Does Humana Cover Farxiga

Discover how to obtain Farxiga coverage with Humana, reasons for denial, uninsured costs, and answers to common questions in this informative article.
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Coverage for Farxiga by Humana

 

  • Humana may cover Farxiga, primarily used to treat type 2 diabetes, under specific prescription plans.
  •  

  • Coverage depends on your specific plan's formulary; check if Farxiga is listed.
  •  

  • Prescription criteria usually require a diagnosis of type 2 diabetes or heart failure.
  •  

  • Prior authorization may be necessary, requiring your doctor to justify the medical necessity of Farxiga.
  •  

  • Some plans may necessitate trying other medications before covering Farxiga (step therapy).
  •  

  • Check with Humana customer service or your healthcare provider for detailed rules and personalized eligibility verification.

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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.

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 Farxiga Coverage with Humana

 

Overview of Farxiga and Humana Coverage

 

  • Farxiga is a medication used to manage type 2 diabetes, heart failure, and chronic kidney disease. To ensure you're covered through Humana, review Humana's formulary to see Farxiga's status.
  •  

  • Humana offers various plans; ensure you check if your specific plan covers Farxiga under its drug formulary.

 

Review Your Humana Plan

 

  • Visit the Humana website and log into your member account to access your plan details.
  •  

  • Search for the prescription drug coverage or formulary section to confirm if Farxiga is listed.

 

Consult with Your Healthcare Provider

 

  • Discuss with your doctor about your need for Farxiga and obtain a prescription.
  •  

  • Ask your healthcare provider for assistance with obtaining a prior authorization if required by Humana.

 

Contact Humana Customer Service

 

  • Call Humana's customer service for clarification on coverage and any potential out-of-pocket costs associated with Farxiga.
  •  

  • Ask about any requirements for prior authorization, step therapy, or quantity limits for Farxiga.

 

Submit Required Documentation

 

  • If prior authorization is required, have your healthcare provider submit the necessary forms and documents to Humana.
  •  

  • Ensure all paperwork is filled out correctly to avoid delays in getting approval.

 

Review Approval Status

 

  • Once submitted, regularly check the status of your prior authorization request through your Humana account or by calling customer service.
  •  

  • Be prepared to provide additional information if requested for the authorization process.

 

Pursue Alternatives if Necessary

 

  • If coverage is denied, consult with your healthcare provider about alternative medications covered by your Humana plan.
  •  

  • Consider filing an appeal with Humana if you believe Farxiga is medically necessary for your treatment.

 

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FAQs

Does Humana Cover Farxiga

Discover how to obtain Farxiga coverage with Humana, reasons for denial, uninsured costs, and answers to common questions in this informative article.
Curex allergy drops unboxing

Is Farxiga Covered by Humana

 

Coverage for Farxiga by Humana

 

  • Humana may cover Farxiga, primarily used to treat type 2 diabetes, under specific prescription plans.
  •  

  • Coverage depends on your specific plan's formulary; check if Farxiga is listed.
  •  

  • Prescription criteria usually require a diagnosis of type 2 diabetes or heart failure.
  •  

  • Prior authorization may be necessary, requiring your doctor to justify the medical necessity of Farxiga.
  •  

  • Some plans may necessitate trying other medications before covering Farxiga (step therapy).
  •  

  • Check with Humana customer service or your healthcare provider for detailed rules and personalized eligibility verification.

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Humana's Approved Criteria for Farxiga Coverage

 

Eligibility for Farxiga Coverage

 

  • Patient has a diagnosis of type 2 diabetes mellitus and requires additional glycemic control.
  •  

  • Individual is diagnosed with heart failure, and Farxiga is prescribed to reduce the risk of cardiovascular death and hospitalization.
  •  

  • Diagnosis of chronic kidney disease (CKD), and Farxiga is part of the treatment plan to reduce the risk of kidney disease progression, cardiovascular death, and hospitalization for heart failure.

 

Prior Authorization Requirements

 

  • Documentation proving failure, intolerance, or contraindication to other preferred oral antidiabetic medications unless Farxiga is part of the treatment plan for CKD or heart failure.
  •  

  • Evidence of appropriate dosing as per FDA-approved guidelines, aligning with the patient’s diagnosis and treatment plan.

 

Patient Monitoring and Reassessment

 

  • Submission of updated clinical notes reflecting ongoing evaluation and effectiveness of Farxiga in the treatment regime, especially in chronic kidney disease, heart failure, or type 2 diabetes management.
  •  

  • Requirement for periodic re-authorization to ensure the medication continues to be appropriate and effective for the patient's current health condition.

 

Collaboration with Healthcare Providers

 

  • Coordination with healthcare professionals including endocrinologists, cardiologists, or nephrologists as relevant to the use of Farxiga in the treatment plan.
  •  

  • Collaboration to ensure compliance with Humana’s criteria and to facilitate smooth access to necessary documentation and patient information.

 

Why Humana Might Deny Farxiga Coverage

 

Reasons Humana Might Deny Farxiga Coverage

 

  • **Prescription Not Medically Necessary:** Humana may deny coverage if the prescribed use of Farxiga does not align with medical necessity criteria defined by the insurance plan.
  •  

  • **Alternative Treatments Available:** If there are less costly or equally effective alternative medications or treatments available, Humana might choose not to cover Farxiga.
  •  

  • **Off-Label Use:** Farxiga prescribed for conditions not approved by the FDA, or not approved in Humana’s policy, can lead to denial of coverage.
  •  

  • **Step Therapy Requirements Not Met:** Humana might require trying other medications first (step therapy) and can deny coverage if these requirements haven't been fulfilled.
  •  

  • **Lack of Preauthorization:** If preauthorization was required but not obtained prior to prescribing Farxiga, coverage might be denied.
  •  

  • **Non-Compliance with Plan Requirements:** Denial can occur if there's a failure to meet specific plan requirements, such as incomplete patient information or missing documentation.
  •  

  • **Insurance Plan Exclusions:** Some insurance plans may have specific exclusions for certain drugs or drug categories, including Farxiga.

 

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How Much Does Farxiga Cost without Insurance?

 

Estimated Cost of Farxiga Without Insurance

 

  • Farxiga, a medication used primarily for the management of type 2 diabetes and certain forms of heart failure, can be quite costly without insurance coverage.
  •  

  • The cash price for Farxiga typically ranges between $500 and $550 for a 30-day supply, depending on the pharmacy and location.
  •  

  • Some pharmacies may offer discount programs or cards that can slightly lower this cost, but significant savings are usually only available through insurance coverage.
  •  

  • Always consider checking with multiple pharmacies or online services where discounts might be more prevalent.

 

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 Farxiga Coverage with Humana

 

Overview of Farxiga and Humana Coverage

 

  • Farxiga is a medication used to manage type 2 diabetes, heart failure, and chronic kidney disease. To ensure you're covered through Humana, review Humana's formulary to see Farxiga's status.
  •  

  • Humana offers various plans; ensure you check if your specific plan covers Farxiga under its drug formulary.

 

Review Your Humana Plan

 

  • Visit the Humana website and log into your member account to access your plan details.
  •  

  • Search for the prescription drug coverage or formulary section to confirm if Farxiga is listed.

 

Consult with Your Healthcare Provider

 

  • Discuss with your doctor about your need for Farxiga and obtain a prescription.
  •  

  • Ask your healthcare provider for assistance with obtaining a prior authorization if required by Humana.

 

Contact Humana Customer Service

 

  • Call Humana's customer service for clarification on coverage and any potential out-of-pocket costs associated with Farxiga.
  •  

  • Ask about any requirements for prior authorization, step therapy, or quantity limits for Farxiga.

 

Submit Required Documentation

 

  • If prior authorization is required, have your healthcare provider submit the necessary forms and documents to Humana.
  •  

  • Ensure all paperwork is filled out correctly to avoid delays in getting approval.

 

Review Approval Status

 

  • Once submitted, regularly check the status of your prior authorization request through your Humana account or by calling customer service.
  •  

  • Be prepared to provide additional information if requested for the authorization process.

 

Pursue Alternatives if Necessary

 

  • If coverage is denied, consult with your healthcare provider about alternative medications covered by your Humana plan.
  •  

  • Consider filing an appeal with Humana if you believe Farxiga is medically necessary for your treatment.

 

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Farxiga FAQ

What are the side effects of Farxiga?

 

Common Side Effects of Farxiga

 

  • Increased urination due to its diuretic effect, which may lead to dehydration. Maintain adequate hydration.
  • Potential urinary tract infections or yeast infections in genital areas, due to changes in the urinary environment.

 

Metabolic Effects

 

  • Weight loss can occur, linked to its mechanism of expelling glucose via urine.
  • Electrolyte imbalances, such as elevated potassium levels in blood, may appear in some cases.

 

Serious Reactions

 

  • Ketoacidosis risk: Watch for symptoms like nausea, vomiting, or abdominal pain.
  • Rarely, serious infections like Fournier's gangrene can develop. Seek immediate attention if you notice pain, redness, or swelling in genital or anal areas.

 

Can Farxiga help with weight loss?

 

Can Farxiga Aid Weight Loss?

 

  • Farxiga (dapagliflozin) is primarily a medication for managing type 2 diabetes and heart failure. It helps control blood sugar by promoting the excretion of glucose through urine.
  •  

  • Though not prescribed primarily for weight loss, some patients experience weight reduction as a secondary benefit.
  •  

  • Weight loss occurs because Farxiga facilitates the removal of excess calories in the form of glucose. However, the effect is usually modest and not guaranteed for everyone.
  •  

  • Consult a healthcare professional to understand if Farxiga is suitable for your condition and weight management goals.

 

Is Farxiga used for heart failure treatment?

 

Farxiga for Heart Failure

 

  • Farxiga (dapagliflozin) is primarily a SGLT2 inhibitor, initially developed to treat type 2 diabetes by helping the kidneys excrete glucose.
  •  

  • Recent studies have shown Farxiga's efficacy in heart failure management, particularly heart failure with reduced ejection fraction (HFrEF), by reducing hospitalizations and improving cardiovascular outcomes.
  •  

  • The medication works by decreasing fluid overload and blood pressure, lessening the heart's workload.
  •  

  • Farxiga is approved for heart failure treatment regardless of diabetes status, broadening its use in cardiology.
  •  

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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.

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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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