Does Regence Cover Lantus

Learn if Regence covers Lantus, why coverage might be denied, how to secure it, Lantus costs without insurance, and answers to common questions.
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Does Regence Cover Lantus

 

  • Regence may cover Lantus (insulin glargine) if it is deemed medically necessary for managing diabetes. Coverage typically depends on the specific health plan and policy terms.
  •  

  • Coverage often requires a prescription from a healthcare provider, verifying that Lantus is essential for the patient's treatment.
  •  

  • Preauthorization might be needed, which involves a review to confirm necessity, especially if Lantus is a non-preferred drug on formulary lists.
  •  

  • Patients may need to demonstrate that other insulins were ineffective or caused adverse effects to justify Lantus use under their Regence plan.
  •  

  • There might be a limit on the quantity covered per month, adhering to standard dosage recommendations.
  •  

  • Cost-sharing measures, like copayments or coinsurance, may apply based on the plan's pharmacy 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 Lantus Coverage with Regence

 

Verify Your Coverage

 

  • Log in to your Regence member account through their official website.
  •  

  • Navigate to the benefits section to review your current prescription drug coverage.
  •  

  • Search for Lantus or contact Regence customer service directly to confirm if Lantus is included in your plan’s formulary.

 

Consult with Your Healthcare Provider

 

  • Discuss with your doctor why Lantus is necessary and ensure they provide the correct diagnosis and prescription coding.
  •  

  • If needed, request your doctor to prepare any necessary documentation justifying the medical need for Lantus.

 

Complete a Prior Authorization Form

 

  • If Regence requires prior authorization for Lantus, download or request the necessary forms from their website or customer service.
  •  

  • Work with your healthcare provider to complete the form accurately, ensuring all sections are filled out with precise and relevant details.
  •  

  • Submit the completed form to Regence via the specified method (fax, mail, or online submission portal).

 

Follow Up on Your Prior Authorization

 

  • Contact Regence to verify receipt of your prior authorization form and inquire about the typical processing timeline.
  •  

  • Stay in communication with your doctor, as they may need to provide additional information during the review process.

 

Explore Financial Assistance Programs

 

  • If Regence does not cover Lantus or the coverage is not enough, explore manufacturer coupons or patient assistance programs offered by Sanofi, the manufacturer of Lantus.
  •  

  • Consider connecting with healthcare advocacy groups for additional resources and guidance on securing medication access.

 

Keep Detailed Records

 

  • Maintain copies of all correspondences, submissions, and communications with Regence for future reference.
  •  

  • Document dates and names of representatives you've spoken with during the process in case you need to reference this in future communications.

 

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FAQs

Does Regence Cover Lantus

Learn if Regence covers Lantus, why coverage might be denied, how to secure it, Lantus costs without insurance, and answers to common questions.
Curex allergy drops unboxing

Is Lantus Covered by Regence

 

Does Regence Cover Lantus

 

  • Regence may cover Lantus (insulin glargine) if it is deemed medically necessary for managing diabetes. Coverage typically depends on the specific health plan and policy terms.
  •  

  • Coverage often requires a prescription from a healthcare provider, verifying that Lantus is essential for the patient's treatment.
  •  

  • Preauthorization might be needed, which involves a review to confirm necessity, especially if Lantus is a non-preferred drug on formulary lists.
  •  

  • Patients may need to demonstrate that other insulins were ineffective or caused adverse effects to justify Lantus use under their Regence plan.
  •  

  • There might be a limit on the quantity covered per month, adhering to standard dosage recommendations.
  •  

  • Cost-sharing measures, like copayments or coinsurance, may apply based on the plan's pharmacy benefits.

 

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Regence's Approved Criteria for Lantus Coverage

 

Eligibility Criteria for Lantus Coverage

 

  • Patient has been diagnosed with diabetes mellitus, which includes both type 1 and type 2 diabetes.
  •  
  • Lantus is being prescribed for the management of blood glucose levels.
  •  
  • Documentation shows inadequate control of blood glucose levels with current therapy. This should be supported by clinical evidence such as HbA1c levels.

 

Clinical Documentation Requirements

 

  • Prescription by a licensed healthcare provider, specializing in endocrinology or diabetes care is preferred but not mandatory.
  •  
  • Comprehensive treatment plan including glucose monitoring, lifestyle modifications, and concurrent medications.
  •  
  • Detailed record of previous and current antidiabetic medications and the patient's response to those treatments.

 

Special Considerations

 

  • Coverage may extend in special cases for pediatric patients with type 1 diabetes who require basal insulin.
  •  
  • Consideration for patients with gestational diabetes who require intensive insulin therapy to manage their blood glucose levels.
  •  
  • Individuals transitioning from other insulin regimens who require stabilizing adjustments.

 

Renewal and Continuous Coverage

 

  • Ongoing Lantus therapy requires regular follow-up and documentation showing the effectiveness of the treatment in managing diabetes.
  •  
  • Periodic reevaluation of treatment plan effectiveness, usually occurring every 6 to 12 months.
  •  
  • Continuation of coverage is dependent on the patient's adherence to prescribed therapy and adjustments made as necessary based on clinical assessments.

 

Why Regence Might Deny Lantus Coverage

 

Situations Where Regence Might Deny Lantus Coverage

 

  • Prescription is Outside of Established Guidelines: If the use of Lantus does not adhere to the FDA-approved indication or exceeds the dosing guidelines, coverage might be denied.
  •  

  • Non-Formulary Medication: Lantus may not be covered if it is not listed on the Regence formulary, which specifies the medications that are covered under the insurance plan.
  •  

  • Lack of Prior Authorization: Coverage may be denied if prior authorization is required but not obtained before purchasing Lantus.
  •  

  • Failure to Meet Medical Necessity: Regence might deny coverage if the use of Lantus is not deemed medically necessary based on the patient's health status or prescribed therapy.
  •  

  • Availability of Generic Alternatives: If a generic equivalent such as insulin glargine is available and considered equally effective, coverage for the brand-name Lantus might be denied.
  •  

  • Duplicate Therapy: Coverage can be denied if Lantus is prescribed alongside another long-acting insulin without clear clinical justification for both.
  •  

  • Experimental or Investigational Use: If Lantus is used for a condition or treatment that is classified as experimental or investigational, it may not be covered.
  •  

  • Policy Exclusions: Certain health insurance policies may explicitly exclude coverage for Lantus or certain uses of it.

 

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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 Regence

 

Verify Your Coverage

 

  • Log in to your Regence member account through their official website.
  •  

  • Navigate to the benefits section to review your current prescription drug coverage.
  •  

  • Search for Lantus or contact Regence customer service directly to confirm if Lantus is included in your plan’s formulary.

 

Consult with Your Healthcare Provider

 

  • Discuss with your doctor why Lantus is necessary and ensure they provide the correct diagnosis and prescription coding.
  •  

  • If needed, request your doctor to prepare any necessary documentation justifying the medical need for Lantus.

 

Complete a Prior Authorization Form

 

  • If Regence requires prior authorization for Lantus, download or request the necessary forms from their website or customer service.
  •  

  • Work with your healthcare provider to complete the form accurately, ensuring all sections are filled out with precise and relevant details.
  •  

  • Submit the completed form to Regence via the specified method (fax, mail, or online submission portal).

 

Follow Up on Your Prior Authorization

 

  • Contact Regence to verify receipt of your prior authorization form and inquire about the typical processing timeline.
  •  

  • Stay in communication with your doctor, as they may need to provide additional information during the review process.

 

Explore Financial Assistance Programs

 

  • If Regence does not cover Lantus or the coverage is not enough, explore manufacturer coupons or patient assistance programs offered by Sanofi, the manufacturer of Lantus.
  •  

  • Consider connecting with healthcare advocacy groups for additional resources and guidance on securing medication access.

 

Keep Detailed Records

 

  • Maintain copies of all correspondences, submissions, and communications with Regence for future reference.
  •  

  • Document dates and names of representatives you've spoken with during the process in case you need to reference this in future communications.

 

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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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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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