$49$0.99

Does Harvard Pilgrim Health Care Cover Trulicity

Find out if Harvard Pilgrim covers Trulicity, reasons for denial, how to secure coverage, costs without insurance, and get answers to common Trulicity questions.

Treat your allergies with Curex

as seen on

“Curex is changing the landscape of allergies in 2024”

Does Harvard Pilgrim Health Care Cover Trulicity?

Harvard Pilgrim Health Care may cover Trulicity as part of their prescription drug plans, subject to specific criteria and limitations outlined in individual plans.

Coverage typically applies to individuals diagnosed with Type 2 Diabetes, who require this medication as part of their treatment regimen.

Prior authorization may be required, meaning healthcare providers must demonstrate medical necessity before approval.

Patients may need to try alternative medications first, as part of step therapy protocols, before Trulicity is approved.

Members should check their specific plan details or contact customer service to confirm coverage, co-pay amounts, and any other requirements.

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 Harvard Pilgrim Health Care

Initiate with Harvard Pilgrim Health Care

Visit the official Harvard Pilgrim Health Care website to gather information about their prescription drug coverage policies.

Log in to your member account or create one if you haven’t registered yet. This access allows you to view your plan details and see the coverage options available to you.

Check Trulicity Coverage

Navigate to the Prescription Drug section on the member portal to understand the formulary they provide.

Search for Trulicity in the formulary list to see if it is covered under your specific health plan.

If it's not covered, look for any alternative medications that are covered or contact Harvard Pilgrim customer service for more information.

Consult Your Healthcare Provider

Discuss with your healthcare provider about your need for Trulicity and inquire if there is any necessary prior authorization needed from Harvard Pilgrim.

Your healthcare provider can also provide alternative treatment options or help in justifying the necessity for Trulicity.

Request a Prior Authorization

If Trulicity requires prior authorization, your healthcare provider needs to submit the request on your behalf.

Ensure that your provider completes all the necessary paperwork and submits any required clinical documentation effectively.

Follow up with Harvard Pilgrim to track the progress of your authorization request.

Appeal a Denied Request

In the case that your authorization request is denied, refer to the denial letter for guidance on how to appeal the decision.

Work with your healthcare provider to gather additional information or documentation that supports the medical necessity for Trulicity.

Submit an appeal following Harvard Pilgrim’s specified process and timeline.

Explore Financial Assistance Programs

If your plan does not cover Trulicity completely, you might qualify for financial assistance programs.

Contact Trulicity's manufacturer, Eli Lilly, as they may provide patient assistance programs or discount options.

Check with Harvard Pilgrim for any additional patient programs that might reduce medication costs.

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 Harvard Pilgrim Health Care Cover Trulicity

Find out if Harvard Pilgrim covers Trulicity, reasons for denial, how to secure coverage, costs without insurance, and get answers to common Trulicity questions.

Achieve Your Goals Faster with Curex

Is Trulicity Covered by Harvard Pilgrim Health Care

Does Harvard Pilgrim Health Care Cover Trulicity?

Harvard Pilgrim Health Care may cover Trulicity as part of their prescription drug plans, subject to specific criteria and limitations outlined in individual plans.

Coverage typically applies to individuals diagnosed with Type 2 Diabetes, who require this medication as part of their treatment regimen.

Prior authorization may be required, meaning healthcare providers must demonstrate medical necessity before approval.

Patients may need to try alternative medications first, as part of step therapy protocols, before Trulicity is approved.

Members should check their specific plan details or contact customer service to confirm coverage, co-pay amounts, and any other requirements.

A weight management program tailored to you

Start with Curex

Harvard Pilgrim Health Care's Approved Criteria for Trulicity Coverage

Eligibility for Coverage

Harvard Pilgrim Health Care covers Trulicity for patients diagnosed with Type 2 Diabetes Mellitus (T2DM).

Patients must be adults aged 18 years or older.

Candidates should have inadequate glycemic control despite diet and exercise modifications.

Previous Treatment Requirements

Patients must have tried and demonstrated insufficient response or have a contraindication to metformin treatment.

Must have considered and shown intolerance or inadequate response to at least one other oral antidiabetic medication (e.g., sulfonylureas, DPP-4 inhibitors).

Concurrent Medication Stipulations

Trulicity may be covered for use in combination with other antidiabetic medications, provided the therapeutic need lacks coverage with other medications alone.

Usage must be part of a comprehensive treatment plan, including diet and exercise adjustments.

Monitoring and Follow-Up

Patients must agree to regular follow-ups with their healthcare provider to evaluate the efficacy and safety of Trulicity therapy.

Coverage includes initial and ongoing assessments of A1C levels to confirm and maintain the benefit of therapy.

Why Harvard Pilgrim Health Care Might Deny Trulicity Coverage

Reasons for Denial of Trulicity Coverage

Trulicity is not prescribed for an FDA-approved indication. Harvard Pilgrim Health Care may deny coverage if the medication is being used for a condition that has not received FDA approval for treatment with Trulicity.

Lack of medical necessity. If there is insufficient evidence provided in the patient's medical records to demonstrate that Trulicity is medically necessary for the treatment of the patient's condition, coverage may be denied.

Prior authorization not obtained. Harvard Pilgrim Health Care requires prior authorization for Trulicity coverage. Failure to obtain this approval before dispensing the medication will result in denial of coverage.

Failure to meet step therapy requirements. If a patient has not tried and failed other preferred medications or treatments first, as dictated by the step therapy policy, Trulicity coverage may be denied.

Off-label usage. Coverage might be denied if Trulicity is prescribed for an off-label use that is not supported by peer-reviewed medical literature or widely accepted medical guidelines.

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 Harvard Pilgrim Health Care

Initiate with Harvard Pilgrim Health Care

Visit the official Harvard Pilgrim Health Care website to gather information about their prescription drug coverage policies.

Log in to your member account or create one if you haven’t registered yet. This access allows you to view your plan details and see the coverage options available to you.

Check Trulicity Coverage

Navigate to the Prescription Drug section on the member portal to understand the formulary they provide.

Search for Trulicity in the formulary list to see if it is covered under your specific health plan.

If it's not covered, look for any alternative medications that are covered or contact Harvard Pilgrim customer service for more information.

Consult Your Healthcare Provider

Discuss with your healthcare provider about your need for Trulicity and inquire if there is any necessary prior authorization needed from Harvard Pilgrim.

Your healthcare provider can also provide alternative treatment options or help in justifying the necessity for Trulicity.

Request a Prior Authorization

If Trulicity requires prior authorization, your healthcare provider needs to submit the request on your behalf.

Ensure that your provider completes all the necessary paperwork and submits any required clinical documentation effectively.

Follow up with Harvard Pilgrim to track the progress of your authorization request.

Appeal a Denied Request

In the case that your authorization request is denied, refer to the denial letter for guidance on how to appeal the decision.

Work with your healthcare provider to gather additional information or documentation that supports the medical necessity for Trulicity.

Submit an appeal following Harvard Pilgrim’s specified process and timeline.

Explore Financial Assistance Programs

If your plan does not cover Trulicity completely, you might qualify for financial assistance programs.

Contact Trulicity's manufacturer, Eli Lilly, as they may provide patient assistance programs or discount options.

Check with Harvard Pilgrim for any additional patient programs that might reduce medication costs.

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 Harvard Pilgrim Health Care Cover Trulicity

Find out if Harvard Pilgrim covers Trulicity, reasons for denial, how to secure coverage, costs without insurance, and get answers to common Trulicity questions.

Achieve Your Goals Faster with Curex