Does Humana Cover Trulicity

Explore why Humana may deny Trulicity, how to secure coverage, the costs without insurance, and answers to common FAQs in this comprehensive guide.
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Does Humana Cover Trulicity?

 

  • Humana does typically cover Trulicity, a medication for managing type 2 diabetes, under its pharmacy benefit plans. Coverage may vary based on the specific plan you have.
  •  

  • Most Humana plans require prior authorization for Trulicity, meaning your doctor must demonstrate medical necessity before the medication is approved for coverage.
  •  

  • Some plans may have tiered drug pricing, where Trulicity is categorized under a certain tier. This can affect the copayment or coinsurance amounts you are required to pay.
  •  

  • Eligibility for coverage may include having a prescription from your healthcare provider and meeting any specific criteria laid out by Humana, such as trying other medications first.
  •  

  • It's crucial to review your specific Humana plan details or contact Humana directly to confirm coverage specifics, including any potential out-of-pocket costs and formulary status.

 

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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.

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 Humana

 

Verify Trulicity Coverage with Humana

 

  • Check your current Humana insurance policy documents or the Humana online member portal to determine if Trulicity is included in your prescription drug coverage.
  •  

  • Contact Humana customer support at the number on your insurance card for clarification on coverage specific to Trulicity and inquire about any particular plan requirements.

 

Understand Your Prescription Plan

 

  • Identify the specific Humana plan you are enrolled in, as different plans may offer varying levels of drug coverage, including medications like Trulicity.
  •  

  • Review the plan’s formulary, a list of covered prescription drugs, to ensure Trulicity is classified under the medications available to you.

 

Consult with Your Healthcare Provider

 

  • Schedule a discussion with your doctor or healthcare provider to confirm that Trulicity is the recommended medication for your condition.
  •  

  • Ask your healthcare provider if they can provide prior authorization documentation if Humana requires it for Trulicity coverage.

 

Accessing Humana's Pharmacy Benefits

 

  • Log into the Humana member portal to review pharmacy benefits and identify any prerequisites for accessing Trulicity.
  •  

  • Explore Humana's preferred pharmacy network to find where you can fill your Trulicity prescription efficiently.

 

Addressing Coverage Issues

 

  • If Trulicity is not covered under your current policy, discuss with Humana customer service possible plan adjustments or upgrades that include Trulicity.
  •  

  • Consider Humana's Medicare Advantage or Part D plans, which may offer different coverage options, including Trulicity.

 

Understand the Costs

 

  • Review any co-pays, coinsurance, or deductibles associated with Trulicity under your Humana plan to understand potential out-of-pocket expenses.
  •  

  • Inquire about financial assistance programs or savings cards for Trulicity that Humana may participate in or recommend.

 

Follow Up

 

  • Ensure that your pharmacy is billing Humana correctly for Trulicity by confirming with your pharmacist after the initial prescription claim.
  •  

  • Contact Humana again if any discrepancies arise or for further clarification on long-term coverage options for maintaining Trulicity access.

 

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FAQs

Does Humana Cover Trulicity

Explore why Humana may deny Trulicity, how to secure coverage, the costs without insurance, and answers to common FAQs in this comprehensive guide.
Curex allergy drops unboxing

Is Trulicity Covered by Humana

 

Does Humana Cover Trulicity?

 

  • Humana does typically cover Trulicity, a medication for managing type 2 diabetes, under its pharmacy benefit plans. Coverage may vary based on the specific plan you have.
  •  

  • Most Humana plans require prior authorization for Trulicity, meaning your doctor must demonstrate medical necessity before the medication is approved for coverage.
  •  

  • Some plans may have tiered drug pricing, where Trulicity is categorized under a certain tier. This can affect the copayment or coinsurance amounts you are required to pay.
  •  

  • Eligibility for coverage may include having a prescription from your healthcare provider and meeting any specific criteria laid out by Humana, such as trying other medications first.
  •  

  • It's crucial to review your specific Humana plan details or contact Humana directly to confirm coverage specifics, including any potential out-of-pocket costs and formulary status.

 

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Humana's Approved Criteria for Trulicity Coverage

 

Trulicity Coverage Criteria by Humana

 

  • Trulicity is covered for individuals with a diagnosis of type 2 diabetes.
  •  

  • Coverage is applicable for patients who require assistance in controlling blood glucose levels as part of their therapeutic regimen.
  •  

  • Patients must have a documented history of inadequate glycemic control despite using diet and exercise alone or in combination with other antidiabetic agents.
  •  

  • Individuals are eligible for coverage if Trulicity is prescribed by a licensed healthcare provider specializing in diabetes management.
  •  

  • Trulicity may be covered when there is documented medical necessity, and the prescribing physician provides a clear rationale for its use.
  •  

  • Members may be evaluated for coverage if Trulicity is used as an adjunct therapy to improve blood sugar control, particularly in cases where alternative medications have not yielded desired outcomes.
  •  

  • Authorization for coverage may require periodic assessment of patient progress and confirmation that the treatment aligns with Humana’s clinical guidelines for diabetes management.
  •  

  • Trulicity is covered as part of a comprehensive treatment plan involving lifestyle modification and regular monitoring of blood glucose levels.
  •  

  • Coverage considerations include patient adherence to prescribed treatment protocols and engagement in recommended lifestyle changes to optimize therapeutic outcomes.

 

Why Humana Might Deny Trulicity Coverage

 

Conditions of Non-Coverage for Trulicity by Humana

 

  • **Non-FDA Approved Use:** If Trulicity is prescribed for a condition not approved by the FDA, Humana may deny coverage.
  •  

  • **Lack of Medical Necessity:** If Humana determines that Trulicity is not medically necessary for the patient's condition according to their policy guidelines, coverage might be denied.
  •  

  • **Excluded from Formulary:** If Trulicity is not listed on Humana's formulary or is on a tier that the patient’s plan excludes, the prescription may not be covered.
  •  

  • **Prior Authorization Requirements Not Met:** If Humana requires prior authorization for Trulicity and the necessary documentation or approval is not obtained, the claim may be denied.
  •  

  • **Step Therapy Not Completed:** If the patient hasn't tried other specified medications or treatments as part of Humana's step therapy protocol, coverage for Trulicity may be denied.
  •  

  • **Coverage Limitations or Caps:** If the patient has exceeded any coverage limits or caps for Trulicity set by Humana, further prescriptions might not be covered.
  •  

  • **Non-Compliance with Policy Terms:** If the patient is not compliant with other specific terms in their Humana policy or plan requirements, this might result in denial of Trulicity coverage.

 

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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.

 

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 Humana

 

Verify Trulicity Coverage with Humana

 

  • Check your current Humana insurance policy documents or the Humana online member portal to determine if Trulicity is included in your prescription drug coverage.
  •  

  • Contact Humana customer support at the number on your insurance card for clarification on coverage specific to Trulicity and inquire about any particular plan requirements.

 

Understand Your Prescription Plan

 

  • Identify the specific Humana plan you are enrolled in, as different plans may offer varying levels of drug coverage, including medications like Trulicity.
  •  

  • Review the plan’s formulary, a list of covered prescription drugs, to ensure Trulicity is classified under the medications available to you.

 

Consult with Your Healthcare Provider

 

  • Schedule a discussion with your doctor or healthcare provider to confirm that Trulicity is the recommended medication for your condition.
  •  

  • Ask your healthcare provider if they can provide prior authorization documentation if Humana requires it for Trulicity coverage.

 

Accessing Humana's Pharmacy Benefits

 

  • Log into the Humana member portal to review pharmacy benefits and identify any prerequisites for accessing Trulicity.
  •  

  • Explore Humana's preferred pharmacy network to find where you can fill your Trulicity prescription efficiently.

 

Addressing Coverage Issues

 

  • If Trulicity is not covered under your current policy, discuss with Humana customer service possible plan adjustments or upgrades that include Trulicity.
  •  

  • Consider Humana's Medicare Advantage or Part D plans, which may offer different coverage options, including Trulicity.

 

Understand the Costs

 

  • Review any co-pays, coinsurance, or deductibles associated with Trulicity under your Humana plan to understand potential out-of-pocket expenses.
  •  

  • Inquire about financial assistance programs or savings cards for Trulicity that Humana may participate in or recommend.

 

Follow Up

 

  • Ensure that your pharmacy is billing Humana correctly for Trulicity by confirming with your pharmacist after the initial prescription claim.
  •  

  • Contact Humana again if any discrepancies arise or for further clarification on long-term coverage options for maintaining Trulicity access.

 

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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.

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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.

 

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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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