Does Christiana Care Health System Cover Lantus

Explore Lantus coverage with Christiana Care. Learn how to get coverage, costs without insurance, and answers to FAQs.
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Coverage Overview

 

  • Christiana Care Health System typically includes coverage for Lantus, a long-acting insulin, under their comprehensive health plans. However, specific coverage can vary based on plan type and individual patient needs.
  •  

  • Patients must be enrolled in a plan that covers prescription medications, and Lantus should be prescribed by a healthcare professional affiliated with Christiana Care Health System.

 

Situations Covered

 

  • Lantus is usually covered for patients with Type 1 or Type 2 diabetes when recommended by the care provider as part of their diabetes management plan.
  •  

  • Coverage may include situations where Lantus is clinically necessary and no suitable alternative treatment is effective.

 

Basic Rules and Criteria for Coverage

 

  • A doctor’s prescription is required to verify the medical necessity of Lantus.
  •  

  • Prior authorization may be needed to ensure that the use aligns with the patient's care plan.
  •  

  • Co-payments or co-insurance may apply, depending on the specific health plan's terms and conditions.

 

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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 Christiana Care Health System

 

Contact Christiana Care Health System

 

  • Start by calling or visiting the customer service department of the Christiana Care Health System. Obtain the specific contact information by visiting their official website or looking through any patient information you may have received.
  •  

  • Request detailed information about pharmacy benefits and prescription coverage concerning Lantus (insulin glargine).

 

Verify Your Insurance Plan

 

  • Confirm whether your current health insurance plan with Christiana Care covers Lantus. Examine your plan documents, or discuss directly with a representative to understand coverage limits and requirements.
  •  

  • Inquire about any out-of-pocket costs, co-pays, or deductibles that might apply to Lantus insulin coverage.

 

Consult Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider affiliated with Christiana Care. Discuss your need for Lantus and any alternative medications available under your insurance coverage.
  •  

  • Request the necessary prescriptions and authorizations to ensure Lantus is the best choice for your treatment.

 

Submit Prior Authorization

 

  • Coordinate with your healthcare provider to initiate a prior authorization request if needed. This process is often required by insurance companies before they agree to cover specific medications like Lantus.
  •  

  • Ensure that all necessary medical documentation and reasoning are provided to support the use of Lantus.

 

Visit the Pharmacy

 

  • Take your Lantus prescription to a pharmacy that partners with Christiana Care Health System. Confirm with your insurance provider to ascertain that the pharmacy is in-network.
  •  

  • Present your insurance card and any prior authorization documents to streamline the process.

 

Monitor Your Coverage

 

  • Keep track of any changes or updates in your insurance policy terms provided by Christiana Care Health System regarding Lantus coverage.
  •  

  • Reach out to the pharmacy or Christiana Care's customer service if you face any issues accessing your insulin or encounter unexpected costs.

 

Review and Adjust as Necessary

 

  • Regularly review your insurance plan during open enrollment periods to ensure ongoing coverage of Lantus. Discuss any possible changes in formulary or co-pay adjustments with your insurance representative.
  •  

  • Consider discussing with your healthcare provider or insurance company if alternative treatment options are more favorable according to new policy adjustments.

 

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FAQs

Does Christiana Care Health System Cover Lantus

Explore Lantus coverage with Christiana Care. Learn how to get coverage, costs without insurance, and answers to FAQs.
Curex allergy drops unboxing

Is Lantus Covered by Christiana Care Health System

 

Coverage Overview

 

  • Christiana Care Health System typically includes coverage for Lantus, a long-acting insulin, under their comprehensive health plans. However, specific coverage can vary based on plan type and individual patient needs.
  •  

  • Patients must be enrolled in a plan that covers prescription medications, and Lantus should be prescribed by a healthcare professional affiliated with Christiana Care Health System.

 

Situations Covered

 

  • Lantus is usually covered for patients with Type 1 or Type 2 diabetes when recommended by the care provider as part of their diabetes management plan.
  •  

  • Coverage may include situations where Lantus is clinically necessary and no suitable alternative treatment is effective.

 

Basic Rules and Criteria for Coverage

 

  • A doctor’s prescription is required to verify the medical necessity of Lantus.
  •  

  • Prior authorization may be needed to ensure that the use aligns with the patient's care plan.
  •  

  • Co-payments or co-insurance may apply, depending on the specific health plan's terms and conditions.

 

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Christiana Care Health System's Approved Criteria for Lantus Coverage

 

Eligibility for Lantus Coverage

 

  • Patients with a diagnosis of Type 1 Diabetes Mellitus requiring long-acting insulin for glucose control. A physician's documentation confirming the diagnosis and necessity for treatment is required.
  •  

  • Patients with Type 2 Diabetes Mellitus who have not achieved glycemic control with oral anti-diabetic medications, as evidenced by HbA1c levels over 7.0%. Provider must submit recent lab results and documentation of previous medication use.
  •  

  • Individuals needing insulin therapy as a result of gestational diabetes, gestational diabetes is covered under plan benefits, provided verification by the attending healthcare professional.
  •  

  • Cases where a transition from another long-acting insulin to Lantus is deemed medically necessary due to side effects, lack of efficacy, or specific medical conditions. Detailed medical history and physician's rationale for the switch required.
  •  

  • Patients requiring Lantus for an optimal diabetes management plan as part of a larger disease management initiative led by Christiana Care Health System. Enrollment in the relevant program and coordination with a certified diabetes educator must be documented.

 

Additional Requirements

 

  • Submission of a prior authorization request completed by the healthcare provider, which includes all necessary medical history and rationale for the prescription of Lantus over other insulins.
  •  

  • Periodical reviews may be required for continued coverage, including updates on the patient’s progress, HbA1c levels, and any adjustments made to the diabetes management plan.
  •  

  • Verification of participation in appropriate self-management education programs, if applicable, to ensure the effective use of Lantus and to mitigate risks associated with insulin therapy.

 

Why Christiana Care Health System Might Deny Lantus Coverage

 

Non-Formulary Status

 

  • Christiana Care Health System might deny coverage if Lantus is not included in their formulary list of approved medications, requiring a prescriber to request a formulary exception.

 

Non-Compliance with Prior Authorization

 

  • Coverage may be denied if prior authorization requirements are not met before the prescription is filled, meaning that the healthcare provider did not submit the necessary documentation for approval.

 

Failure to Meet Step Therapy Requirements

 

  • If patients have not attempted treatment with preferred alternatives as per step therapy protocols, Christiana Care Health System might not cover Lantus.

 

Lack of Medical Necessity

 

  • If there is insufficient evidence to demonstrate that Lantus is medically necessary for the patient's condition, coverage could be denied.

 

Policy Exclusions

 

  • Certain health plans under Christiana Care Health System may have specific exclusions that do not cover Lantus, regardless of medical necessity.

 

Off-Label Use

 

  • If Lantus is prescribed for a condition that is not approved by regulatory authorities or is considered off-label, it may not be covered by Christiana Care Health System.

 

Incomplete or Incorrect Documentation

 

  • The health system may deny coverage if there are errors or missing information in the submitted prescription details or patient records associated with Lantus.

 

Non-Adherence to Plan Guidelines

 

  • Coverage may be denied if the patient or healthcare provider fails to adhere to specific guidelines or procedures outlined by Christiana Care Health System for Lantus prescriptions.

 

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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 Christiana Care Health System

 

Contact Christiana Care Health System

 

  • Start by calling or visiting the customer service department of the Christiana Care Health System. Obtain the specific contact information by visiting their official website or looking through any patient information you may have received.
  •  

  • Request detailed information about pharmacy benefits and prescription coverage concerning Lantus (insulin glargine).

 

Verify Your Insurance Plan

 

  • Confirm whether your current health insurance plan with Christiana Care covers Lantus. Examine your plan documents, or discuss directly with a representative to understand coverage limits and requirements.
  •  

  • Inquire about any out-of-pocket costs, co-pays, or deductibles that might apply to Lantus insulin coverage.

 

Consult Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider affiliated with Christiana Care. Discuss your need for Lantus and any alternative medications available under your insurance coverage.
  •  

  • Request the necessary prescriptions and authorizations to ensure Lantus is the best choice for your treatment.

 

Submit Prior Authorization

 

  • Coordinate with your healthcare provider to initiate a prior authorization request if needed. This process is often required by insurance companies before they agree to cover specific medications like Lantus.
  •  

  • Ensure that all necessary medical documentation and reasoning are provided to support the use of Lantus.

 

Visit the Pharmacy

 

  • Take your Lantus prescription to a pharmacy that partners with Christiana Care Health System. Confirm with your insurance provider to ascertain that the pharmacy is in-network.
  •  

  • Present your insurance card and any prior authorization documents to streamline the process.

 

Monitor Your Coverage

 

  • Keep track of any changes or updates in your insurance policy terms provided by Christiana Care Health System regarding Lantus coverage.
  •  

  • Reach out to the pharmacy or Christiana Care's customer service if you face any issues accessing your insulin or encounter unexpected costs.

 

Review and Adjust as Necessary

 

  • Regularly review your insurance plan during open enrollment periods to ensure ongoing coverage of Lantus. Discuss any possible changes in formulary or co-pay adjustments with your insurance representative.
  •  

  • Consider discussing with your healthcare provider or insurance company if alternative treatment options are more favorable according to new policy adjustments.

 

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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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