Does Centene Corporation Cover Lantus

Explore if Centene covers Lantus, why it might not, how to secure coverage, and the cost without insurance in this insightful guide.
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Situations Covered by Centene Corporation for Lantus

 

  • Lantus is typically covered when prescribed for diabetes management as part of Centene Corporation's health plans, subject to individual policy details.
  •  

  • Coverage is generally provided for patients diagnosed with Type 1 or Type 2 diabetes requiring insulin therapy.

 

Basic Rules and Criteria for Coverage

 

  • The patient needs to meet specific medical criteria, including a formal diagnosis and a prescription from a healthcare provider.
  •  

  • There may be prior authorization requirements before coverage is approved, depending on the specific plan.
  •  

  • Patients might need to use preferred pharmacy networks to obtain Lantus at lower costs or under copayment plans.
  •  

  • Some plans might have a tiered formulary that affects the coverage level and out-of-pocket costs for Lantus.

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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 Centene Corporation

 

Verify Insurance Eligibility

 

  • Contact Centene Corporation to confirm your eligibility for pharmaceutical benefits. You can do this by calling the customer service number on the back of your insurance card.
  •  

  • Ensure that your current insurance plan with Centene covers prescription medications, as different plans have varying degrees of drug coverage.

 

Consultation with Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Lantus, a long-acting insulin.
  •  

  • Request a prescription from your doctor, ensuring they provide any necessary documentation that supports the medical necessity of Lantus for your condition.

 

Formulary Check

 

  • Access Centene's pharmaceutical formulary – this list indicates the prescription medications covered by the insurance plan.
  •  

  • Verify if Lantus is included in the formulary. If it is listed, note any potential restrictions or copay information that may apply.

 

Prior Authorization

 

  • If required, work with your healthcare provider to submit a prior authorization request to Centene. This is often necessary for medications not routinely covered.
  •  

  • Include any supporting documents, such as lab reports or a history of other treatments, that justify your need for Lantus.

 

Prescription Submission

 

  • Have your healthcare provider send the Lantus prescription directly to a pharmacy that accepts your Centene insurance.
  •  

  • Ensure that the pharmacy processes your prescription through the correct insurance plan to utilize your coverage effectively.

 

Follow Up

 

  • If there are issues with coverage or denial of your prescription, contact Centene's customer service for assistance and clarification.
  •  

  • Work with your healthcare provider to address any additional documentation that may be required by Centene for approval.

 

Explore Assistance Programs

 

  • If your insurance does not fully cover Lantus or if the out-of-pocket cost is significant, inquire with Centene about any available assistance programs that might offset costs.
  •  

  • Research other patient assistance programs outside of Centene, such as manufacturer discounts, that may reduce the cost of Lantus.

 

Continuous Review

 

  • Periodically review changes to the Centene formulary or your specific insurance policy that could affect future coverage for Lantus.
  •  

  • Stay informed about any medication substitutions or alternatives that might be covered if future changes impact Lantus availability.

 

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FAQs

Does Centene Corporation Cover Lantus

Explore if Centene covers Lantus, why it might not, how to secure coverage, and the cost without insurance in this insightful guide.
Curex allergy drops unboxing

Is Lantus Covered by Centene Corporation

 

Situations Covered by Centene Corporation for Lantus

 

  • Lantus is typically covered when prescribed for diabetes management as part of Centene Corporation's health plans, subject to individual policy details.
  •  

  • Coverage is generally provided for patients diagnosed with Type 1 or Type 2 diabetes requiring insulin therapy.

 

Basic Rules and Criteria for Coverage

 

  • The patient needs to meet specific medical criteria, including a formal diagnosis and a prescription from a healthcare provider.
  •  

  • There may be prior authorization requirements before coverage is approved, depending on the specific plan.
  •  

  • Patients might need to use preferred pharmacy networks to obtain Lantus at lower costs or under copayment plans.
  •  

  • Some plans might have a tiered formulary that affects the coverage level and out-of-pocket costs for Lantus.

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Centene Corporation's Approved Criteria for Lantus Coverage

 

Approved Criteria for Lantus Coverage

 

  • The patient must have a diagnosis of Type 1 or Type 2 diabetes requiring insulin therapy.
  •  

  • For Type 1 diabetes, Lantus is covered for individuals requiring a long-acting basal insulin to manage blood glucose levels.
  •  

  • For Type 2 diabetes, Lantus is approved if there is an inadequate response to oral antidiabetic drugs and the patient requires insulin therapy to achieve glycemic control.
  •  

  • Initial prescription requests should include documentation of prior diabetes treatment regimens and related glycemic outcomes.
  •  

  • Renewal of Lantus coverage requires evidence of clinical benefit and/or improvement in glycemic control, alongside a treatment plan indicating continued need for insulin therapy.
  •  

  • Coverage is also available for children aged six and older with Type 1 diabetes upon demonstration of medical necessity for long-acting insulin.

 

Additional Supportive Conditions

 

  • Coverage for Lantus is applicable if the patient has experienced significant adverse reactions to NPH insulin or other alternatives, necessitating a switch to long-acting insulin analogs.
  •  

  • For gestational diabetes, Lantus may be covered when insulin therapy is required based on the obstetrician’s or healthcare provider’s assessment.
  •  

  • In cases of physical or developmental challenges that make day-to-day glucose management with multiple insulin administrations difficult, Lantus coverage is supported.

 

Why Centene Corporation Might Deny Lantus Coverage

 

Exclusions for Lantus Coverage

 

  • Non-Medically Necessary: Lantus may be denied if it is determined not to be medically necessary for the treatment of a specific condition based on Centene Corporation's criteria.
  •  

  • Off-Label Use: Lantus will not be covered when prescribed for off-label uses not approved by Centene's guidelines or if lacking sufficient evidence for effectiveness.
  •  

  • Lack of Prior Authorization: If prior authorization requirements are not met or documentation is incomplete, coverage for Lantus can be denied.
  •  

  • Alternative Therapy Available: Centene may deny Lantus if a more cost-effective or clinically equivalent alternative therapy is available.
  •  

  • Non-Formulary: Lantus might not be covered if it is not included in the specific formulary list of the Centene health plan.
  •  

  • Duplicate Therapy: Coverage may be denied if Lantus is part of a duplicate therapy, implying another insulin treatment is already in use.

 

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 Centene Corporation

 

Verify Insurance Eligibility

 

  • Contact Centene Corporation to confirm your eligibility for pharmaceutical benefits. You can do this by calling the customer service number on the back of your insurance card.
  •  

  • Ensure that your current insurance plan with Centene covers prescription medications, as different plans have varying degrees of drug coverage.

 

Consultation with Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Lantus, a long-acting insulin.
  •  

  • Request a prescription from your doctor, ensuring they provide any necessary documentation that supports the medical necessity of Lantus for your condition.

 

Formulary Check

 

  • Access Centene's pharmaceutical formulary – this list indicates the prescription medications covered by the insurance plan.
  •  

  • Verify if Lantus is included in the formulary. If it is listed, note any potential restrictions or copay information that may apply.

 

Prior Authorization

 

  • If required, work with your healthcare provider to submit a prior authorization request to Centene. This is often necessary for medications not routinely covered.
  •  

  • Include any supporting documents, such as lab reports or a history of other treatments, that justify your need for Lantus.

 

Prescription Submission

 

  • Have your healthcare provider send the Lantus prescription directly to a pharmacy that accepts your Centene insurance.
  •  

  • Ensure that the pharmacy processes your prescription through the correct insurance plan to utilize your coverage effectively.

 

Follow Up

 

  • If there are issues with coverage or denial of your prescription, contact Centene's customer service for assistance and clarification.
  •  

  • Work with your healthcare provider to address any additional documentation that may be required by Centene for approval.

 

Explore Assistance Programs

 

  • If your insurance does not fully cover Lantus or if the out-of-pocket cost is significant, inquire with Centene about any available assistance programs that might offset costs.
  •  

  • Research other patient assistance programs outside of Centene, such as manufacturer discounts, that may reduce the cost of Lantus.

 

Continuous Review

 

  • Periodically review changes to the Centene formulary or your specific insurance policy that could affect future coverage for Lantus.
  •  

  • Stay informed about any medication substitutions or alternatives that might be covered if future changes impact Lantus availability.

 

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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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