Does Security Health Plan Cover Lantus

Explore Lantus coverage under Security Health Plan, learn why claims might be denied, and discover options for obtaining coverage and managing costs.
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Coverage for Lantus under Security Health Plan

 

  • Security Health Plan generally covers prescription medications like Lantus, subject to the plan's formulary and specific terms.
  •  

  • Coverage may include situations where Lantus is medically necessary for managing diabetes, as determined by a healthcare provider.
  •  

  • To get Lantus covered, the insured individual typically needs a valid prescription from a licensed healthcare professional.
  •  

  • Coverage may require prior authorization, where the healthcare provider justifies the need for Lantus over other insulin options.
  •  

  • Enrollees may be responsible for copayments or coinsurance, depending on the plan's specific tier for Lantus.
  •  

  • The drug must be purchased from an in-network pharmacy to ensure the best coverage and pricing benefits.
  •  

  • Patients should verify their individual plan details as coverage may vary based on the specific Security Health Plan product selected.

 

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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 Security Health Plan

 

Start with Security Health Plan Enrollment

 

  • Visit the official Security Health Plan website to view their insurance plans.
  • Contact a Security Health Plan representative to discuss your specific health insurance needs, including any requirements for prescription coverage.
  • Enroll in a suitable plan that offers prescription drug coverage, making sure it potentially includes coverage for medications like Lantus.

 

Verify Prescription Drug Coverage

 

  • Log into your Security Health Plan member account or contact the customer service to get a list of covered medications.
  • Search for Lantus on the formulary list to confirm its coverage status under your chosen plan.
  • If Lantus isn't covered or has restrictions, inquire about any required prior authorizations or alternative covered insulin options.

 

Consult with Your Healthcare Provider

 

  • Discuss your Lantus needs with your healthcare provider. Ensure they are aware that Security Health Plan is your insurer.
  • If necessary, your doctor may need to provide a medical necessity letter or complete a prior authorization request for Lantus.
  • In case Lantus is not initially covered, ask your provider to suggest alternative medications that may be covered by your plan.

 

Submit Required Documentation

 

  • If a prior authorization is required, gather all necessary paperwork from your healthcare provider.
  • Send the completed prior authorization and any supporting documentation to Security Health Plan following their submission guidelines.
  • Track the status of your submission through your Security Health Plan account or by calling their customer service.

 

Utilize Security Health Plan Resources

 

  • Select in-network pharmacies to fill your prescription for Lantus to maximize your coverage benefits.
  • Explore any additional resources that Security Health Plan offers, such as discount programs or mail-order pharmacy services for ongoing medications.
  • If coverage issues arise, reach out to a Security Health Plan representative to resolve any discrepancies or to request an appeal.

 

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FAQs

Does Security Health Plan Cover Lantus

Explore Lantus coverage under Security Health Plan, learn why claims might be denied, and discover options for obtaining coverage and managing costs.
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Is Lantus Covered by Security Health Plan

 

Coverage for Lantus under Security Health Plan

 

  • Security Health Plan generally covers prescription medications like Lantus, subject to the plan's formulary and specific terms.
  •  

  • Coverage may include situations where Lantus is medically necessary for managing diabetes, as determined by a healthcare provider.
  •  

  • To get Lantus covered, the insured individual typically needs a valid prescription from a licensed healthcare professional.
  •  

  • Coverage may require prior authorization, where the healthcare provider justifies the need for Lantus over other insulin options.
  •  

  • Enrollees may be responsible for copayments or coinsurance, depending on the plan's specific tier for Lantus.
  •  

  • The drug must be purchased from an in-network pharmacy to ensure the best coverage and pricing benefits.
  •  

  • Patients should verify their individual plan details as coverage may vary based on the specific Security Health Plan product selected.

 

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Security Health Plan's Approved Criteria for Lantus Coverage

 

Criteria for Lantus Coverage

 

  • Eligible patients must have a diagnosis of diabetes mellitus, either Type 1 or Type 2, as Lantus is indicated for improving glycemic control in these populations.
  •  

  • Patients require a documented clinical necessity for a long-acting insulin due to suboptimal control on their current insulin regimen, which necessitates an adjustment to therapy including Lantus.
  •  

  • Prescriber's attestation on the prescription that the patient has tried and failed achieving adequate glycemic control with at least two other formulary covered insulin therapies, or the patient has experienced significant adverse effects from these options that contraindicate their continued use.
  •  

  • Lantus is covered as part of a comprehensive diabetes management strategy, including consistent blood glucose monitoring, dietary adjustments, and lifestyle modifications that have been attempted and documented.
  •  

  • Prescribing physician must provide evidence of the patient's adherence to recommended diabetes care schedules, including regular visits and monitoring, to ensure patient responsibility and effective treatment tracking.
  •  

  • In cases of comorbid conditions that affect diabetes management, such as gestational diabetes or usage alongside an insulin pump, additional documentation supporting the necessity of Lantus for effective control must be presented.

 

Additional Considerations

 

  • Continuation of coverage for Lantus will require periodic review of the patient's treatment efficacy and safety, supported by updated documentation, to determine ongoing need relative to improvement in glycemic control.
  •  

  • For patients transitioning to Lantus following hospitalization for diabetes-related complications, a short-term coverage plan may be approved based on the immediate post-discharge care plan proffered by the treating institution.
  •  

  • Coverage may also include educational resources or support programs provided to enhance patient understanding and management of their condition, ensuring informed usage of Lantus as part of therapy.

 

Why Security Health Plan Might Deny Lantus Coverage

 

Situations Where Lantus Coverage Might Be Denied by Security Health Plan

 

  • Prescription Not Following Formulary: Security Health Plan may deny coverage if Lantus is not listed on the formulary, which is the list of covered medications provided by the insurance plan.
  •  

  • Lack of Medical Necessity: If the use of Lantus is not deemed medically necessary or if the plan's guidelines suggest a different treatment option, coverage may be denied.
  •  

  • Prior Authorization Not Obtained: If a prior authorization required for Lantus is not obtained before the prescription is filled, Security Health Plan might deny coverage.
  •  

  • Non-Compliance with Step Therapy: Coverage might be denied if the specific requirements of step therapy are not met, meaning other therapies have not been tried and failed as required by the plan.
  •  

  • Prescription from Non-Network Provider: If the prescription is written by a healthcare provider who is not within the Security Health Plan's network, coverage for Lantus may be denied.
  •  

  • Lantus Prescribed for Non-Approved Use: If Lantus is prescribed for an off-label use that is not approved by Security Health Plan, coverage might not be provided.
  •  

  • Failure to Meet Quantity Limits: If the prescribed quantity exceeds the plan's established limits without proper justification, coverage may be denied.
  •  

  • Duplicate Therapy: If Lantus is prescribed alongside other medications that Security Health Plan deems duplicative, the plan might deny coverage for Lantus.

 

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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 Security Health Plan

 

Start with Security Health Plan Enrollment

 

  • Visit the official Security Health Plan website to view their insurance plans.
  • Contact a Security Health Plan representative to discuss your specific health insurance needs, including any requirements for prescription coverage.
  • Enroll in a suitable plan that offers prescription drug coverage, making sure it potentially includes coverage for medications like Lantus.

 

Verify Prescription Drug Coverage

 

  • Log into your Security Health Plan member account or contact the customer service to get a list of covered medications.
  • Search for Lantus on the formulary list to confirm its coverage status under your chosen plan.
  • If Lantus isn't covered or has restrictions, inquire about any required prior authorizations or alternative covered insulin options.

 

Consult with Your Healthcare Provider

 

  • Discuss your Lantus needs with your healthcare provider. Ensure they are aware that Security Health Plan is your insurer.
  • If necessary, your doctor may need to provide a medical necessity letter or complete a prior authorization request for Lantus.
  • In case Lantus is not initially covered, ask your provider to suggest alternative medications that may be covered by your plan.

 

Submit Required Documentation

 

  • If a prior authorization is required, gather all necessary paperwork from your healthcare provider.
  • Send the completed prior authorization and any supporting documentation to Security Health Plan following their submission guidelines.
  • Track the status of your submission through your Security Health Plan account or by calling their customer service.

 

Utilize Security Health Plan Resources

 

  • Select in-network pharmacies to fill your prescription for Lantus to maximize your coverage benefits.
  • Explore any additional resources that Security Health Plan offers, such as discount programs or mail-order pharmacy services for ongoing medications.
  • If coverage issues arise, reach out to a Security Health Plan representative to resolve any discrepancies or to request an appeal.

 

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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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