Does Cigna Cover Diethylpropion (Tenuate)

Explore Cigna's coverage of Diethylpropion, how to appeal denials, cost without insurance, and FAQs in this comprehensive guide.
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Cigna Coverage for Diethylpropion (Tenuate)

 

  • Cigna may cover Diethylpropion (Tenuate) if it is prescribed for weight loss in cases where other methods have not been effective.
  •  

  • Coverage usually depends on your specific plan and requires a prior authorization to ensure medical necessity.
  •  

  • Only patients with obesity-related conditions or those with a body mass index (BMI) often higher than a specified limit might qualify.
  •  

  • Documentation from the healthcare provider detailing previous weight loss attempts is often necessary.
  •  

  • Cigna might require periodic follow-ups to assess the efficacy of the medication.
  •  

  • Some plans might have a restriction on the duration for which the drug is covered, usually reviewed on a short-term basis.

 

Remember to check with your specific Cigna plan and consult with your healthcare provider for individualized requirements and coverage.

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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.

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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.

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

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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 Diethylpropion (Tenuate) Coverage with Cigna

 

Check Your Plan Details

 

  • Log in to your Cigna account via their official website or app.
  •  
  • Navigate to the prescription drug coverage section to review your current plan details.
  •  
  • Look for any mention of weight loss medications or specific mentions of Diethylpropion (Tenuate).

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Diethylpropion (Tenuate).
  •  
  • Obtain a prescription and ensure that your healthcare provider includes necessary information that may be needed for insurance coverage, such as BMI, health history, and attempted weight loss methods.

 

Contact Cigna Customer Service

 

  • Reach out to Cigna's customer service to inquire about coverage specifics for Diethylpropion (Tenuate) under your plan.
  •  
  • Ask for details on any prior authorization or step therapy requirements that might be applicable.

 

Submit a Prior Authorization Request

 

  • Work with your healthcare provider to submit a prior authorization request if required by Cigna.
  •  
  • Ensure all necessary documents and justifications are included to facilitate approval.

 

Appeal a Denied Request

 

  • If your request is denied, review Cigna's appeal process detailed on their website or in any denial correspondence.
  •  
  • Gather any additional supporting documentation from your healthcare provider, emphasizing medical necessity.
  •  
  • Submit the appeal promptly, following the instructions provided by Cigna.

 

Explore Additional Savings Programs

 

  • Check if Cigna offers any prescription discount programs or patient assistance options for Diethylpropion (Tenuate).
  •  
  • Consider third-party savings programs or coupons that might offer discounts on your prescription.

 

Re-evaluate Your Coverage Annually

 

  • Annually review your Cigna plan during open enrollment to ensure it continues to meet your medication needs.
  •  
  • Consider switching to a plan that provides better coverage for Diethylpropion (Tenuate) if necessary.

 

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FAQs

Does Cigna Cover Diethylpropion (Tenuate)

Explore Cigna's coverage of Diethylpropion, how to appeal denials, cost without insurance, and FAQs in this comprehensive guide.
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Is Diethylpropion (Tenuate) Covered by Cigna

 

Cigna Coverage for Diethylpropion (Tenuate)

 

  • Cigna may cover Diethylpropion (Tenuate) if it is prescribed for weight loss in cases where other methods have not been effective.
  •  

  • Coverage usually depends on your specific plan and requires a prior authorization to ensure medical necessity.
  •  

  • Only patients with obesity-related conditions or those with a body mass index (BMI) often higher than a specified limit might qualify.
  •  

  • Documentation from the healthcare provider detailing previous weight loss attempts is often necessary.
  •  

  • Cigna might require periodic follow-ups to assess the efficacy of the medication.
  •  

  • Some plans might have a restriction on the duration for which the drug is covered, usually reviewed on a short-term basis.

 

Remember to check with your specific Cigna plan and consult with your healthcare provider for individualized requirements and coverage.

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Cigna's Approved Criteria for Diethylpropion (Tenuate) Coverage

 

Coverage Criteria for Diethylpropion (Tenuate)

 

  • Diethylpropion (Tenuate) is covered for individuals who have been diagnosed with obesity. This is typically defined as a body mass index (BMI) of 30 kg/m² or higher. Alternatively, coverage may be available for individuals with a BMI of 27 kg/m² or higher if associated with related conditions such as hypertension, type 2 diabetes, or dyslipidemia.
  •  

  • The patient must be enrolled in a comprehensive weight-management program. This should include a structured diet and exercise regimen directed by healthcare professionals.
  •  

  • The prescribing physician must provide documentation showing that the patient has not achieved or maintained adequate weight loss with a structured weight-loss program alone.
  •  

  • Continued coverage for Diethylpropion (Tenuate) requires demonstration of response, defined as a weight loss of at least 4 pounds during the first 4 weeks of therapy (excluding the initial titration period).
  •  

  • Diethylpropion (Tenuate) should be used as part of a short-term plan for weight reduction, combined with exercise, lifestyle changes, and low-calorie diet. Sleeping aids, antianxiety medications, and antidepressants are excluded from concurrent usage.
  •  

  • Physician must provide evidence of monitoring the patient's progress and adjusting treatment as necessary to optimize outcomes and ensure patient safety.

 

Why Cigna Might Deny Diethylpropion (Tenuate) Coverage

 

Reasons for Coverage Denial of Diethylpropion (Tenuate)

 

  • The medication is utilized for cosmetic weight loss rather than for significant obesity with accompanying health risks.
  •  

  • There is a lack of supporting medical documentation justifying the need for Diethylpropion based on the patient's medical history and current health condition.
  •  

  • The patient has a contraindication for the use of Diethylpropion, such as severe hypertension or a history of cardiovascular disease.
  •  

  • The prescribed dosage exceeds the recommended guidelines without documented approval for a higher dose.
  •  

  • Diethylpropion is prescribed for a duration that exceeds the maximum approved treatment length without proper evaluation and justification.
  •  

  • The patient has previously demonstrated a lack of response to Diethylpropion, indicating inefficacy and making further coverage not medically necessary.
  •  

  • There is evidence of potential misuse or abuse of the medication, such as obtaining prescriptions from multiple providers.
  •  

 

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How Much Does Diethylpropion (Tenuate) Cost without Insurance?

 

Approximate Cost of Diethylpropion (Tenuate) Without Insurance

 

  • The cost of Diethylpropion (Tenuate), a prescription medication used for weight loss, can vary widely depending on the pharmacy location and any available discounts or generic alternatives.
  •  

  • On average, the price for a supply of 30, 75 mg controlled-release tablets can range from $50 to $100 without insurance.
  •  

  • For the immediate-release version, the cost for a supply of 30, 25 mg tablets is typically around $30 to $70 without insurance.
  •  

  • Prices can fluctuate due to factors such as location, manufacturer pricing, and availability of alternative generic options.
  •  

  • It's often beneficial to check with different pharmacies for any potential coupons or discounts that may further reduce the cost.

 

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 Diethylpropion (Tenuate) Coverage with Cigna

 

Check Your Plan Details

 

  • Log in to your Cigna account via their official website or app.
  •  
  • Navigate to the prescription drug coverage section to review your current plan details.
  •  
  • Look for any mention of weight loss medications or specific mentions of Diethylpropion (Tenuate).

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Diethylpropion (Tenuate).
  •  
  • Obtain a prescription and ensure that your healthcare provider includes necessary information that may be needed for insurance coverage, such as BMI, health history, and attempted weight loss methods.

 

Contact Cigna Customer Service

 

  • Reach out to Cigna's customer service to inquire about coverage specifics for Diethylpropion (Tenuate) under your plan.
  •  
  • Ask for details on any prior authorization or step therapy requirements that might be applicable.

 

Submit a Prior Authorization Request

 

  • Work with your healthcare provider to submit a prior authorization request if required by Cigna.
  •  
  • Ensure all necessary documents and justifications are included to facilitate approval.

 

Appeal a Denied Request

 

  • If your request is denied, review Cigna's appeal process detailed on their website or in any denial correspondence.
  •  
  • Gather any additional supporting documentation from your healthcare provider, emphasizing medical necessity.
  •  
  • Submit the appeal promptly, following the instructions provided by Cigna.

 

Explore Additional Savings Programs

 

  • Check if Cigna offers any prescription discount programs or patient assistance options for Diethylpropion (Tenuate).
  •  
  • Consider third-party savings programs or coupons that might offer discounts on your prescription.

 

Re-evaluate Your Coverage Annually

 

  • Annually review your Cigna plan during open enrollment to ensure it continues to meet your medication needs.
  •  
  • Consider switching to a plan that provides better coverage for Diethylpropion (Tenuate) if necessary.

 

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Diethylpropion (Tenuate) FAQ

What are the common side effects of Diethylpropion?

 

Common Side Effects of Diethylpropion

 

  • Diethylpropion may cause dizziness and drowsiness; avoid driving or operating heavy machinery if affected.
  •  

  • Patients often report headaches and insomnia. Adjust usage to early daytime to help mitigate insomnia.
  •  

  • It can lead to digestive issues like nausea, dry mouth, and constipation; drinking ample water and maintaining a balanced diet may assist.
  •  

  • Commonly, users experience increased heart rate or palpitations; seek medical advice if severe or persistent.
  •  

  • Nervousness and restlessness are possible; managing stress and limiting caffeine can be beneficial.

 

How effective is Diethylpropion for weight loss?

 

Effectiveness of Diethylpropion for Weight Loss

 

  • Diethylpropion is an appetite suppressant, aiding in short-term obesity management.
  •  

  • Primarily effective when combined with a structured diet and exercise plan.
  •  

  • Clinical studies show a modest weight reduction on average, typically around 3-4% body weight over 12 weeks.
  •  

  • Most beneficial in the initial phase of a weight loss program, stimulating early weight loss which can motivate further progress.
  •  

  • Advantages can diminish over time as appetite levels adjust, necessitating lifestyle modifications for sustained loss.
  •  

 

Considerations

 

  • Prescribed for short periods due to potential side effects and risk of dependency.
  •  

  • Not suitable for individuals with specific health conditions, such as cardiovascular disease or uncontrolled hypertension.

 

Is Diethylpropion similar to phentermine?

 

Overview of Diethylpropion and Phentermine

 

  • Both Diethylpropion and Phentermine are prescription medications classified as appetite suppressants and sympathomimetic amines.
  •  

  • They are primarily used to assist weight loss in individuals who are obese and have related risk factors such as diabetes or high blood pressure.

 

Mechanism of Action

 

  • Diethylpropion and Phentermine stimulate the central nervous system, increasing heart rate and blood pressure while decreasing appetite by affecting hypothalamic neurotransmitters.
  •  

  • Though they function similarly, Phentermine typically has a stronger effect and longer duration than Diethylpropion.

 

Potential Side Effects

 

  • Common side effects of both drugs include increased heart rate, dry mouth, insomnia, dizziness, and constipation.
  •  

  • Due to their stimulant properties, they pose a risk of dependency or abuse.

 

Usage Considerations

 

  • Both medications are intended for short-term use and should be accompanied by lifestyle changes like diet and exercise.
  •  

  • It's crucial to evaluate each individual's health status and history for a safe and effective treatment plan.

 

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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.

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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.

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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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