$49$0.99

Does EmblemHealth Cover Trulicity

Explore EmblemHealth's Trulicity coverage, reasons for denial, steps to secure approval, costs without insurance, and common questions answered.

Treat your allergies with Curex

as seen on

“Curex is changing the landscape of allergies in 2024”

EmblemHealth Coverage for Trulicity

Trulicity is covered by EmblemHealth primarily under its prescription drug plans. The exact coverage can vary depending on your specific plan within EmblemHealth.

To qualify for coverage, you often need a prior authorization from your healthcare provider, demonstrating medical necessity.

Coverage typically includes people diagnosed with type 2 diabetes who require Trulicity as part of their treatment plan.

Patients may face a copay or coinsurance; specific amounts depend on their individual plan benefits and tier placement of Trulicity.

Generic alternatives might be preferred; hence, documentation supporting Trulicity's necessity over alternatives might be needed.

It’s crucial to consult with EmblemHealth directly or review your plan details for precise information on coverage, including any network pharmacy restrictions.

Want to try immunotherapy?

Start with Curex

Covered

Uncovered

Treat your allergies with Curex - $49 $9.99

Review your allergy test results with a Curex allergist.

Start Now

Clinical Support

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 Trulicity Coverage with EmblemHealth

Verify Your Insurance Plan

Check your EmblemHealth insurance plan details on the official EmblemHealth website or through your member account. This will provide information on what your plan covers regarding prescriptions.

Look for any specific coverage terms related to Trulicity or similar medications. Some plans may have restrictions or prerequisites.

Consult with Your Healthcare Provider

Discuss your need for Trulicity with your healthcare provider. Ensure they provide a diagnosis and prescription that aligns with EmblemHealth's coverage requirements.

Your healthcare provider might need to submit prior authorization or additional documentation to support the medical necessity of Trulicity.

Contact EmblemHealth

Reach out to EmblemHealth's customer service for clarification on the process of obtaining medication coverage. You can find their contact information on their official website and through your member account portal.

Discuss your need for Trulicity and ask if there are specific programs or coverage options available.

Submit a Prior Authorization Request

If required, work with your healthcare provider to submit a prior authorization request. This is often necessary when medications like Trulicity are not on the standard formulary list.

Ensure all required documentation, including the provider's notes and the necessity of the medication, is included in the submission.

Explore EmblemHealth's Prescription Programs

Investigate if EmblemHealth offers any special savings programs or wellness benefits that may help offset the cost of Trulicity.

Some insurance providers offer pharmacy networks where you can get medications at reduced prices, so ask if EmblemHealth has similar arrangements.

Appeal if Necessary

If your initial request for coverage is denied, you have the right to appeal the decision. EmblemHealth provides a process for appeals, which can be found in your policy documents or by contacting customer service.

Gather all supportive documents from your healthcare provider and prepare a comprehensive appeal statement explaining the necessity of Trulicity for your treatment.

Use EmblemHealth's Preferred Pharmacies

Determine if EmblemHealth has a list of preferred pharmacies. Filling your prescription at one of these pharmacies might lead to lower costs.

Ensure the pharmacy you choose is part of the EmblemHealth network to maximize your plan benefits.

Happy Customers

We love helping people!

Allie, Nevada

"I have two cats I can finally cuddle!"
‍

Cat and dog allergies

Zachary, Texas

“I can breathe through my nose for the first time in like 20 years!"

Dust and mold allergies

Erika, New York

“I've noticed less sneezing and shortness of breath.”

Tree and grass allergies

Richard, Texas

I love the convenience!
‍

Tree and cat allergies

We Treat Allergies

Food Allergies

Weed Pollens

Cat Allergies

Dog Allergies

Dust Mites

Molds

Tree Pollens

curex user showing allergy treatment kit

a male patient showing allergy drops vial

50,000+ users have overcome their allergies

Am I eligible?

At-home Immunotherapy

Benefits of Curex

At-home treatment

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

5-30x higher cumulative dose vs allergy shots

Sublingual immunotherapy delivers a higher dose of allergens over the course of treatment.

Potential for results in as few as 6 months

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

Excellent safety profile

Studies that have been reviewed by certified physicians show that sublingual immunotherapy is a safe treatment option

Treatment prescribed
by clinician

Clinicaly made allergen extracts are customized for your allergies

Your immune system gets desensitized to allergens, giving you long-term relief.

FAQs

Does EmblemHealth Cover Trulicity

Explore EmblemHealth's Trulicity coverage, reasons for denial, steps to secure approval, costs without insurance, and common questions answered.

Achieve Your Goals Faster with Curex

Is Trulicity Covered by EmblemHealth

EmblemHealth Coverage for Trulicity

Trulicity is covered by EmblemHealth primarily under its prescription drug plans. The exact coverage can vary depending on your specific plan within EmblemHealth.

To qualify for coverage, you often need a prior authorization from your healthcare provider, demonstrating medical necessity.

Coverage typically includes people diagnosed with type 2 diabetes who require Trulicity as part of their treatment plan.

Patients may face a copay or coinsurance; specific amounts depend on their individual plan benefits and tier placement of Trulicity.

Generic alternatives might be preferred; hence, documentation supporting Trulicity's necessity over alternatives might be needed.

It’s crucial to consult with EmblemHealth directly or review your plan details for precise information on coverage, including any network pharmacy restrictions.

A weight management program tailored to you

Start with Curex

EmblemHealth's Approved Criteria for Trulicity Coverage

Eligibility Criteria for Trulicity Coverage

Patient must have a documented diagnosis of type 2 diabetes mellitus.

Trulicity may be prescribed as part of a comprehensive diabetes treatment plan alongside dietary management and exercise.

Patient must be 18 years of age or older.

Trulicity should be prescribed by a healthcare provider specializing in diabetes care, such as an endocrinologist or primary care physician.

Medical Necessity Documentation

Documentation must demonstrate that the patient has not achieved adequate glycemic control on metformin or other first-line therapy, unless contraindicated or not tolerated.

Records indicating patient's HbA1c levels or other glycemic measurements should be included to support the need for Trulicity.

Concurrent Medication Management

Patients using Trulicity must not be concurrently using another GLP-1 receptor agonist.

Regular monitoring should be conducted to evaluate the effectiveness of Trulicity as part of the patient's management regimen.

Requirement for Continuous Treatment Review

Coverage for Trulicity requires regular follow-up assessments to determine ongoing eligibility and treatment effectiveness.

Updates to patient’s treatment plan and records of periodic evaluations should be documented for continued coverage.

Why EmblemHealth Might Deny Trulicity Coverage

Reasons for Denial of Trulicity Coverage

**Non-Formulary Drug:** Trulicity may not be listed on EmblemHealth's formulary, leading to denial if certain criteria are not met.

**Off-Label Use:** If Trulicity is prescribed for conditions not approved by the FDA or not listed in the coverage policy, it could result in denial.

**Lack of Medical Necessity:** EmblemHealth may deny coverage if the use of Trulicity is not deemed medically necessary based on their criteria.

**Incomplete Documentation:** Failure to provide necessary documentation supporting the need for Trulicity may lead to a denial.

**Failure to Use Preferred Alternatives:** If Trulicity is not a first-line medication, and preferred alternatives have not been tried or are not documented as ineffective, coverage might be denied.

**Step Therapy Requirements:** If EmblemHealth has specific step therapy protocols that have not been followed prior to the prescription of Trulicity, coverage can be denied.

**Absence of Prior Authorization:** Trulicity might require prior authorization, and coverage may be denied if this process is not completed.

**Exclusion from Plan Benefits:** If the health plan specifically excludes coverage for GLP-1 receptor agonists or injectables within the policy, Trulicity will not be covered.

**Exceeding Dosage Limits:** If prescribed dosage exceeds the plan's established limits, Trulicity may not be covered.

**Policy Changes:** Updates to EmblemHealth's drug coverage policies that exclude certain medications can result in Trulicity being denied if it has been removed from coverage.

Together with our partners we have changed the lives of over 300,000 patients.

Join Curex

How Much Does Trulicity Cost without Insurance?

Trulicity Cost Overview

Trulicity is a brand-name medication commonly used to treat type 2 diabetes. It's administered through a weekly injection.

Approximate Cost Without Insurance

The price of Trulicity can vary depending on the pharmacy or location, but the average cost for one pen of 1.5 mg/0.5 mL solution might run approximately $886 to $1,100.
Each box typically contains four pens, which is a month's supply, resulting in the total cost being roughly $3,544 to $4,400.

Factors Influencing Pricing

Pharmacy: Prices may differ from one pharmacy to another, so it’s beneficial to compare costs.
Location: Costs may vary based on geographic location due to regional pricing strategies and pharmacy benefits.
Discount Programs: Some pharmacies may offer savings programs or coupons that could lower the price.

Additional Cost-Saving Tips

Check for manufacturer discounts or patient assistance programs, which may offer significant savings or even free medication for qualified individuals.
Consider discussing alternative medications with your healthcare provider to find a more affordable option suitable for your needs.
Utilize pharmacy discount cards or look up savings programs online that specifically cater to diabetes medications.

Clinical Support

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

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

Kayla Mardaga, NP

How to Get Trulicity Coverage with EmblemHealth

Verify Your Insurance Plan

Check your EmblemHealth insurance plan details on the official EmblemHealth website or through your member account. This will provide information on what your plan covers regarding prescriptions.

Look for any specific coverage terms related to Trulicity or similar medications. Some plans may have restrictions or prerequisites.

Consult with Your Healthcare Provider

Discuss your need for Trulicity with your healthcare provider. Ensure they provide a diagnosis and prescription that aligns with EmblemHealth's coverage requirements.

Your healthcare provider might need to submit prior authorization or additional documentation to support the medical necessity of Trulicity.

Contact EmblemHealth

Reach out to EmblemHealth's customer service for clarification on the process of obtaining medication coverage. You can find their contact information on their official website and through your member account portal.

Discuss your need for Trulicity and ask if there are specific programs or coverage options available.

Submit a Prior Authorization Request

If required, work with your healthcare provider to submit a prior authorization request. This is often necessary when medications like Trulicity are not on the standard formulary list.

Ensure all required documentation, including the provider's notes and the necessity of the medication, is included in the submission.

Explore EmblemHealth's Prescription Programs

Investigate if EmblemHealth offers any special savings programs or wellness benefits that may help offset the cost of Trulicity.

Some insurance providers offer pharmacy networks where you can get medications at reduced prices, so ask if EmblemHealth has similar arrangements.

Appeal if Necessary

If your initial request for coverage is denied, you have the right to appeal the decision. EmblemHealth provides a process for appeals, which can be found in your policy documents or by contacting customer service.

Gather all supportive documents from your healthcare provider and prepare a comprehensive appeal statement explaining the necessity of Trulicity for your treatment.

Use EmblemHealth's Preferred Pharmacies

Determine if EmblemHealth has a list of preferred pharmacies. Filling your prescription at one of these pharmacies might lead to lower costs.

Ensure the pharmacy you choose is part of the EmblemHealth network to maximize your plan benefits.

Premium Medication you can trust

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.

‍

Each pharmacy in our network undergoes rigorous third-party testing through FDA and DEA certified labs. These tests focus on four key elements, ensuring both safety and efficacy for our treatments.

Trulicity FAQ

What are the common side effects of Trulicity?

Common Side Effects of Trulicity

Nausea: Initially, many patients experience nausea, which often lessens over time as the body adjusts.

Vomiting: Some individuals may experience vomiting, particularly in the first few doses.

Diarrhea: Digestive disturbances such as diarrhea are commonly reported.

Abdominal Pain: Discomfort in the abdomen can occur, often subsiding with continued use.

Decreased Appetite: Patients often report a reduction in appetite.

Fatigue: Some individuals may feel unusually tired after starting treatment.

Reduced Blood Sugar: Blood sugar levels may become low, especially when used in conjunction with other diabetes medications.

How much weight can you lose on Trulicity?

Weight Loss with Trulicity

Trulicity (dulaglutide) is primarily prescribed for managing type 2 diabetes, but many patients also experience weight loss as an additional benefit.

Clinical trials indicate an average weight loss of around 2-6 pounds, but results differ based on individual factors such as diet, exercise, and adherence to the medication.

Some users report greater weight loss; however, it's important to accompany Trulicity with lifestyle changes for optimal results.

Consult with a healthcare provider to tailor a plan that maximizes benefits based on your health needs.

How does Trulicity work for type 2 diabetes?

How Trulicity Works

Trulicity is a GLP-1 receptor agonist, helping to regulate blood sugar levels.

It stimulates insulin release in response to high blood glucose.

It slows gastric emptying, which helps reduce post-meal glucose spikes.

Trulicity suppresses glucagon secretion, lowering glucose production by the liver.

Benefits

Easy-to-use once-weekly injection, improving adherence.

Not associated with causing weight gain; may even promote modest weight loss.

May reduce risk of cardiovascular events in patients with heart disease.

Considerations

May cause gastrointestinal side effects, often resolving over time.

Inform your doctor if you have a history of pancreatitis or gallbladder disease.

Monitor for signs of low blood sugar, especially if using other diabetes medications.

Have questions left?

‍

Get a personalized online consultation with a doctor at Curex

Learn More

Curex is one of America’s largest telehealth providers

Together with our partners we have changed the lives of over 300,000 patients. Here’s what some of them have to say:

“Curex has performed beyond my expectations. I am feeling tremendously better and look forward to continuing the treatment.”

Becky D.

"If I could give 6 stars, I would. BEST... BEST… BEST… service.”

Ferdian K.

“The Curex staff has been professional, efficient, and really focused on my individual needs.”

Ana C.

Start your
journey now

Everything you need is included:

Online consultation

Your prescription

Premium medication

Overnight shipping

Ongoing support

Button Text

A weight management program tailored to you

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. 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?

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.

Can you prescribe Ozempic®* or Wegovy®*?

Our providers focus on personalized medications and dosages that aren’t commercially available at your local pharmacy. We don’t prescribe Ozempic®* or Wegovy®.* We may prescribe treatments containing compounded semaglutide or tirzepatide. 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.

Does EmblemHealth Cover Trulicity

Explore EmblemHealth's Trulicity coverage, reasons for denial, steps to secure approval, costs without insurance, and common questions answered.

Achieve Your Goals Faster with Curex