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Does Network Health Cover Jardiance

Explore Jardiance coverage by Network Health, costs without insurance, and tips to secure coverage. Get answers to FAQs on managing your health plan.

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Does Network Health Cover Jardiance?

Network Health may cover Jardiance, but this depends on specific plan details and medical necessity criteria. Members should review their specific plan's coverage documents or contact Network Health for confirmation.

**Coverage Situations:** Jardiance is typically covered for managing type 2 diabetes when prescribed by a healthcare professional. It might also be covered for other conditions if a doctor provides the necessary medical justification.

**Basic Rules and Criteria:** Coverage often involves prior authorization, meaning your doctor may need to provide certain information to justify the medical necessity of Jardiance. The plan might require trying other lower-cost medications first.

**Steps to Ensure Coverage:** Ensure that your prescribing healthcare provider follows the plan's pre-approval or prior authorization process. Keep an open line of communication with both your provider and Network Health to understand any updates or changes in policy.

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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.

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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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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.

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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 Jardiance Coverage with Network Health

Check Your Eligibility with Network Health

Visit the Network Health website or contact their customer service to check if they cover Jardiance. Verify their policy regarding coverage for this medication.

Make sure you understand any specific requirements or conditions for obtaining coverage, such as necessary medical documentation or pre-authorization from your healthcare provider.

Enroll in a Network Health Plan

If you are not already a member, select a Network Health plan that includes prescription coverage for medications like Jardiance. You can compare different plans on their website to see which one best fits your needs.

Follow the steps provided by Network Health to complete the enrollment process, ensuring you provide any required personal and medical information.

Consult Your Healthcare Provider

Schedule an appointment with your healthcare provider to discuss starting Jardiance. Obtain a prescription and any necessary documentation that Network Health might require.

Ensure your healthcare provider is aware of Network Health's procedures and any required forms or criteria so they can assist you effectively.

Submit Prescription and Documentation

Submit your Jardiance prescription to a pharmacy within Network Health's network to ensure coverage. Confirm any preferences for mail-order services or specific pharmacies.

If Network Health requires any additional documentation, such as proof of medical necessity or prior authorization, ensure it is submitted promptly to avoid delays in coverage.

Verify Coverage and Benefits

Once your prescription is submitted, contact Network Health to confirm that your Jardiance is covered under your plan. Review your co-payments, deductibles, and any coverage limits or restrictions that apply to your prescription.

Check your policy documents or online account to ensure your benefits are accurately reflected and up to date.

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FAQs

Does Network Health Cover Jardiance

Explore Jardiance coverage by Network Health, costs without insurance, and tips to secure coverage. Get answers to FAQs on managing your health plan.

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Is Jardiance Covered by Network Health

Does Network Health Cover Jardiance?

Network Health may cover Jardiance, but this depends on specific plan details and medical necessity criteria. Members should review their specific plan's coverage documents or contact Network Health for confirmation.

**Coverage Situations:** Jardiance is typically covered for managing type 2 diabetes when prescribed by a healthcare professional. It might also be covered for other conditions if a doctor provides the necessary medical justification.

**Basic Rules and Criteria:** Coverage often involves prior authorization, meaning your doctor may need to provide certain information to justify the medical necessity of Jardiance. The plan might require trying other lower-cost medications first.

**Steps to Ensure Coverage:** Ensure that your prescribing healthcare provider follows the plan's pre-approval or prior authorization process. Keep an open line of communication with both your provider and Network Health to understand any updates or changes in policy.

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Network Health's Approved Criteria for Jardiance Coverage

Eligibility Requirements for Jardiance Coverage

Patients must have a verified diagnosis of type 2 diabetes.

A demonstrated need for additional glycemic control, as diet and exercise alone have not achieved targeted HbA1c levels.

Patients who are at risk for cardiovascular disease may receive priority consideration for Jardiance coverage.

Healthcare providers must supply documentation of previous diabetes management strategies and their outcomes.

Clinical Trial Participation

Patients who are participating in clinical trials that involve the use of Jardiance may be eligible for coverage provided appropriate consents and authorizations are in place.

Documentation of study inclusion and ongoing participation is required from the trial center or investigator.

Prescribing Physician Criteria

Prescriptions for Jardiance must be written by a licensed healthcare provider specializing in endocrinology or diabetes management.

The provider must be part of the Network Health network to ensure coordination of coverage and care management.

Prior Authorization Procedure

Healthcare providers must complete a prior authorization form detailing the patient's medical history, diabetes management goals, and rationale for Jardiance therapy.

After submission, the authorization request will be reviewed by Network Health within a specified timeframe, typically not exceeding two weeks.

Monitoring and Follow-Up

Ongoing coverage is contingent upon regular monitoring of the patient's response to Jardiance, including HbA1c levels and renal function tests.

Providers must submit periodic updates as part of continued coverage assessments to demonstrate efficacy and safety.

Comorbid Conditions

Consideration may be given to patients with comorbid conditions such as hypertension or chronic kidney disease, depending on the provider's assessment and documented evidence of Jardiance's potential benefits.

Supporting clinical studies or guidelines that highlight the benefits of Jardiance in such populations should accompany the coverage application.

Why Network Health Might Deny Jardiance Coverage

Network Health Jardiance Coverage Denial Criteria

Jardiance is not approved for the specific medical condition being treated. Only specific conditions approved by the formulary are eligible for coverage.

Prescription of Jardiance does not meet the medical necessity guidelines set forth by Network Health. This includes not aligning with evidence-based clinical guidelines or lack of documentation proving necessity.

No prior authorization obtained for Jardiance prescription when required. Network Health may demand prior authorization for certain medications.

Jardiance prescribed by a provider not considered in-network by Network Health. Only prescriptions from approved providers might be eligible.

Members not adhering to step therapy protocols, which require trying other less expensive medications before advancing to Jardiance.

Failure to comply with formulary restrictions or step edits that demand less costly alternatives be tried first. Jardiance may only be approved if these steps are followed properly.

Lack of sufficient documentation or evidence supporting long-term use of Jardiance, which is not always covered under standard policy guidelines.

Prescriptions exceeding the dosage or quantity limits set by the plan without proper overrides being in place.

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How Much Does Jardiance Cost without Insurance?

Estimated Cost of Jardiance Without Insurance

The cost of Jardiance can vary depending on the pharmacy you visit, but as an oral medication used primarily to treat type 2 diabetes, it is often priced at a premium. Without insurance, the average monthly cost is approximately $550 to $650 for a 30-day supply of 10 mg or 25 mg tablets.

Prices can also vary based on location, pharmacy discounts, and available manufacturer coupons, so it's advisable to shop around or look for any available patient assistance programs to potentially lower the out-of-pocket cost.

Ways to Lower the Cost of Jardiance

**Pharmacy Discount Cards:** Utilizing pharmacy discount cards can sometimes provide substantial savings on your prescription, reducing the price by a notable percentage.

**Manufacturer Coupons and Programs:** Eli Lilly, the manufacturer of Jardiance, may offer savings cards or assistance programs to help eligible patients reduce their costs. It's worth checking through their official website or consulting with your healthcare provider.

**Generic Alternatives:** Although there may not be a generic version of Jardiance available currently, consulting with your healthcare provider about other generic medications for your condition may offer a more budget-friendly option.

**Bulk Purchasing Options:** Some pharmacies might offer discounts for purchasing a 90-day supply instead of a 30-day supply, which can lead to savings in the long term.

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 Jardiance Coverage with Network Health

Check Your Eligibility with Network Health

Visit the Network Health website or contact their customer service to check if they cover Jardiance. Verify their policy regarding coverage for this medication.

Make sure you understand any specific requirements or conditions for obtaining coverage, such as necessary medical documentation or pre-authorization from your healthcare provider.

Enroll in a Network Health Plan

If you are not already a member, select a Network Health plan that includes prescription coverage for medications like Jardiance. You can compare different plans on their website to see which one best fits your needs.

Follow the steps provided by Network Health to complete the enrollment process, ensuring you provide any required personal and medical information.

Consult Your Healthcare Provider

Schedule an appointment with your healthcare provider to discuss starting Jardiance. Obtain a prescription and any necessary documentation that Network Health might require.

Ensure your healthcare provider is aware of Network Health's procedures and any required forms or criteria so they can assist you effectively.

Submit Prescription and Documentation

Submit your Jardiance prescription to a pharmacy within Network Health's network to ensure coverage. Confirm any preferences for mail-order services or specific pharmacies.

If Network Health requires any additional documentation, such as proof of medical necessity or prior authorization, ensure it is submitted promptly to avoid delays in coverage.

Verify Coverage and Benefits

Once your prescription is submitted, contact Network Health to confirm that your Jardiance is covered under your plan. Review your co-payments, deductibles, and any coverage limits or restrictions that apply to your prescription.

Check your policy documents or online account to ensure your benefits are accurately reflected and up to date.

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Jardiance FAQ

What is Jardiance used for?

What is Jardiance Used For?

Jardiance is primarily used to manage type 2 diabetes by helping to lower blood sugar levels in adults.

It works by promoting the excretion of excess glucose through urine, thus reducing the amount of sugar the body absorbs.

In addition to blood sugar management, Jardiance is also prescribed to reduce the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease.

Patients with heart failure may benefit from Jardiance as it helps in reducing the risk of hospitalization due to heart failure.

What are the side effects of Jardiance?

Common Side Effects of Jardiance

Urinary tract infections: Symptoms may include burning sensation while urinating and frequent urges.
Increased urination: This is due to Jardiance's mechanism of removing excess glucose via urine.

Serious Side Effects

Ketoacidosis: This rare condition might present as difficulty breathing, nausea, or confusion.
Dehydration: Symptoms can be dizziness or light-headedness, especially upon standing.

Allergic Reactions

Rash or hives can occur, requiring immediate medical attention.

Precautions

Consult your healthcare provider before starting if you have kidney issues or are on diuretics.

Can Jardiance cause weight loss?

Can Jardiance Cause Weight Loss?

Yes, Jardiance (empagliflozin) can lead to weight loss. This medication is primarily used to treat type 2 diabetes.

It works by preventing glucose reabsorption in the kidneys, leading to glucose excretion through urine, which may also result in calorie loss.

Clinical trials have shown weight reduction as a common side effect, often averaging 2-3 kg.

This loss can differ among individuals; factors like diet and exercise may influence the extent of weight change.

Always consult with healthcare professionals to understand the benefits and risks associated with your specific health condition.

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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 Network Health Cover Jardiance

Explore Jardiance coverage by Network Health, costs without insurance, and tips to secure coverage. Get answers to FAQs on managing your health plan.

Achieve Your Goals Faster with Curex