Does Quartz Health Solutions Cover Phentermine (Adipex-P, Lomaira)

Learn why Quartz Health Solutions might deny Phentermine coverage, how to get it, potential costs without insurance, and FAQs.
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Does Quartz Health Solutions Cover Phentermine?

 

  • Phentermine (Adipex-P, Lomaira) may be covered by Quartz Health Solutions under their prescription drug plan. Coverage is typically provided when used as part of a comprehensive weight management program.
  •  

  • To have Phentermine covered, it is often required that the patient be diagnosed with obesity-related conditions such as hypertension, type 2 diabetes, or high cholesterol.
  •  

  • Prior authorization might be necessary, meaning the prescribing healthcare provider must demonstrate that Phentermine is medically necessary before coverage is approved.
  •  

  • Patients may need to meet specific criteria, such as having a BMI above a particular threshold or having failed to achieve weight loss through diet and exercise alone.
  •  

  • It is crucial to check the specific plan details as coverage can vary based on the policy purchased and the state of residence.

 

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Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

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At Curex, our mission is to help people improve their health and quality of life by understanding their allergies and treating them at their source.We provide more than individualized prescription treatments; we provide individualized care.

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 Phentermine (Adipex-P, Lomaira) Coverage with Quartz Health Solutions

 

Verify Phentermine is Covered

 

  • Check your specific Quartz Health Solutions plan details or contact Quartz customer service to ensure Phentermine (Adipex-P, Lomaira) is included in your pharmacy benefits.
  •  

  • Consult your provider’s formulary, which is a list of covered medications, to confirm whether Phentermine is covered.
  •  

  • Understand any cost-sharing responsibilities like copayments, coinsurance, or deductibles for prescription medications.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Phentermine and whether it is an appropriate treatment option for you.
  •  

  • Ensure your provider understands that you need the medication to be covered by insurance, which may require documentation or prior authorization.
  •  

  • Discuss alternative medications if Phentermine is not covered or if there are specific plan requirements for obtaining it.

 

Obtain Prior Authorization

 

  • Work with your healthcare provider to complete any necessary prior authorization forms required by Quartz Health Solutions.
  •  

  • Provide any additional documentation, such as medical history or evidence of previous unsuccessful weight loss attempts, if necessary.
  •  

  • Wait for the authorization to be processed, and follow up with both your provider and Quartz if there are any delays or issues.

 

Choose a Quartz-Approved Pharmacy

 

  • Locate a pharmacy that is approved by Quartz Health Solutions to ensure your prescription will be covered.
  •  

  • Contact the pharmacy in advance to confirm they can fill a prescription for Phentermine under your insurance plan.
  •  

  • Ask the pharmacy about any specific procedures or documentation required when picking up your prescription.

 

Submit Your Prescription

 

  • Provide the pharmacy with your Phentermine prescription and relevant insurance information.
  •  

  • Ensure that the pharmacy correctly files the prescription with Quartz Health Solutions to receive coverage benefits.
  •  

  • Pay any required copayments or coinsurance fees at the time of pickup.

 

Follow Up

 

  • Regularly review your Quartz Health Solutions account to ensure your Phentermine prescription is accurately processed and benefits are correctly applied.
  •  

  • Contact Quartz Health Solutions customer service if you encounter any discrepancies or if coverage issues arise.
  •  

  • Discuss ongoing treatment plans with your healthcare provider, and update Quartz if your medication needs change.

 

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Does Quartz Health Solutions Cover Phentermine (Adipex-P, Lomaira)

Learn why Quartz Health Solutions might deny Phentermine coverage, how to get it, potential costs without insurance, and FAQs.
Curex allergy drops unboxing

Is Phentermine (Adipex-P, Lomaira) Covered by Quartz Health Solutions

 

Does Quartz Health Solutions Cover Phentermine?

 

  • Phentermine (Adipex-P, Lomaira) may be covered by Quartz Health Solutions under their prescription drug plan. Coverage is typically provided when used as part of a comprehensive weight management program.
  •  

  • To have Phentermine covered, it is often required that the patient be diagnosed with obesity-related conditions such as hypertension, type 2 diabetes, or high cholesterol.
  •  

  • Prior authorization might be necessary, meaning the prescribing healthcare provider must demonstrate that Phentermine is medically necessary before coverage is approved.
  •  

  • Patients may need to meet specific criteria, such as having a BMI above a particular threshold or having failed to achieve weight loss through diet and exercise alone.
  •  

  • It is crucial to check the specific plan details as coverage can vary based on the policy purchased and the state of residence.

 

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Quartz Health Solutions's Approved Criteria for Phentermine (Adipex-P, Lomaira) Coverage

 

Criteria for Coverage of Phentermine (Adipex-P, Lomaira)

 

  • Phentermine is approved for coverage as part of a comprehensive weight management program.
  •  

  • Coverage is available for adult patients with a Body Mass Index (BMI) of 30 kg/m2 or greater, or 27 kg/m2 or greater in the presence of other risk factors such as hypertension, type 2 diabetes, or dyslipidemia.
  •  

  • Patients must demonstrate a past history of unsuccessful weight loss attempts through diet and exercise alone before Phentermine is considered.
  •  

  • To receive coverage, Phentermine must be prescribed by a healthcare provider with expertise in obesity or metabolic management.
  •  

  • Initial coverage is generally provided for a limited duration, such as 12 weeks, with possible extensions evaluated based on continued weight loss and health improvement benchmarks.
  •  

  • Patients may be required to participate in a concurrent lifestyle intervention program focused on nutrition, physical activity, and behavior modification.
  •  

  • Regular follow-up and documentation of progress, side effects, and adherence to prescribed treatment and lifestyle changes are necessary for continued coverage.

 

Why Quartz Health Solutions Might Deny Phentermine (Adipex-P, Lomaira) Coverage

 

Reasons for Denial of Coverage for Phentermine (Adipex-P, Lomaira)

 

  • Quartz Health Solutions does not cover Phentermine if it is prescribed for cosmetic weight loss purposes rather than for a diagnosed medical condition associated with obesity.
  •  

  • Phentermine coverage is denied when the patient has not demonstrated a previous unsuccessful attempt with non-pharmacological weight loss methods such as diet or exercise.
  •  

  • Patients who do not meet the specific BMI (Body Mass Index) criteria set by Quartz Health Solutions may have their coverage for Phentermine denied.
  •  

  • Quartz Health Solutions may reject coverage if the patient has a history of cardiovascular disease or other contraindications that the medication is known to exacerbate.
  •  

  • Phentermine prescriptions that exceed the typical duration limit outlined by Quartz Health Solutions, without documented necessity, may not be covered.
  •  

  • Use of Phentermine in combination with other weight loss medications not approved by Quartz Health Solutions can lead to coverage denial.
  •  

  • If the prescribing physician is outside of the Quartz Health Solutions network without proper referral or pre-authorization, coverage might be denied.
  •  

  • Patient non-compliance with previous treatments or lack of follow-up documentation could result in a denial for Phentermine coverage.
  •  

 

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How Much Does Phentermine (Adipex-P, Lomaira) Cost without Insurance?

 

Cost of Phentermine (Adipex-P, Lomaira) Without Insurance

 

  • The price of Phentermine can vary based on the pharmacy location and dosage strength. Typically, the cost for Adipex-P (the tablet form) without insurance is approximately $30 to $100 for a 30-day supply, at the standard dose of 37.5 mg per tablet.
  •  

  • Lomaira, which is a lower-dosage version of Phentermine, might be priced differently. The average cost without insurance for Lomaira is around $50 to $90 for a 30-day supply, depending on the pharmacy and location.
  •  

  • It's worth noting that these costs reflect retail prices, and there might be cheaper generic options available. Additionally, some pharmacies offer discount programs or coupons which can significantly lower the price.
  •  

  • Shopping around at different pharmacies or using online resources may help in obtaining the best available price without insurance.

 

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 Phentermine (Adipex-P, Lomaira) Coverage with Quartz Health Solutions

 

Verify Phentermine is Covered

 

  • Check your specific Quartz Health Solutions plan details or contact Quartz customer service to ensure Phentermine (Adipex-P, Lomaira) is included in your pharmacy benefits.
  •  

  • Consult your provider’s formulary, which is a list of covered medications, to confirm whether Phentermine is covered.
  •  

  • Understand any cost-sharing responsibilities like copayments, coinsurance, or deductibles for prescription medications.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Phentermine and whether it is an appropriate treatment option for you.
  •  

  • Ensure your provider understands that you need the medication to be covered by insurance, which may require documentation or prior authorization.
  •  

  • Discuss alternative medications if Phentermine is not covered or if there are specific plan requirements for obtaining it.

 

Obtain Prior Authorization

 

  • Work with your healthcare provider to complete any necessary prior authorization forms required by Quartz Health Solutions.
  •  

  • Provide any additional documentation, such as medical history or evidence of previous unsuccessful weight loss attempts, if necessary.
  •  

  • Wait for the authorization to be processed, and follow up with both your provider and Quartz if there are any delays or issues.

 

Choose a Quartz-Approved Pharmacy

 

  • Locate a pharmacy that is approved by Quartz Health Solutions to ensure your prescription will be covered.
  •  

  • Contact the pharmacy in advance to confirm they can fill a prescription for Phentermine under your insurance plan.
  •  

  • Ask the pharmacy about any specific procedures or documentation required when picking up your prescription.

 

Submit Your Prescription

 

  • Provide the pharmacy with your Phentermine prescription and relevant insurance information.
  •  

  • Ensure that the pharmacy correctly files the prescription with Quartz Health Solutions to receive coverage benefits.
  •  

  • Pay any required copayments or coinsurance fees at the time of pickup.

 

Follow Up

 

  • Regularly review your Quartz Health Solutions account to ensure your Phentermine prescription is accurately processed and benefits are correctly applied.
  •  

  • Contact Quartz Health Solutions customer service if you encounter any discrepancies or if coverage issues arise.
  •  

  • Discuss ongoing treatment plans with your healthcare provider, and update Quartz if your medication needs change.

 

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Our weight loss medication is delivered straight to your doorstep from a state-licensed pharmacy within our reliable network, ensuring you receive your medication when you need it.

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Phentermine (Adipex-P, Lomaira) FAQ

What are the side effects of phentermine?

 

Common Side Effects

 

  • Increased heart rate
  • Insomnia
  • Anxiety
  • Dry mouth

 

Less Common Side Effects

 

  • Dizziness
  • Constipation
  • Chest discomfort

 

Severe Side Effects

 

  • Shortness of breath
  • Severe headache
  • Heart palpitations

 

Recommendations

 

  • Avoid combining with other stimulants.
  • Limit alcohol consumption.
  • Consult a physician if side effects are severe or persist.

 

Important Note

 

  • Use only as prescribed by your doctor.
  • Avoid taking it late in the day to prevent insomnia.

 

How does phentermine help with weight loss?

 

How Phentermine Aids Weight Loss

 

  • Phentermine suppresses appetite by releasing neurotransmitters like norepinephrine in the brain, which helps reduce hunger.
  •  

  • It is similar to an amphetamine and works by stimulating the central nervous system, increasing heart rate and blood pressure, which can decrease appetite.
  •  

  • The medication should be combined with a reduced-calorie diet, increased physical activity, and behavior therapy for optimal results.
  •  

  • Often used for short-term management of obesity, typically up to 12 weeks, as part of a broader weight-loss program.

 

Is phentermine safe to use long-term?

 

Phentermine Safety

 

  • Phentermine is mainly prescribed for short-term use, generally up to 12 weeks, due to the lack of long-term efficacy and safety studies.
  •  

  • While it can be effective for weight loss over a short period, the potential for dependency and cardiovascular issues makes prolonged use risky.
  •  

  • Long-term use may lead to side effects like elevated blood pressure, palpitations, insomnia, and mood changes.
  •  

  • Consult your healthcare provider regularly to evaluate its ongoing necessity and monitor any adverse effects.
  •  

  • Alternative weight management strategies, such as lifestyle changes, should be prioritized for sustainable results.

 

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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.

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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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