financial assistance programs that may be available for Lantus users. Many pharmaceutical companies offer patient assistance programs.
  •  

  • Contact Lantus directly or search online for Lantus savings programs, discounts, or copay cards that might reduce the cost further.

 

Follow Up with Amerigroup

 

  • If your prior authorization has been denied or if there are issues with your coverage, contact Amerigroup for more details. Be proactive in addressing any documentation or additional information they might need.
  •  

  • Work with your healthcare provider to appeal any denied requests or to provide further justification if necessary.

 

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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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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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