Does Blue Cross Blue Shield of Alabama Cover Lantus

Explore if Blue Cross Blue Shield of Alabama covers Lantus insulin, denial reasons, coverage tips, costs without insurance, and FAQs.
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Coverage for Lantus

 

  • Blue Cross Blue Shield of Alabama generally covers Lantus under its pharmacy benefits for diabetes management.
  •  

  • Insurance plans may vary, so reviewing your specific policy under the “Prescription Drug Benefits” section or consulting a customer service representative is recommended.

 

Criteria for Coverage

 

  • A prescription from a licensed healthcare provider is required.
  •  

  • Utilization management rules, such as prior authorization, may apply to ensure medical necessity.
  •  

  • In some cases, step therapy might be necessary, meaning other treatments must be tried first.

 

Getting Lantus

 

  • Verify if your plan has a preferred pharmacy network for better pricing and availability.
  •  

  • Check for any available generic alternatives or biosimilars, as they are often covered more favorably by insurance plans.

 

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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 Blue Cross Blue Shield of Alabama

 

Contact Your Healthcare Provider

 

  • Discuss with your doctor the necessity of Lantus for your diabetes management to ensure it's part of your prescribed treatment plan.
  •  

  • Obtain a prescription from your healthcare provider if you haven't done so already.

 

Review Your Insurance Plan

 

  • Log into your Blue Cross Blue Shield of Alabama account to review your current coverage details.
  •  

  • Check if Lantus is listed under the covered medications in your specific plan. Look for the drug formulary or contact customer service for clarification.

 

Contact Customer Service

 

  • Call the customer service number on your insurance card to speak with a representative for personalized assistance.
  •  

  • Inquire whether approval or prior authorization is needed for Lantus, and ask about the steps involved if it's required.

 

Submit Any Necessary Documents

 

  • If prior authorization is needed, ask your healthcare provider to submit the necessary documents to Blue Cross Blue Shield of Alabama.
  •  

  • Keep a record of all submissions, including dates and confirmation receipts, if applicable.

 

Monitor Claims and Approvals

 

  • Check the status of your claim or authorization regularly through your online account or by contacting customer service.
  •  

  • Be ready to provide additional documentation if requested by Blue Cross Blue Shield of Alabama.

 

Pick Up Your Prescription

 

  • Once approved, go to your pharmacy to fill your Lantus prescription. Ensure that the pharmacy has filed the claim with your insurance provider.
  •  

  • Verify your copay to ensure it aligns with the terms of your insurance plan.

 

Appealing Denials

 

  • If your initial request for coverage is denied, review the explanation of benefits to understand the reason.
  •  

  • Prepare to appeal the decision by gathering supporting documents and a letter from your healthcare provider explaining the medical necessity of Lantus.

 

Stay Informed

 

  • Regularly review your plan during open enrollment periods to ensure it continues to meet your needs.
  •  

  • Stay informed about any changes in the drug formulary that may affect your Lantus coverage.

 

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FAQs

Does Blue Cross Blue Shield of Alabama Cover Lantus

Explore if Blue Cross Blue Shield of Alabama covers Lantus insulin, denial reasons, coverage tips, costs without insurance, and FAQs.
Curex allergy drops unboxing

Is Lantus Covered by Blue Cross Blue Shield of Alabama

 

Coverage for Lantus

 

  • Blue Cross Blue Shield of Alabama generally covers Lantus under its pharmacy benefits for diabetes management.
  •  

  • Insurance plans may vary, so reviewing your specific policy under the “Prescription Drug Benefits” section or consulting a customer service representative is recommended.

 

Criteria for Coverage

 

  • A prescription from a licensed healthcare provider is required.
  •  

  • Utilization management rules, such as prior authorization, may apply to ensure medical necessity.
  •  

  • In some cases, step therapy might be necessary, meaning other treatments must be tried first.

 

Getting Lantus

 

  • Verify if your plan has a preferred pharmacy network for better pricing and availability.
  •  

  • Check for any available generic alternatives or biosimilars, as they are often covered more favorably by insurance plans.

 

A weight management program tailored to you

Start with Curex

Blue Cross Blue Shield of Alabama's Approved Criteria for Lantus Coverage

 

Criteria for Lantus Coverage

 

  • Patient must have a diagnosed need for insulin therapy to manage diabetes mellitus.
  •  

  • Lantus is covered if prescribed as part of a comprehensive diabetes management plan where less expensive insulin options have been tried and proven ineffective or inappropriate.
  •  

  • For patients with type 1 diabetes, Lantus must be prescribed as part of a treatment plan including rapid-acting insulin at mealtimes.
  •  

  • Patients with type 2 diabetes must demonstrate inadequate glycemic control with alternative insulin regimens before coverage for Lantus is approved.
  •  

  • Children and adolescents under 18 should have documentation of diabetes diagnosis and a need for basal insulin support.
  •  

  • Lantus may be covered for patients with gestational diabetes when other treatment options are contraindicated or have been ineffective.
  •  

  • Medical records must document regular monitoring of blood glucose levels, indicating the necessity of Lantus for achieving stable control.
  •  

  • Prior authorization may be required, confirming that the prescribed Lantus is necessary for effective disease management.
  •  

 

Why Blue Cross Blue Shield of Alabama Might Deny Lantus Coverage

 

Reasons for Lantus Denial

 

  • Not meeting medical necessity criteria as defined by Blue Cross Blue Shield of Alabama.
  •  

  • Lantus use not approved for the patient's specific medical condition by their healthcare policy.
  •  

  • Clinically inappropriate prescribing outside the recommended treatment protocol or guidelines.
  •  

  • Patient does not meet the age-related coverage criteria for Lantus.
  •  

  • Previous attempts to manage condition with alternative therapies were not adequately documented or pursued.
  •  

  • Prescription exceeds quantity limits without sufficient justification.
  •  

  • Failure to provide required diagnostic tests or lab results to support the Lantus prescription.
  •  

  • Use of Lantus considered experimental or investigational for the treatment plan in question.
  •  

  • Coverage restricted due to availability of a preferred alternative drug that is provided by the insurance plan.
  •  

  • Patient's policy does not include pharmacy benefits covering injectable medications.

 

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 Blue Cross Blue Shield of Alabama

 

Contact Your Healthcare Provider

 

  • Discuss with your doctor the necessity of Lantus for your diabetes management to ensure it's part of your prescribed treatment plan.
  •  

  • Obtain a prescription from your healthcare provider if you haven't done so already.

 

Review Your Insurance Plan

 

  • Log into your Blue Cross Blue Shield of Alabama account to review your current coverage details.
  •  

  • Check if Lantus is listed under the covered medications in your specific plan. Look for the drug formulary or contact customer service for clarification.

 

Contact Customer Service

 

  • Call the customer service number on your insurance card to speak with a representative for personalized assistance.
  •  

  • Inquire whether approval or prior authorization is needed for Lantus, and ask about the steps involved if it's required.

 

Submit Any Necessary Documents

 

  • If prior authorization is needed, ask your healthcare provider to submit the necessary documents to Blue Cross Blue Shield of Alabama.
  •  

  • Keep a record of all submissions, including dates and confirmation receipts, if applicable.

 

Monitor Claims and Approvals

 

  • Check the status of your claim or authorization regularly through your online account or by contacting customer service.
  •  

  • Be ready to provide additional documentation if requested by Blue Cross Blue Shield of Alabama.

 

Pick Up Your Prescription

 

  • Once approved, go to your pharmacy to fill your Lantus prescription. Ensure that the pharmacy has filed the claim with your insurance provider.
  •  

  • Verify your copay to ensure it aligns with the terms of your insurance plan.

 

Appealing Denials

 

  • If your initial request for coverage is denied, review the explanation of benefits to understand the reason.
  •  

  • Prepare to appeal the decision by gathering supporting documents and a letter from your healthcare provider explaining the medical necessity of Lantus.

 

Stay Informed

 

  • Regularly review your plan during open enrollment periods to ensure it continues to meet your needs.
  •  

  • Stay informed about any changes in the drug formulary that may affect your Lantus coverage.

 

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Our weight loss medication is delivered straight to your doorstep from a state-licensed pharmacy within our reliable network, ensuring you receive your medication when you need it.

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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.

 

Have questions left?

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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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