Does Quartz Health Solutions Cover Xarelto

Explore if Quartz Health Solutions covers Xarelto, reasons for denial, ways to secure coverage, costs without insurance, and FAQs.
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Xarelto Coverage by Quartz Health Solutions

 

  • Quartz Health Solutions may cover Xarelto, a prescription medication used to prevent blood clots, under certain conditions.
  •  

  • To receive coverage, Xarelto must be deemed medically necessary by a healthcare provider, often supported by a diagnosis indicating a high risk of clotting issues.
  •  

  • Coverage generally applies for approved conditions such as atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE).
  •  

  • Policyholders may need to meet specific criteria, including prior authorization or step therapy requirements, meaning alternative medications are tried first.
  •  

  • Copayments, coinsurance, and deductible terms will apply as stated in your Quartz Health Solutions plan.
  •  

  • It is advisable to contact Quartz Health Solutions directly for personalized information and assistance regarding eligibility and benefits.

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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 Xarelto Coverage with Quartz Health Solutions

 

Contact Quartz Health Solutions

 

  • Begin by reaching out to Quartz Health Solutions' customer service. You can find their contact information on their website. This initial step helps you verify their coverage policies for Xarelto.
  •  

  • Ask for a confirmation about which plans offer prescription drug coverage, specifically for Xarelto. Gathering this information will assist in making an informed decision.

 

Review Your Current Plan

 

  • If you are already a member of Quartz Health Solutions, review your existing plan documents. This includes the formulary, which is a list of covered drugs.
  •  

  • Ensure that your plan includes Xarelto. You can do this by logging into their member services portal or checking the printed materials provided when you enrolled.

 

Consult with Your Doctor

 

  • Schedule an appointment with your healthcare provider to discuss the necessity of Xarelto as part of your treatment plan.
  •  

  • Request a detailed prescription plan from your doctor, including any pertinent medical records that justify the need for Xarelto.

 

Submit a Prior Authorization Request

 

  • If Xarelto is not automatically covered, your healthcare provider might need to submit a prior authorization form. This is typically necessary for medications that require special approval from the insurer.
  •  

  • Work with your doctor's office to ensure all necessary documentation and justification are submitted to Quartz Health Solutions.

 

Explore Alternative Plans

 

  • If your current plan does not cover Xarelto, consider exploring other plans offered by Quartz Health Solutions during the open enrollment period.
  •  

  • Look for plans with a comprehensive prescription benefit that includes Xarelto. Compare premiums, out-of-pocket costs, and pharmacy networks.

 

Apply for Financial Assistance

 

  • Investigate any financial assistance programs available through Quartz Health Solutions or directly from the manufacturer of Xarelto.
  •  

  • Fill out any required forms for assistance programs that may help lower your prescription costs or offer coverage.

 

Stay Informed on Policy Changes

 

  • Check your email and mail for any updates from Quartz Health Solutions regarding changes to drug coverage policies.
  •  

  • Stay proactive by visiting their website periodically for the latest information on formulary updates or healthcare regulations that might affect your coverage.

 

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FAQs

Does Quartz Health Solutions Cover Xarelto

Explore if Quartz Health Solutions covers Xarelto, reasons for denial, ways to secure coverage, costs without insurance, and FAQs.
Curex allergy drops unboxing

Is Xarelto Covered by Quartz Health Solutions

 

Xarelto Coverage by Quartz Health Solutions

 

  • Quartz Health Solutions may cover Xarelto, a prescription medication used to prevent blood clots, under certain conditions.
  •  

  • To receive coverage, Xarelto must be deemed medically necessary by a healthcare provider, often supported by a diagnosis indicating a high risk of clotting issues.
  •  

  • Coverage generally applies for approved conditions such as atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE).
  •  

  • Policyholders may need to meet specific criteria, including prior authorization or step therapy requirements, meaning alternative medications are tried first.
  •  

  • Copayments, coinsurance, and deductible terms will apply as stated in your Quartz Health Solutions plan.
  •  

  • It is advisable to contact Quartz Health Solutions directly for personalized information and assistance regarding eligibility and benefits.

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Quartz Health Solutions's Approved Criteria for Xarelto Coverage

 

Xarelto Coverage Criteria by Quartz Health Solutions

 

  • **Dosage and Administration**: The prescription must align with FDA-approved dosages and administration guidelines specific to the patient's condition, ensuring safety and efficacy.
  •  

  • **Indications for Use**: Xarelto is covered for specific conditions such as non-valvular atrial fibrillation, to reduce stroke and systemic embolism risk, as well as for the treatment and prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE).
  •  

  • **Special Populations**: Coverage is extended to adults in need of anticoagulant therapy where Xarelto is the preferred therapeutic alternative due to patient-specific factors, such as the inability to maintain therapeutic INR with warfarin.
  •  

  • **Renal Impairment**: Patients with renal impairment must meet specific creatinine clearance criteria, ensuring adjusted dosing regimens are safe for their renal function level.
  •  

  • **Concurrent Medications**: Coverage allows for Xarelto when concurrent medications, such as certain antiplatelet agents, do not contraindicate its use, ensuring safety and avoidance of adverse interactions.
  •  

  • **History of Compliance**: Patients must have a documented history of compliance with prescribed anti-coagulant regimens, demonstrating their commitment to adhering to the treatment plan.
  •  

  • **Provider Approval**: Prescription must be written by a licensed healthcare provider who specializes in managing anticoagulation therapy, ensuring an expert recommendation for Xarelto use.
  •  

  • **Prior Authorization**: In some cases, prior authorization may be required, involving a review of patient's medical history and treatment justification to ensure coverage aligns with clinical guidelines.

 

Why Quartz Health Solutions Might Deny Xarelto Coverage

 

Criteria for Xarelto Coverage Denial by Quartz Health Solutions

 

  • Xarelto coverage may be denied if the prescription does not comply with Quartz Health Solutions' defined medical necessity criteria for the medication.
  •  

  • If the prescribed Xarelto dosage falls outside the approved FDA guidelines or Quartz’s formulary requirements, coverage may be denied.
  •  

  • Quartz Health Solutions may deny coverage for Xarelto if there is no prior authorization completed for the prescription, considering it a prerequisite for high-cost medications.
  •  

  • Coverage may be denied if the patient’s medical history or records do not align with the indications approved for Xarelto, such as specific types of venous thromboembolism or atrial fibrillation.
  •  

  • Xarelto may not be covered if there is an availability of a lower-cost alternative that is deemed therapeutically equivalent as per Quartz's formulary guidelines.
  •  

  • Denial could occur if Xarelto is being prescribed for off-label use not supported by established clinical evidence or guidelines as assessed by Quartz Health Solutions.
  •  

  • Patients without documented failure or contraindication to other preferred anticoagulant therapies may face Xarelto coverage denial.

 

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How Much Does Xarelto Cost without Insurance?

 

Approximate Cost of Xarelto Without Insurance

 

  • The cost for Xarelto, a prescription anticoagulant medication, can vary depending on the dosage and quantity prescribed. On average, the cost of a 30-day supply of Xarelto 20 mg tablets, without insurance, can range from $450 to $540.
  •  

  • Prices may differ at various pharmacies, and patients might find lower prices through discount programs or pharmacy discount cards.
  •  

  • Shopping around and comparing prices at different pharmacies or checking with online retailers can sometimes yield better deals or discounts.
  •  

  • Additional savings may be available through pharmaceutical assistance programs, which are offered by the manufacturer for eligible patients who meet specific criteria.

 

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 Xarelto Coverage with Quartz Health Solutions

 

Contact Quartz Health Solutions

 

  • Begin by reaching out to Quartz Health Solutions' customer service. You can find their contact information on their website. This initial step helps you verify their coverage policies for Xarelto.
  •  

  • Ask for a confirmation about which plans offer prescription drug coverage, specifically for Xarelto. Gathering this information will assist in making an informed decision.

 

Review Your Current Plan

 

  • If you are already a member of Quartz Health Solutions, review your existing plan documents. This includes the formulary, which is a list of covered drugs.
  •  

  • Ensure that your plan includes Xarelto. You can do this by logging into their member services portal or checking the printed materials provided when you enrolled.

 

Consult with Your Doctor

 

  • Schedule an appointment with your healthcare provider to discuss the necessity of Xarelto as part of your treatment plan.
  •  

  • Request a detailed prescription plan from your doctor, including any pertinent medical records that justify the need for Xarelto.

 

Submit a Prior Authorization Request

 

  • If Xarelto is not automatically covered, your healthcare provider might need to submit a prior authorization form. This is typically necessary for medications that require special approval from the insurer.
  •  

  • Work with your doctor's office to ensure all necessary documentation and justification are submitted to Quartz Health Solutions.

 

Explore Alternative Plans

 

  • If your current plan does not cover Xarelto, consider exploring other plans offered by Quartz Health Solutions during the open enrollment period.
  •  

  • Look for plans with a comprehensive prescription benefit that includes Xarelto. Compare premiums, out-of-pocket costs, and pharmacy networks.

 

Apply for Financial Assistance

 

  • Investigate any financial assistance programs available through Quartz Health Solutions or directly from the manufacturer of Xarelto.
  •  

  • Fill out any required forms for assistance programs that may help lower your prescription costs or offer coverage.

 

Stay Informed on Policy Changes

 

  • Check your email and mail for any updates from Quartz Health Solutions regarding changes to drug coverage policies.
  •  

  • Stay proactive by visiting their website periodically for the latest information on formulary updates or healthcare regulations that might affect your coverage.

 

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Xarelto FAQ

What are the common side effects of Xarelto?

 

Common Side Effects of Xarelto

 

  • Bleeding is the most common, including nasal, gum, or gastrointestinal bleeding. Be vigilant for any signs of unusual bleeding and seek medical attention if necessary.
  •  

  • Gastrointestinal issues such as nausea and stomach pain may occur. Taking Xarelto with food can help alleviate these symptoms.
  •  

  • Dizziness and fatigue can affect some individuals, especially when first starting the medication. Ensure you maintain hydration and rest as needed.
  •  

  • In rare cases, allergic reactions may manifest as rash or itching. If this occurs, consult your healthcare provider promptly.

 

Is Xarelto a blood thinner?

 

Is Xarelto a Blood Thinner?

 

  • **Xarelto (rivaroxaban)** is indeed a blood thinner, specifically an anticoagulant, which is crucial for preventing blood clots that can lead to conditions like stroke or deep vein thrombosis (DVT).
  •  

  • It works by inhibiting **factor Xa**, an essential component in the coagulation cascade, reducing the ability of blood to form clots.
  •  

  • As a **direct oral anticoagulant (DOAC)**, it provides several advantages over traditional blood thinners like warfarin, such as having fewer dietary restrictions and not requiring regular blood monitoring.
  •  

  • It's important to take it as prescribed by a healthcare provider, considering potential drug interactions and contraindications.

 

Can you drink alcohol while taking Xarelto?

 

Drinking Alcohol with Xarelto

 

  • Xarelto, a blood thinner, may increase bleeding risk, and alcohol can amplify this risk.
  •  

  • Both substances affect liver function, potentially impacting medication metabolism and effectiveness.
  •  

  • Consuming alcohol while on Xarelto may enhance side effects like dizziness, increasing injury risk.
  •  

  • It’s crucial to consult your healthcare provider to discuss allowable alcohol intake based on your health status and dosage.
  •  

 

General Recommendations

 

  • Moderation is key – if approved, limit alcohol consumption as per medical advice.
  •  

  • Avoid binge drinking, which drastically heightens risk of adverse reactions.
  •  

  • Inform your medical team about recreational activities involving alcohol.

 

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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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