Does Quartz Health Solutions Cover Lantus

Explore Lantus coverage with Quartz Health Solutions, reasons for denial, how to obtain coverage, Lantus costs without insurance, and frequently asked questions.
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Coverage of Lantus by Quartz Health Solutions

 

  • Lantus, a long-acting insulin for diabetes, might be covered under Quartz Health Solutions, contingent upon specific health plans and benefit packages. It's pivotal to check individual policy documents or contact Quartz directly for precise coverage details.
  •  

  • Generally, coverage for Lantus involves prior authorization. This means your healthcare provider needs to demonstrate the medical necessity of Lantus over alternative treatments to get approval from Quartz.
  •  

  • Patients must be diagnosed with diabetes and require insulin therapy as per their treatment plan to qualify for coverage. Compliance with Quartz's formulary guidelines is necessary, which may involve trying other preferred insulins first unless deemed unsuitable by your healthcare provider.
  •  

  • Members should also confirm if Lantus is listed on the Quartz formulary. Coverage can vary, and out-of-pocket costs may depend on the specific plan tier Lantus is categorized under.

 

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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.

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 Lantus Coverage with Quartz Health Solutions

 

Contact Quartz Health Solutions Customer Service

 

  • Call the Quartz Health Solutions customer service hotline to inquire about prescription drug benefits and verify coverage for Lantus.
  •  

  • Gather necessary information beforehand, such as your member ID, plan details, and prescription information, to make the process smoother.

 

Check Your Plan's Formulary

 

  • Login to your Quartz Health Solutions member portal to access your health plan’s online formulary, which contains a list of covered medications.
  •  

  • Search for Lantus in the formulary. Determine any specific requirements, such as prior authorization, step therapy, or quantity limits, that might be associated with Lantus coverage.

 

Consult With Your Healthcare Provider

 

  • Discuss with your healthcare provider about the necessity of starting Lantus and ensure they are aware of your insurance requirements.
  •  

  • If prior authorization is needed, ask your healthcare provider to submit the necessary paperwork to Quartz Health Solutions to get approval for Lantus.

 

Explore Quartz's Preferred Pharmacy Network

 

  • Identify pharmacies within Quartz's preferred network where you can fill your Lantus prescription at the most reduced cost or without additional fees.
  •  

  • Ensure that your chosen pharmacy can facilitate electronic submission of claims for efficient processing of your insurance benefits.

 

Submit a Claim for Reimbursement (If Necessary)

 

  • If you had to pay out-of-pocket for Lantus, submit a claim form for reimbursement. Forms can be found on the Quartz Health Solutions website or by contacting customer service.
  •  

  • Attach all necessary documentation, such as receipts and medical necessity documentation, and submit according to the instructions provided by Quartz.

 

Monitor Your Coverage Annually

 

  • Review your plan’s coverage annually during open enrollment to ensure Lantus or similar medications continue to be covered without unexpected changes.
  •  

  • Consider discussing coverage details and any concerns with a Quartz representative or your HR department if your plan is employer-sponsored.

 

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Sublingual immunotherapy delivers a higher dose of allergens over the course of treatment.

Potential for results in as few as 6 months

Individual results vary but some users have reported a noticeable difference in as few as 6-12 months since starting treatments

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FAQs

Does Quartz Health Solutions Cover Lantus

Explore Lantus coverage with Quartz Health Solutions, reasons for denial, how to obtain coverage, Lantus costs without insurance, and frequently asked questions.
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Is Lantus Covered by Quartz Health Solutions

 

Coverage of Lantus by Quartz Health Solutions

 

  • Lantus, a long-acting insulin for diabetes, might be covered under Quartz Health Solutions, contingent upon specific health plans and benefit packages. It's pivotal to check individual policy documents or contact Quartz directly for precise coverage details.
  •  

  • Generally, coverage for Lantus involves prior authorization. This means your healthcare provider needs to demonstrate the medical necessity of Lantus over alternative treatments to get approval from Quartz.
  •  

  • Patients must be diagnosed with diabetes and require insulin therapy as per their treatment plan to qualify for coverage. Compliance with Quartz's formulary guidelines is necessary, which may involve trying other preferred insulins first unless deemed unsuitable by your healthcare provider.
  •  

  • Members should also confirm if Lantus is listed on the Quartz formulary. Coverage can vary, and out-of-pocket costs may depend on the specific plan tier Lantus is categorized under.

 

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Quartz Health Solutions's Approved Criteria for Lantus Coverage

 

Eligibility for Lantus Coverage

 

  • Lantus is covered for individuals diagnosed with Type 1 Diabetes Mellitus when prescribed by a healthcare provider for maintaining glycemic control.
  •  

  • Individuals with Type 2 Diabetes Mellitus are eligible for coverage when Lantus is deemed medically necessary by a healthcare provider for whom other long-acting insulins are insufficient or inappropriate.
  •  

  • Patients with gestational diabetes requiring insulin for glycemic control during pregnancy are eligible for Lantus coverage upon the recommendation of their healthcare provider.

 

Required Medical Documentation

 

  • A recent and comprehensive medical assessment indicating the necessity for Lantus is required, including glycated hemoglobin levels (HbA1c) and current diabetes management strategy.
  •  

  • The prescribing healthcare provider must document failure, intolerance, or contraindication to other appropriate pharmacologic therapies before Lantus is approved.

 

Additional Considerations for Coverage

 

  • Continued coverage requires evidence of clinical benefit as determined by routine monitoring of blood glucose levels and HbA1c, demonstrating improvement or stabilization.
  •  

  • Frequent evaluation is required to ensure Lantus remains an effective part of the treatment regimen, with healthcare providers reassessing long-term therapy requirements during routine visits.

 

Patient Education Requirements

 

  • Education on the proper use, storage, and administration of Lantus is necessary, including the management of potential side effects and hypoglycemia.
  •  

  • Ongoing diabetes education and nutritional counseling are encouraged to complement Lantus therapy and ensure optimized lifestyle changes.

 

Why Quartz Health Solutions Might Deny Lantus Coverage

 

Reasons Lantus Coverage May Be Denied by Quartz Health Solutions

 

  • Lantus is deemed not medically necessary according to Quartz's current clinical guidelines or specific patient requirements.
  •  

  • The prescription does not comply with Quartz's prior authorization requirements or is missing necessary documentation.
  •  

  • The patient’s plan specifically excludes Lantus from their formulary or categorizes it under non-covered prescription medications.
  •  

  • Lantus is being used for an off-label use not supported by Quartz policy, which can lead to a denial of coverage.
  •  

  • The required step therapy protocol was not followed, where a less costly or preferred alternative was not attempted first.
  •  

  • The patient's condition does not meet the specific criteria established by Quartz for Lantus coverage, such as diagnosis or patient history.

 

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How Much Does Lantus Cost without Insurance?

 

Cost of Lantus Without Insurance

 

  • The price of Lantus (insulin glargine) without insurance can vary based on factors such as the pharmacy, location, and available discounts. Typically, the retail price ranges between $250 and $350 for a 10ml vial at a retail pharmacy.
  •  

  • For the Lantus SoloStar pen, which is a more convenient option for some, the price is generally similar, ranging from $400 to $500 for a pack of five pens.
  •  

  • Prices can fluctuate slightly, so it is advisable to check with local pharmacies or online services for the most current prices and potential savings options.
  •  

  • Consider exploring patient assistance programs offered by the manufacturer or third-party organizations, which might offer Lantus at reduced prices or even for free if you qualify based on income.

 

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 Lantus Coverage with Quartz Health Solutions

 

Contact Quartz Health Solutions Customer Service

 

  • Call the Quartz Health Solutions customer service hotline to inquire about prescription drug benefits and verify coverage for Lantus.
  •  

  • Gather necessary information beforehand, such as your member ID, plan details, and prescription information, to make the process smoother.

 

Check Your Plan's Formulary

 

  • Login to your Quartz Health Solutions member portal to access your health plan’s online formulary, which contains a list of covered medications.
  •  

  • Search for Lantus in the formulary. Determine any specific requirements, such as prior authorization, step therapy, or quantity limits, that might be associated with Lantus coverage.

 

Consult With Your Healthcare Provider

 

  • Discuss with your healthcare provider about the necessity of starting Lantus and ensure they are aware of your insurance requirements.
  •  

  • If prior authorization is needed, ask your healthcare provider to submit the necessary paperwork to Quartz Health Solutions to get approval for Lantus.

 

Explore Quartz's Preferred Pharmacy Network

 

  • Identify pharmacies within Quartz's preferred network where you can fill your Lantus prescription at the most reduced cost or without additional fees.
  •  

  • Ensure that your chosen pharmacy can facilitate electronic submission of claims for efficient processing of your insurance benefits.

 

Submit a Claim for Reimbursement (If Necessary)

 

  • If you had to pay out-of-pocket for Lantus, submit a claim form for reimbursement. Forms can be found on the Quartz Health Solutions website or by contacting customer service.
  •  

  • Attach all necessary documentation, such as receipts and medical necessity documentation, and submit according to the instructions provided by Quartz.

 

Monitor Your Coverage Annually

 

  • Review your plan’s coverage annually during open enrollment to ensure Lantus or similar medications continue to be covered without unexpected changes.
  •  

  • Consider discussing coverage details and any concerns with a Quartz representative or your HR department if your plan is employer-sponsored.

 

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Lantus FAQ

What is Lantus used for?

 

What is Lantus Used For?

 

  • Lantus is primarily used to manage blood sugar levels in individuals with type 1 and type 2 diabetes.
  •  

  • It is a long-acting insulin, providing a steady release of insulin over a 24-hour period with no pronounced peak, mimicking natural insulin secretion.
  •  

  • It's taken once daily, often at the same time each day, helping to maintain consistent blood glucose control.
  •  

  • Beneficial for patients requiring basal insulin to prevent hyperglycemia between meals and overnight.
  •  

  • Alongside diet and exercise, Lantus is vital for comprehensive diabetes management.

 

How does Lantus work in the body?

 

How Lantus Works

 

  • Lantus is a long-acting insulin, also known as insulin glargine. It provides a stable and continuous release of insulin to control blood sugar levels.
  •  

  • The formulation of Lantus enables it to dissolve slowly upon injection, creating a slow and steady insulin level that lasts up to 24 hours.
  •  

  • This minimizes the risk of blood sugar peaks and troughs, providing more consistent blood glucose management.
  •  

  • Lantus mimics the basal level of insulin production in the pancreas, thus helping to maintain glucose balance between meals and overnight.
  •  

  • It binds to insulin receptors, facilitating glucose uptake into muscle and fat tissues, while inhibiting hepatic glucose production.

 

What are the side effects of Lantus?

 

Common Side Effects

 

  • Injection site reactions such as redness, swelling, or itching can occur.
  • Hypoglycemia, or low blood sugar, is a frequent side effect.
  • Weight gain may happen due to improved glucose utilization.

 

Less Common Side Effects

 

  • Allergic reactions like rash or itching may occur but are rare.
  • Systemic reactions such as swelling of hands/feet can occur.
  • Visual changes might be experienced during initial treatment.

 

Serious Side Effects

 

  • Severe hypoglycemia requiring intervention.
  • Signs of allergic reactions like difficulty breathing, require immediate attention.
  • Hypokalemia may develop, leading to muscle weakness or cramps.

 

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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 (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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