Does Regence Cover Prozac

Explore Regence's coverage policies on Prozac. Learn denial reasons, coverage tips, costs without insurance, and get answers to common questions.
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Regence Coverage for Prozac

 

  • Regence typically covers Prozac for mental health conditions like depression and anxiety, subject to plan specifics.
  •  

  • Coverage depends on whether Prozac is listed in your specific plan’s formulary; formulary tiers may affect cost.
  •  

  • A valid prescription from a licensed healthcare provider is required.
  •  

  • Pre-authorization might be needed, especially for off-label uses or higher dosages.
  •  

  • Out-of-pocket expenses may vary based on your health plan; check deductibles and co-pay amounts.
  •  

  • It's advisable to consult with customer support or your plan's documentation to confirm specific coverage details.

 

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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 Prozac Coverage with Regence

 

Verify Prozac Coverage by Regence

 

  • Contact Regence customer service to inquire if Prozac (fluoxetine) is covered under your specific plan.
  •  

  • Review the plan's Formulary (list of covered medications) which can often be accessed through your Regence online member account to confirm if Prozac is included.

 

Consult Your Healthcare Provider

 

  • Schedule a consultation with your healthcare provider to discuss the necessity of Prozac for your treatment.
  •  

  • Request a formal prescription for Prozac if your provider determines it's appropriate for your condition.

 

Set Up a Regence Account

 

  • Visit the Regence website and create an online member account if you haven't done so already. This will allow easier access to your plan details and benefits.
  •  

  • Log into your account to review plan specifics and locate tools for pharmacy services and coverage.

 

Initiate Pre-Authorization (if required)

 

  • Determine if pre-authorization is necessary for Prozac by consulting Regence customer service or checking your member account.
  •  

  • If required, have your healthcare provider submit a pre-authorization request to Regence, including a rationale for the necessity of Prozac.

 

Find a Participating Pharmacy

 

  • Use the Regence online portal to identify pharmacies included in the Regence network that can fill Prozac prescriptions.
  •  

  • Verify that the pharmacy can process prescriptions covered under your plan to ensure seamless benefits application.

 

Fill Your Prescription

 

  • Visit the participating pharmacy with your Prozac prescription and provide your Regence insurance information.
  •  

  • Confirm coverage and co-payment amounts before processing your prescription order.

 

Review Explanation of Benefits (EOB)

 

  • After your prescription is filled, review the Explanation of Benefits (EOB) statement sent by Regence to ensure Prozac is appropriately covered and billed.
  •  

  • Contact Regence customer service for any discrepancies or if there are coverage issues.

 

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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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Studies that have been reviewed by certified physicians show that sublingual immunotherapy is a safe treatment option
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FAQs

Does Regence Cover Prozac

Explore Regence's coverage policies on Prozac. Learn denial reasons, coverage tips, costs without insurance, and get answers to common questions.
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Is Prozac Covered by Regence

 

Regence Coverage for Prozac

 

  • Regence typically covers Prozac for mental health conditions like depression and anxiety, subject to plan specifics.
  •  

  • Coverage depends on whether Prozac is listed in your specific plan’s formulary; formulary tiers may affect cost.
  •  

  • A valid prescription from a licensed healthcare provider is required.
  •  

  • Pre-authorization might be needed, especially for off-label uses or higher dosages.
  •  

  • Out-of-pocket expenses may vary based on your health plan; check deductibles and co-pay amounts.
  •  

  • It's advisable to consult with customer support or your plan's documentation to confirm specific coverage details.

 

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Regence's Approved Criteria for Prozac Coverage

 

Regence Approved Coverage Criteria for Prozac

 

  • Prozac is covered for individuals diagnosed with Major Depressive Disorder (MDD) who have not responded adequately to at least one other antidepressant medication.
  •  

  • Coverage extends to patients with Obsessive-Compulsive Disorder (OCD) who have tried alternative therapies and require pharmacological intervention.
  •  

  • Patients with Bulimia Nervosa are eligible for Prozac coverage to help manage symptoms of binge eating and purging.
  •  

  • Prozac is approved for coverage in cases of Panic Disorder where patients experience recurrent unexpected panic attacks and require treatment.
  •  

  • Coverage is available for individuals diagnosed with Premenstrual Dysphoric Disorder (PMDD) to alleviate symptoms associated with severe premenstrual changes.
  •  

  • Prozac can be covered for patients with Post-Traumatic Stress Disorder (PTSD) as part of a comprehensive treatment plan, especially when other medications have proven ineffective.
  •  

  • Continued treatment with Prozac is covered when the prescribing clinician provides documentation demonstrating the therapeutic benefit and necessity for ongoing use.

 

Why Regence Might Deny Prozac Coverage

 

Reasons Regence Might Deny Prozac Coverage

 

  • **Not Medically Necessary**: Plan criteria not met demonstrating clinical necessity for Prozac.
  •  

  • **Experimental or Investigational Use**: Usage deemed as experimental for certain conditions not covered under the policy.
  •  

  • **Plan Exclusions**: Specific exclusions in the policy that do not cover Prozac for certain conditions or treatments.
  •  

  • **Lack of Prior Authorization**: Prozac therapy initiated without obtaining necessary prior authorization as required by Regence.
  •  

  • **Non-Formulary Drug**: Prozac not included in the covered formulary list, and no successful exception request has been made.
  •  

  • **Generic Requirement**: Must use a generic version unless documented and approved for a brand necessary condition.

 

Together with our partners we have changed the lives of over 300,000 patients.

How Much Does Prozac Cost without Insurance?

 

Approximate Cost of Prozac Without Insurance

 

  • The cost of Prozac (fluoxetine), a medication commonly used to treat depression and anxiety disorders, can vary based on the dosage, quantity, and location.
  •  

  • For a 30-day supply of generic fluoxetine, the average cost can range from $4 to $20 for the commonly prescribed dosages like 10mg, 20mg, or 40mg.
  •  

  • The branded version, Prozac, can be more expensive, with prices ranging from $120 to $150 or more without insurance for a similar 30-day supply.
  •  

  • Prices may vary between different pharmacies, and discount programs or pharmacy membership plans can potentially reduce the out-of-pocket cost.

 

Our team is here to help!

Dr. Neeta Ogden, MD

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

Dr. Ravi Patel, VP Telemedicine

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

Jill Hamburg, PA - C

Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

Dr. Chet Tharpe, Medical Director

Curex has set the standard for the virtual allergy experience. From the comfort of their home, patients nationwide are able to receive a personalized treatment plan from an experienced clinician, aimed at treating the source of their allergies, not just the symptoms.

Kayla Mardaga, NP

Curex offers convenient at-home allergy testing options. Our goal is to determine if a patient would benefit from immunotherapy and then customize a treatment plan that can reduce both the symptoms and the reliance on allergy medications.

How to Get Prozac Coverage with Regence

 

Verify Prozac Coverage by Regence

 

  • Contact Regence customer service to inquire if Prozac (fluoxetine) is covered under your specific plan.
  •  

  • Review the plan's Formulary (list of covered medications) which can often be accessed through your Regence online member account to confirm if Prozac is included.

 

Consult Your Healthcare Provider

 

  • Schedule a consultation with your healthcare provider to discuss the necessity of Prozac for your treatment.
  •  

  • Request a formal prescription for Prozac if your provider determines it's appropriate for your condition.

 

Set Up a Regence Account

 

  • Visit the Regence website and create an online member account if you haven't done so already. This will allow easier access to your plan details and benefits.
  •  

  • Log into your account to review plan specifics and locate tools for pharmacy services and coverage.

 

Initiate Pre-Authorization (if required)

 

  • Determine if pre-authorization is necessary for Prozac by consulting Regence customer service or checking your member account.
  •  

  • If required, have your healthcare provider submit a pre-authorization request to Regence, including a rationale for the necessity of Prozac.

 

Find a Participating Pharmacy

 

  • Use the Regence online portal to identify pharmacies included in the Regence network that can fill Prozac prescriptions.
  •  

  • Verify that the pharmacy can process prescriptions covered under your plan to ensure seamless benefits application.

 

Fill Your Prescription

 

  • Visit the participating pharmacy with your Prozac prescription and provide your Regence insurance information.
  •  

  • Confirm coverage and co-payment amounts before processing your prescription order.

 

Review Explanation of Benefits (EOB)

 

  • After your prescription is filled, review the Explanation of Benefits (EOB) statement sent by Regence to ensure Prozac is appropriately covered and billed.
  •  

  • Contact Regence customer service for any discrepancies or if there are coverage issues.

 

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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.

Each pharmacy in our network undergoes rigorous third-party testing through FDA and DEA certified labs. These tests focus on four key elements, ensuring both safety and efficacy for our treatments.

Prozac FAQ

1. What are the common side effects of Prozac?

 

Common Side Effects of Prozac

 

  • Nausea: Often occurs during initial treatment or after dose increases.
  •  

  • Headache: Can vary in intensity and duration among users.
  •  

  • Sleep disturbances: Includes insomnia or unusual dreams.
  •  

  • Sexual dysfunction: Includes decreased libido, delayed ejaculation, or orgasmic issues.
  •  

  • Dry mouth: May lead to increased thirst or discomfort.
  •  

  • Drowsiness: Some users experience fatigue or lethargy.
  •  

  • Anxiety: Agitation or nervousness may occur, especially early in treatment.
  •  

  • Diarrhea: Varying consistency and frequency may be noted.

2. How long does it take for Prozac to start working?

 

How Prozac Works

 

  • Prozac, an SSRI, increases serotonin levels in the brain by inhibiting reuptake. Improved serotonin availability helps stabilize mood.

 

Onset of Effects

 

  • Initial physical effects, such as improved energy, may be noted within 1-2 weeks.
  •  

  • Significant mood improvement typically requires 4-6 weeks, varying between individuals.

 

Factors Influencing Efficacy

 

  • Dosage and individual metabolism play crucial roles in response time.
  •  

  • Concurrent medication and underlying health conditions can influence onset and effectiveness.
  •  

  • Adherence to prescribed dosing schedule is essential for optimal results.

3. Can Prozac cause weight gain or loss?

 

Prozac and Weight Changes

 

  • **Weight Gain**: Some users may experience weight gain. This can be due to changes in metabolism, increased appetite, or changes in energy levels. It's important to monitor your weight and discuss changes with your doctor.
  •  

  • **Weight Loss**: Others might experience weight loss, possibly due to decreased appetite or improved mood leading to more physical activity. Again, tracking weight changes and discussing them with your healthcare provider is essential.
  •  

  • **Individual Response**: Weight changes are often individual. Some people might not experience any change. Knowing your body’s response and maintaining a balanced diet and exercise routine is crucial.

 

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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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