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Does Security Health Plan Cover Phentermine (Adipex-P, Lomaira)

Learn about Security Health Plan's coverage on Phentermine. Navigate denials, coverage steps, costs without insurance, and FAQs for informed decisions.
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Does Security Health Plan Cover Phentermine (Adipex-P, Lomaira)

 

  • Security Health Plan may cover Phentermine under specific conditions related to medical necessity and treatment of obesity.

    •  

  • Coverage usually requires a prescription and documentation of a clear medical need, often related to a diagnosis by a healthcare professional.

    •  

  • Patients typically must demonstrate that dietary and lifestyle changes alone have not been effective in achieving weight loss goals before approval is granted.

    •  

  • The plan might have defined criteria such as a minimum BMI threshold, usually 30 or higher, or 27 with comorbid conditions.

    •  

  • Pre-authorization may be required, which involves a review of the patient’s medical history, proposed treatment course, and possibly previous weight loss attempts.

    •  

  • All coverage decisions are subject to change and should be verified directly with Security Health Plan to ensure accurate and up-to-date information.

 

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Clinical Support

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 Security Health Plan

 

Research Phentermine Coverage

 

  • Visit the Security Health Plan website to check the medication coverage for Phentermine (Adipex-P, Lomaira). Look specifically for their Pharmacy Benefits or Medications section.

    •  

  • Contact Security Health Plan's customer service for detailed information on coverage options, as they can provide the most accurate guidance on whether Phentermine is covered under your specific plan.

    •  

  • Review your policy documents or member handbook to find any information regarding the coverage for weight-loss medications and specific criteria for Phentermine.

 

Consult with Your Healthcare Provider

 

  • Discuss with your healthcare provider the necessity of Phentermine for your weight management plan. They can provide medical justification, which is often required for insurance coverage.

    •  

  • Request your healthcare provider to write a prescription for Phentermine if they deem it medically necessary.

 

Pre-Authorization Process

 

  • Many insurance providers require pre-authorization for medications like Phentermine. Work with your healthcare provider to submit a pre-authorization request.

    •  

  • Prepare necessary documentation such as medical history, necessity for the medication, and any previous weight management attempts.

 

Submitting a Claim

 

  • If your plan requires you to submit a claim for medication reimbursement, gather all necessary documents like prescription details and receipts.

    •  

  • Use the claim forms available on the Security Health Plan website, following their submission directions accurately to avoid delays.

 

Appeal if Necessary

 

  • If your initial request for coverage is denied, review the reasons for denial found in the notification letter sent by Security Health Plan.

    •  

  • Prepare an appeal by gathering additional documents or information supporting your case and submit it through the process outlined by Security Health Plan.

 

Explore Alternative Options

 

  • Discuss with your healthcare provider alternatives to Phentermine prescribed under covered medications or generic alternatives.

    •  

  • Investigate discount programs or savings cards for Phentermine that might be offered by the manufacturer or third-party services.

 

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Does Security Health Plan Cover Phentermine (Adipex-P, Lomaira)

Learn about Security Health Plan's coverage on Phentermine. Navigate denials, coverage steps, costs without insurance, and FAQs for informed decisions.
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Is Phentermine (Adipex-P, Lomaira) Covered by Security Health Plan

 

Does Security Health Plan Cover Phentermine (Adipex-P, Lomaira)

 

  • Security Health Plan may cover Phentermine under specific conditions related to medical necessity and treatment of obesity.

    •  

  • Coverage usually requires a prescription and documentation of a clear medical need, often related to a diagnosis by a healthcare professional.

    •  

  • Patients typically must demonstrate that dietary and lifestyle changes alone have not been effective in achieving weight loss goals before approval is granted.

    •  

  • The plan might have defined criteria such as a minimum BMI threshold, usually 30 or higher, or 27 with comorbid conditions.

    •  

  • Pre-authorization may be required, which involves a review of the patient’s medical history, proposed treatment course, and possibly previous weight loss attempts.

    •  

  • All coverage decisions are subject to change and should be verified directly with Security Health Plan to ensure accurate and up-to-date information.

 

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Start with Curex

Security Health Plan's Approved Criteria for Phentermine (Adipex-P, Lomaira) Coverage

 

Eligibility Criteria for Phentermine Coverage

 

  • Patient must be 18 years of age or older.

    •  

  • Body Mass Index (BMI) of 30 kg/m² or greater, OR BMI of 27 kg/m² or greater with at least one weight-related comorbidity such as hypertension, type 2 diabetes, or dyslipidemia.

 

Medical Evaluation Requirements

 

  • A comprehensive medical evaluation must be completed and documented. This includes both a physical exam and a review of the patient's medical history.

    •  

  • Evaluation results must support the medical necessity of weight management intervention including pharmacotherapy with Phentermine.

 

Lifestyle Modification Program

 

  • Patient must be enrolled in a structured lifestyle modification program for weight loss, which includes strategies like a reduced-calorie diet, increased physical activity, and behavior therapy.

    •  

  • Active participation in the program must be documented with proof of regular attendance and progress.

 

Trial of Non-Pharmacological Treatments

 

  • Documentation of at least a six-month trial period of non-pharmacological interventions prior to Phentermine initiation.

    •  

  • The trial should include lifestyle changes with diet and exercise, and evidence showing insufficient weight loss with these methods alone.

 

Specialist Consultation

 

  • A consultation with a specialist in obesity or endocrinology before starting Phentermine therapy is recommended.

    •  

  • A specialist’s assessment is required to confirm that Phentermine is appropriate given the patient's health profile.

 

Duration and Monitoring

 

  • Initial prescription should not exceed 12 weeks of therapy. Continuation of therapy requires re-evaluation and doctor approval.

    •  

  • Regular follow-up appointments to monitor progress and any potential side effects should be scheduled and documented throughout the treatment period.

 

Why Security Health Plan Might Deny Phentermine (Adipex-P, Lomaira) Coverage

 

Reasons for Denial of Phentermine Coverage by Security Health Plan

 

  • Phentermine (Adipex-P, Lomaira) is not covered if it is intended for cosmetic weight loss rather than a medical necessity related to obesity-related health conditions.

    •  

  • Prescriptions for Phentermine are denied when there is a lack of documentation showing that standard weight loss approaches, including lifestyle changes and dietary modifications, have been attempted and proven insufficient.

    •  

  • Coverage is not provided if Phentermine is prescribed for a duration that exceeds the typical short-term use recommendation, due to concerns over safety and effectiveness beyond such periods.

    •  

  • The medication will not be covered if it is prescribed in combination with other weight loss drugs that raise safety concerns, unless specifically supported by clinical guidelines and documentation.

    •  

  • Security Health Plan may reject coverage if the prescribed dosage exceeds the approved maximum dosage limits without sufficient medical justification.

    •  

  • Phentermine prescriptions may be denied if there is a suspicion of abuse or potential for misuse, particularly in patients with a history of substance misuse.

    •  

  • Coverage might not be extended to patients with contraindications documented in their medical history, such as existing heart disease, uncontrolled high blood pressure, or overactive thyroid conditions.

 

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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.

 

Clinical Support

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 Security Health Plan

 

Research Phentermine Coverage

 

  • Visit the Security Health Plan website to check the medication coverage for Phentermine (Adipex-P, Lomaira). Look specifically for their Pharmacy Benefits or Medications section.

    •  

  • Contact Security Health Plan's customer service for detailed information on coverage options, as they can provide the most accurate guidance on whether Phentermine is covered under your specific plan.

    •  

  • Review your policy documents or member handbook to find any information regarding the coverage for weight-loss medications and specific criteria for Phentermine.

 

Consult with Your Healthcare Provider

 

  • Discuss with your healthcare provider the necessity of Phentermine for your weight management plan. They can provide medical justification, which is often required for insurance coverage.

    •  

  • Request your healthcare provider to write a prescription for Phentermine if they deem it medically necessary.

 

Pre-Authorization Process

 

  • Many insurance providers require pre-authorization for medications like Phentermine. Work with your healthcare provider to submit a pre-authorization request.

    •  

  • Prepare necessary documentation such as medical history, necessity for the medication, and any previous weight management attempts.

 

Submitting a Claim

 

  • If your plan requires you to submit a claim for medication reimbursement, gather all necessary documents like prescription details and receipts.

    •  

  • Use the claim forms available on the Security Health Plan website, following their submission directions accurately to avoid delays.

 

Appeal if Necessary

 

  • If your initial request for coverage is denied, review the reasons for denial found in the notification letter sent by Security Health Plan.

    •  

  • Prepare an appeal by gathering additional documents or information supporting your case and submit it through the process outlined by Security Health Plan.

 

Explore Alternative Options

 

  • Discuss with your healthcare provider alternatives to Phentermine prescribed under covered medications or generic alternatives.

    •  

  • Investigate discount programs or savings cards for Phentermine that might be offered by the manufacturer or third-party services.

 

Premium Medication you can trust

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.

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.

 

Have questions left?

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A weight management program tailored to you

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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Curex provides allergy care plans for allergies, asthma, eczema and pet allergies.

Curex providers may prescribe sublingual allergy drops that contain the same ingredients as allergy shots but are more convenient & affordable.
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