Does Independence Blue Cross Cover Forteo

Discover why Independence Blue Cross may deny Forteo coverage and learn how to secure it. Find out Forteo costs without insurance and check our Forteo FAQ.
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“Curex is changing the landscape of allergies in 2024”
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Coverage for Forteo

 

  • Independence Blue Cross may cover Forteo as part of its prescription drug benefits. Coverage is typically provided for osteoporosis treatment in patients who have a high risk of fracture.
  •  

  • Candidates generally include postmenopausal women and men with osteoporosis, or individuals with a history of osteoporotic fractures.

 

Basic Rules and Criteria

 

  • Coverage often requires prior authorization, where your healthcare provider must demonstrate medical necessity based on established criteria.
  •  

  • Patients may need to have tried other osteoporosis treatments unsuccessfully before Forteo is approved.
  •  

  • Quantity limits or step therapy protocols might be in place, requiring the use of first-line treatments before Forteo.

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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 Forteo Coverage with Independence Blue Cross

 

Determine Your Plan Type

 

  • Identify if you have a Medicare, Medicaid, or a commercial plan with Independence Blue Cross, as coverage details might vary.
  •  

  • Locate your member ID card which will have your plan type and contact information for customer service.

 

Check Medication Coverage

 

  • Visit the Independence Blue Cross official website to access your plan's formulary, which is a list of medications covered under your insurance plan.
  •  

  • Search for Forteo (teriparatide) in the formulary list to verify if it is covered under your plan.

 

Contact Customer Service

 

  • Call the customer service number listed on your member ID card to confirm the coverage details for Forteo.
  •  

  • Inquire if any specific conditions or requirements must be met for coverage, such as prior authorization.

 

Consult Your Healthcare Provider

 

  • Discuss with your doctor about starting Forteo and whether they need to provide any documentation or complete any forms.
  •  

  • Ensure your healthcare provider understands any pre-approval requirements and gathers the necessary medical records.

 

Obtain Prior Authorization

 

  • If prior authorization is required, work with your healthcare provider to submit the appropriate request to Independence Blue Cross.
  •  

  • Provide any additional documentation requested by the insurer to support the necessity of Forteo for your health condition.

 

Follow-up and Appeals

 

  • Contact Independence Blue Cross to check the status of your prior authorization request.
  •  

  • If your request is denied, discuss appeals options with your healthcare provider. Gather additional information or documentation to support your appeal.

 

Pharmacy and Prescription Fulfillment

 

  • Once approved, fill your Forteo prescription at a network pharmacy affiliated with Independence Blue Cross.
  •  

  • Verify if there's a preferred pharmacy network to potentially lower your out-of-pocket costs.

 

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

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Does Independence Blue Cross Cover Forteo

Discover why Independence Blue Cross may deny Forteo coverage and learn how to secure it. Find out Forteo costs without insurance and check our Forteo FAQ.
Curex allergy drops unboxing

Is Forteo Covered by Independence Blue Cross

 

Coverage for Forteo

 

  • Independence Blue Cross may cover Forteo as part of its prescription drug benefits. Coverage is typically provided for osteoporosis treatment in patients who have a high risk of fracture.
  •  

  • Candidates generally include postmenopausal women and men with osteoporosis, or individuals with a history of osteoporotic fractures.

 

Basic Rules and Criteria

 

  • Coverage often requires prior authorization, where your healthcare provider must demonstrate medical necessity based on established criteria.
  •  

  • Patients may need to have tried other osteoporosis treatments unsuccessfully before Forteo is approved.
  •  

  • Quantity limits or step therapy protocols might be in place, requiring the use of first-line treatments before Forteo.

A weight management program tailored to you

Start with Curex

Independence Blue Cross's Approved Criteria for Forteo Coverage

 

Eligibility Criteria for Forteo Coverage

 

  • Patient must have a confirmed diagnosis of osteoporosis with a high risk of fracture. This includes individuals who have already sustained an osteoporotic fracture or who have multiple risk factors for fracture.
  •  

  • Candidates for Forteo must be either postmenopausal women or men with osteoporosis who are at high risk for fracture.
  •  

  • Patients with glucocorticoid-induced osteoporosis (GIOP) on chronic systemic glucocorticoid therapy experiencing bone loss or who are at a high risk for fracture may qualify.
  •  

  • There should be documented evidence showing that the patient has not adequately responded to or is intolerant of other osteoporosis therapies such as bisphosphonates, or other treatments are contraindicated.
  •  

  • Prescriptions must be written by a healthcare provider specializing in the diagnosis and treatment of osteoporosis.

 

Additional Requirements

 

  • Pre-treatment evaluation should include a baseline bone mineral density (BMD) test for future comparison and monitoring purposes.
  •  

  • There should be documentation of a comprehensive osteoporosis management plan, including lifestyle modification and calcium and vitamin D supplementation, if not contraindicated.
  •  

  • Continuous renal function evaluation may be required to ensure safe administration of Forteo.
  •  

  • Requests for coverage must include a detailed medical history relevant to osteoporosis and any relevant lab results.

 

Why Independence Blue Cross Might Deny Forteo Coverage

 

Reasons for Denial of Forteo Coverage by Independence Blue Cross

 

  • Forteo is not covered if it is being used for conditions or diagnoses that are not FDA-approved.
  •  

  • Coverage may be denied if Forteo is prescribed for patients not falling under medically necessary criteria as defined by Independence Blue Cross.
  •  

  • If the prescribed dosage or duration of Forteo use exceeds what is considered allowable for treatment, it may not be covered.
  •  

  • Prescription of Forteo may be denied if there hasn't been a trial or documented failure of other osteoporosis therapies that are typically tried first.
  •  

  • Coverage may not be extended if the patient has certain preexisting health conditions or risk factors identified as contraindications for Forteo.
  •  

  • If the patient is not within the age range or demographic groups that are typically eligible for Forteo treatment, coverage may be denied.
  •  

  • Forteo coverage might not be granted if proper documentation and justification for its necessity are not provided by the prescribing healthcare provider.
  •  

 

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

How Much Does Forteo Cost without Insurance?

 

Cost of Forteo Without Insurance

 

  • The price of Forteo (teriparatide injection) without insurance is quite substantial, typically ranging between $3,500 and $4,000 for a 28-day supply, which is a 2.4 mL pen of 600 mcg per 2.4 mL strength.
  •  

  • Keep in mind that pharmaceutical prices can vary based on the pharmacy, geographical location, and any available discounts or pharmacy-specific savings programs.
  •  

  • Patients can check with specific pharmacies for the most accurate pricing and inquire about any potential savings programs or discounts.
  •  

  • Consider contacting the manufacturer or exploring patient assistance programs, as they sometimes offer help to reduce costs for those without insurance coverage.

 

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 Forteo Coverage with Independence Blue Cross

 

Determine Your Plan Type

 

  • Identify if you have a Medicare, Medicaid, or a commercial plan with Independence Blue Cross, as coverage details might vary.
  •  

  • Locate your member ID card which will have your plan type and contact information for customer service.

 

Check Medication Coverage

 

  • Visit the Independence Blue Cross official website to access your plan's formulary, which is a list of medications covered under your insurance plan.
  •  

  • Search for Forteo (teriparatide) in the formulary list to verify if it is covered under your plan.

 

Contact Customer Service

 

  • Call the customer service number listed on your member ID card to confirm the coverage details for Forteo.
  •  

  • Inquire if any specific conditions or requirements must be met for coverage, such as prior authorization.

 

Consult Your Healthcare Provider

 

  • Discuss with your doctor about starting Forteo and whether they need to provide any documentation or complete any forms.
  •  

  • Ensure your healthcare provider understands any pre-approval requirements and gathers the necessary medical records.

 

Obtain Prior Authorization

 

  • If prior authorization is required, work with your healthcare provider to submit the appropriate request to Independence Blue Cross.
  •  

  • Provide any additional documentation requested by the insurer to support the necessity of Forteo for your health condition.

 

Follow-up and Appeals

 

  • Contact Independence Blue Cross to check the status of your prior authorization request.
  •  

  • If your request is denied, discuss appeals options with your healthcare provider. Gather additional information or documentation to support your appeal.

 

Pharmacy and Prescription Fulfillment

 

  • Once approved, fill your Forteo prescription at a network pharmacy affiliated with Independence Blue Cross.
  •  

  • Verify if there's a preferred pharmacy network to potentially lower your out-of-pocket 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.

Forteo FAQ

What are the common side effects of Forteo?

 

Common Side Effects of Forteo

 

  • Nausea: A frequent complaint among users, often resolves as your body adjusts to the medication.
  •  

  • Dizziness: Usually occurs after an injection, so sitting or lying down shortly afterward can help.
  •  

  • Leg Cramps: Regular stretching exercises may alleviate this discomfort.
  •  

  • Joint Pain: May be managed by over-the-counter painkillers, but consult your doctor first.
  •  

  • Injection Site Reactions: Mild redness or itching at the injection site is common, often soothed by cold compresses.

 

How does Forteo work for osteoporosis?

 

How Forteo Works

 

  • Forteo, or teriparatide, is a form of parathyroid hormone that helps stimulate new bone formation.
  •  

  • It works by increasing bone remodeling, which is crucial for improving bone density.

 

Osteoporosis Effectiveness

 

  • Used primarily for osteoporosis patients who have a high risk of fractures.
  •  

  • Improves bone microarchitecture, which enhances bone strength.

 

Administration

 

  • Administered via daily subcutaneous injection for up to 2 years.
  •  

  • Patients should follow their doctor’s instructions for the correct administration.

 

How long can you safely take Forteo?

 

Duration of Forteo Use

 

  • Forteo (teriparatide) is recommended for a maximum duration of 2 years over a patient's lifetime.
  •  

  • This limitation is based on studies that show an increased risk of osteosarcoma in rats. Though this risk hasn't been confirmed in humans, the duration is restricted for safety.

 

Considerations and Monitoring

 

  • During treatment, regular bone density scans and evaluations for potential side effects are necessary.
  •  

  • Patients should ensure they are not taking medications or have conditions that could further exacerbate potential risks.

 

Have questions left?

Get a personalized online consultation with a doctor at Curex

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

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 Independence Blue Cross Cover Forteo

Discover why Independence Blue Cross may deny Forteo coverage and learn how to secure it. Find out Forteo costs without insurance and check our Forteo FAQ.
Curex allergy drops unboxing

Does Independence Blue Cross Cover Forteo

 

Coverage for Forteo

 

  • Independence Blue Cross may cover Forteo as part of its prescription drug benefits. Coverage is typically provided for osteoporosis treatment in patients who have a high risk of fracture.
  •  

  • Candidates generally include postmenopausal women and men with osteoporosis, or individuals with a history of osteoporotic fractures.

 

Basic Rules and Criteria

 

  • Coverage often requires prior authorization, where your healthcare provider must demonstrate medical necessity based on established criteria.
  •  

  • Patients may need to have tried other osteoporosis treatments unsuccessfully before Forteo is approved.
  •  

  • Quantity limits or step therapy protocols might be in place, requiring the use of first-line treatments before Forteo.

A weight management program tailored to you

Start with Curex

Why Independence Blue Cross Might Deny Forteo Coverage

 

Eligibility Criteria for Forteo Coverage

 

  • Patient must have a confirmed diagnosis of osteoporosis with a high risk of fracture. This includes individuals who have already sustained an osteoporotic fracture or who have multiple risk factors for fracture.
  •  

  • Candidates for Forteo must be either postmenopausal women or men with osteoporosis who are at high risk for fracture.
  •  

  • Patients with glucocorticoid-induced osteoporosis (GIOP) on chronic systemic glucocorticoid therapy experiencing bone loss or who are at a high risk for fracture may qualify.
  •  

  • There should be documented evidence showing that the patient has not adequately responded to or is intolerant of other osteoporosis therapies such as bisphosphonates, or other treatments are contraindicated.
  •  

  • Prescriptions must be written by a healthcare provider specializing in the diagnosis and treatment of osteoporosis.

 

Additional Requirements

 

  • Pre-treatment evaluation should include a baseline bone mineral density (BMD) test for future comparison and monitoring purposes.
  •  

  • There should be documentation of a comprehensive osteoporosis management plan, including lifestyle modification and calcium and vitamin D supplementation, if not contraindicated.
  •  

  • Continuous renal function evaluation may be required to ensure safe administration of Forteo.
  •  

  • Requests for coverage must include a detailed medical history relevant to osteoporosis and any relevant lab results.

 

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

Forteo FAQ

 

Reasons for Denial of Forteo Coverage by Independence Blue Cross

 

  • Forteo is not covered if it is being used for conditions or diagnoses that are not FDA-approved.
  •  

  • Coverage may be denied if Forteo is prescribed for patients not falling under medically necessary criteria as defined by Independence Blue Cross.
  •  

  • If the prescribed dosage or duration of Forteo use exceeds what is considered allowable for treatment, it may not be covered.
  •  

  • Prescription of Forteo may be denied if there hasn't been a trial or documented failure of other osteoporosis therapies that are typically tried first.
  •  

  • Coverage may not be extended if the patient has certain preexisting health conditions or risk factors identified as contraindications for Forteo.
  •  

  • If the patient is not within the age range or demographic groups that are typically eligible for Forteo treatment, coverage may be denied.
  •  

  • Forteo coverage might not be granted if proper documentation and justification for its necessity are not provided by the prescribing healthcare provider.
  •  

 

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 Much Does Forteo Cost without Insurance?

 

Cost of Forteo Without Insurance

 

  • The price of Forteo (teriparatide injection) without insurance is quite substantial, typically ranging between $3,500 and $4,000 for a 28-day supply, which is a 2.4 mL pen of 600 mcg per 2.4 mL strength.
  •  

  • Keep in mind that pharmaceutical prices can vary based on the pharmacy, geographical location, and any available discounts or pharmacy-specific savings programs.
  •  

  • Patients can check with specific pharmacies for the most accurate pricing and inquire about any potential savings programs or discounts.
  •  

  • Consider contacting the manufacturer or exploring patient assistance programs, as they sometimes offer help to reduce costs for those without insurance coverage.

 

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.

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

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.