Does Quartz Health Solutions Cover Diethylpropion (Tenuate)

Explore Quartz Health Solutions' coverage for Diethylpropion (Tenuate), reasons for denial, costs without insurance, and FAQs. Learn how to secure coverage.
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Coverage for Diethylpropion (Tenuate) by Quartz Health Solutions

 

  • Diethylpropion (Tenuate) is a medication used as an appetite suppressant for the short-term management of obesity.
  •  

  • Coverage by Quartz Health Solutions typically requires that patients meet specific medical criteria, such as a body mass index (BMI) above a certain threshold and a documented history of obesity management attempts with lifestyle modifications.
  •  

  • A prior authorization may be required to confirm that the prescription is medically necessary according to Quartz Health's policy.
  •  

  • Diethylpropion coverage also mandates monitoring by a healthcare provider due to its potential side effects and the risk of misuse or dependence.
  •  

  • Patients should consult their Quartz Health Solutions policy details or contact a service representative for specific coverage terms and any necessary forms or additional information required for coverage approval.

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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 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 Diethylpropion (Tenuate) Coverage with Quartz Health Solutions

 

Understand Quartz Health Solutions Coverage Policies

 

  • Visit the Quartz Health Solutions official website to familiarize yourself with their coverage policies and guidelines for prescription medications.
  •  

  • Look for information related to prescription drug coverage, formulary lists, and any specific criteria for medications like Diethylpropion (Tenuate).

 

Consult with Your Healthcare Provider

 

  • Speak with your healthcare provider about your need for Diethylpropion (Tenuate) and discuss your medical necessity. Ensure they understand Quartz's requirements for approval.
  •  

  • Request a prior authorization from your healthcare provider. Quartz may require this to demonstrate the medical necessity of Diethylpropion before covering the cost.

 

Contact Quartz Health Solutions

 

  • Call the customer service number provided on your Quartz health insurance card. Inquire about the steps required for prescription coverage for Diethylpropion.
  •  

  • Ask about any necessary documentation or forms you or your healthcare provider need to submit for prior authorization or appeals, if initially denied.

 

Submit Prior Authorization Request

 

  • Work with your healthcare provider to complete and submit any required forms for prior authorization. Ensure all medical records and justifications for the prescription are included.
  •  

  • Make sure the submission is done through the proper channel as indicated by Quartz, which could usually be via fax or an online portal.

 

Follow Up on Your Request

 

  • Stay in contact with both your healthcare provider and Quartz Health Solutions to check the status of your prior authorization request.
  •  

  • Be prepared to provide additional information if Quartz requires further clarification regarding your prescription request.

 

Prepare for Appeals if Necessary

 

  • If your initial request is denied, obtain a detailed explanation of the reasons from Quartz Health Solutions.
  •  

  • Work with your healthcare provider to address any points made in the denial and resubmit an appeal with additional information or documentation as needed.
  •  

  • Follow up diligently on the appeals process and maintain communication with Quartz to ensure your case is thoroughly reviewed.

 

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FAQs

Does Quartz Health Solutions Cover Diethylpropion (Tenuate)

Explore Quartz Health Solutions' coverage for Diethylpropion (Tenuate), reasons for denial, costs without insurance, and FAQs. Learn how to secure coverage.
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Is Diethylpropion (Tenuate) Covered by Quartz Health Solutions

 

Coverage for Diethylpropion (Tenuate) by Quartz Health Solutions

 

  • Diethylpropion (Tenuate) is a medication used as an appetite suppressant for the short-term management of obesity.
  •  

  • Coverage by Quartz Health Solutions typically requires that patients meet specific medical criteria, such as a body mass index (BMI) above a certain threshold and a documented history of obesity management attempts with lifestyle modifications.
  •  

  • A prior authorization may be required to confirm that the prescription is medically necessary according to Quartz Health's policy.
  •  

  • Diethylpropion coverage also mandates monitoring by a healthcare provider due to its potential side effects and the risk of misuse or dependence.
  •  

  • Patients should consult their Quartz Health Solutions policy details or contact a service representative for specific coverage terms and any necessary forms or additional information required for coverage approval.

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Quartz Health Solutions's Approved Criteria for Diethylpropion (Tenuate) Coverage

 

Criteria for Coverage of Diethylpropion (Tenuate)

 

  • Patient must be diagnosed with obesity, defined as a body mass index (BMI) of 30 kg/m² or higher without associated health conditions, or a BMI of 27 kg/m² or higher with at least one obesity-related comorbid condition (e.g., hypertension, type 2 diabetes, dyslipidemia).
  •  

  • Patient has been engaged in a structured weight management program that includes diet, exercise, and behavioral modification for a minimum of three months. Documentation of participation and adherence is required.
  •  

  • Diethylpropion is prescribed as part of a comprehensive plan for weight loss in conjunction with lifestyle modification.
  •  

  • Prescribing physician is either a specialist in obesity management or the patient's primary care physician with experience in treating obesity.
  •  

  • Patient has no contraindications to diethylpropion, including but not limited to advanced arteriosclerosis, cardiovascular disease, moderate to severe hypertension, hyperthyroidism, or glaucoma.
  •  

  • There is no history of drug abuse, as diethylpropion has a potential for dependence.
  •  

  • Patient has not received diethylpropion therapy within the last 12 months, or there must be a medical justification documented by the prescribing physician for reinitiation of therapy.
  •  

  • Authorization for coverage is typically granted for an initial period of up to 12 weeks, with potential renewal contingent upon documentation of at least a 5% reduction in baseline body weight and continued adherence to the weight management program.

 

Why Quartz Health Solutions Might Deny Diethylpropion (Tenuate) Coverage

 

Situations When Quartz Health Solutions Does Not Cover Diethylpropion (Tenuate)

 

  • Diethylpropion (Tenuate) is not covered if it is prescribed for patients who do not meet the criteria for chronic obesity. This includes individuals with a BMI lower than specified thresholds determined by the coverage policy.
  •  

  • The medication is not covered for cosmetic weight loss or any other condition not classified as a legitimate medical obesity treatment need.
  •  

  • If Diethylpropion (Tenuate) is utilized as the first-line treatment for obesity without prior trial and failure of other preferred treatments, it may not be covered.
  •  

  • Coverage is denied if the patient has a known history of hypersensitivity to Diethylpropion or any components of the medication.
  •  

  • Quartz Health Solutions does not cover the use of Diethylpropion if it has been prescribed in combination with other weight loss drugs not approved by the health plan.
  •  

  • The medication is not approved for use among individuals with specific contraindicated health conditions such as uncontrolled hypertension, advanced arteriosclerosis, or known history of drug abuse.
  •  

 

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How Much Does Diethylpropion (Tenuate) Cost without Insurance?

 

Approximate Cost of Diethylpropion (Tenuate) Without Insurance

 

  • The cost of Diethylpropion (Tenuate), a prescription medication used for weight loss, can vary widely depending on the pharmacy location and any available discounts or generic alternatives.
  •  

  • On average, the price for a supply of 30, 75 mg controlled-release tablets can range from $50 to $100 without insurance.
  •  

  • For the immediate-release version, the cost for a supply of 30, 25 mg tablets is typically around $30 to $70 without insurance.
  •  

  • Prices can fluctuate due to factors such as location, manufacturer pricing, and availability of alternative generic options.
  •  

  • It's often beneficial to check with different pharmacies for any potential coupons or discounts that may further reduce the cost.

 

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 Diethylpropion (Tenuate) Coverage with Quartz Health Solutions

 

Understand Quartz Health Solutions Coverage Policies

 

  • Visit the Quartz Health Solutions official website to familiarize yourself with their coverage policies and guidelines for prescription medications.
  •  

  • Look for information related to prescription drug coverage, formulary lists, and any specific criteria for medications like Diethylpropion (Tenuate).

 

Consult with Your Healthcare Provider

 

  • Speak with your healthcare provider about your need for Diethylpropion (Tenuate) and discuss your medical necessity. Ensure they understand Quartz's requirements for approval.
  •  

  • Request a prior authorization from your healthcare provider. Quartz may require this to demonstrate the medical necessity of Diethylpropion before covering the cost.

 

Contact Quartz Health Solutions

 

  • Call the customer service number provided on your Quartz health insurance card. Inquire about the steps required for prescription coverage for Diethylpropion.
  •  

  • Ask about any necessary documentation or forms you or your healthcare provider need to submit for prior authorization or appeals, if initially denied.

 

Submit Prior Authorization Request

 

  • Work with your healthcare provider to complete and submit any required forms for prior authorization. Ensure all medical records and justifications for the prescription are included.
  •  

  • Make sure the submission is done through the proper channel as indicated by Quartz, which could usually be via fax or an online portal.

 

Follow Up on Your Request

 

  • Stay in contact with both your healthcare provider and Quartz Health Solutions to check the status of your prior authorization request.
  •  

  • Be prepared to provide additional information if Quartz requires further clarification regarding your prescription request.

 

Prepare for Appeals if Necessary

 

  • If your initial request is denied, obtain a detailed explanation of the reasons from Quartz Health Solutions.
  •  

  • Work with your healthcare provider to address any points made in the denial and resubmit an appeal with additional information or documentation as needed.
  •  

  • Follow up diligently on the appeals process and maintain communication with Quartz to ensure your case is thoroughly reviewed.

 

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Diethylpropion (Tenuate) FAQ

What are the common side effects of Diethylpropion?

 

Common Side Effects of Diethylpropion

 

  • Diethylpropion may cause dizziness and drowsiness; avoid driving or operating heavy machinery if affected.
  •  

  • Patients often report headaches and insomnia. Adjust usage to early daytime to help mitigate insomnia.
  •  

  • It can lead to digestive issues like nausea, dry mouth, and constipation; drinking ample water and maintaining a balanced diet may assist.
  •  

  • Commonly, users experience increased heart rate or palpitations; seek medical advice if severe or persistent.
  •  

  • Nervousness and restlessness are possible; managing stress and limiting caffeine can be beneficial.

 

How effective is Diethylpropion for weight loss?

 

Effectiveness of Diethylpropion for Weight Loss

 

  • Diethylpropion is an appetite suppressant, aiding in short-term obesity management.
  •  

  • Primarily effective when combined with a structured diet and exercise plan.
  •  

  • Clinical studies show a modest weight reduction on average, typically around 3-4% body weight over 12 weeks.
  •  

  • Most beneficial in the initial phase of a weight loss program, stimulating early weight loss which can motivate further progress.
  •  

  • Advantages can diminish over time as appetite levels adjust, necessitating lifestyle modifications for sustained loss.
  •  

 

Considerations

 

  • Prescribed for short periods due to potential side effects and risk of dependency.
  •  

  • Not suitable for individuals with specific health conditions, such as cardiovascular disease or uncontrolled hypertension.

 

Is Diethylpropion similar to phentermine?

 

Overview of Diethylpropion and Phentermine

 

  • Both Diethylpropion and Phentermine are prescription medications classified as appetite suppressants and sympathomimetic amines.
  •  

  • They are primarily used to assist weight loss in individuals who are obese and have related risk factors such as diabetes or high blood pressure.

 

Mechanism of Action

 

  • Diethylpropion and Phentermine stimulate the central nervous system, increasing heart rate and blood pressure while decreasing appetite by affecting hypothalamic neurotransmitters.
  •  

  • Though they function similarly, Phentermine typically has a stronger effect and longer duration than Diethylpropion.

 

Potential Side Effects

 

  • Common side effects of both drugs include increased heart rate, dry mouth, insomnia, dizziness, and constipation.
  •  

  • Due to their stimulant properties, they pose a risk of dependency or abuse.

 

Usage Considerations

 

  • Both medications are intended for short-term use and should be accompanied by lifestyle changes like diet and exercise.
  •  

  • It's crucial to evaluate each individual's health status and history for a safe and effective treatment plan.

 

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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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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.

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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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