Does Security Health Plan Cover Trulicity

Learn if Security Health Plan covers Trulicity, why coverage might be denied, how to secure coverage, cost without insurance, and FAQs.
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Security Health Plan Coverage for Trulicity

 

  • Trulicity coverage under Security Health Plan typically caters to individuals diagnosed with Type 2 diabetes, focusing on improving blood sugar control.
  •  

  • Candidates must satisfy specific medical criteria, such as having a history of metformin use or intolerance to other antidiabetic medications.
  •  

  • Prior authorization from Security Health Plan is generally required, ensuring medical necessity and alignment with plan guidelines.
  •  

  • Ensure prescriptions are from in-network providers to facilitate a smooth approval process and minimize out-of-pocket costs.
  •  

  • Check the formulary and tier level within Security Health Plan, as coverage and copayment amounts can vary based on plan specifics.
  •  

  • Appeals may be pursued if initial coverage requests are denied, providing additional medical documentation and justification.

 

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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.

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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.

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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 Trulicity Coverage with Security Health Plan

 

Gather Required Information

 

  • Contact your healthcare provider for a prescription of Trulicity if needed for your condition.
  •  

  • Check the specific details of your current plan with Security Health Plan, including any deductibles, co-pays, and coverage limits for prescription medications.
  •  

  • Have your insurance card and personal information ready for any communications.

 

Consult with Your Healthcare Provider

 

  • Discuss with your healthcare provider about prescribing Trulicity and any prior authorization that might be needed.
  •  

  • Inquire if any test results or medical records are required to verify the necessity of Trulicity for your condition.

 

Review Your Policy

 

  • Log into your Security Health Plan account to access your plan's details or review your policy documents manually.
  •  

  • Look for specific information regarding coverage for diabetes medications or specialty drugs like Trulicity.
  •  

  • If unclear, contact Security Health Plan’s customer service for a better understanding of what is covered.

 

Contact Security Health Plan

 

  • Call the customer service line for Security Health Plan and inquire about Trulicity coverage.
  •  

  • Ask about any specific forms or requirements needed for coverage, including whether a prior authorization is necessary.
  •  

  • Inquire about any preferred pharmacies for filling Trulicity to ensure you get in-network coverage rates.

 

Submit Necessary Documents

 

  • Gather and submit all required documentation including the prescription from your healthcare provider and any necessary prior authorization forms.
  •  

  • Ensure all submissions have been confirmed received by Security Health Plan.

 

Fill Prescription

 

  • Once coverage is confirmed, take your prescription to a pharmacy that is considered in-network by Security Health Plan.
  •  

  • Verify your benefits with the pharmacist to determine your out-of-pocket cost for Trulicity.

 

Follow Up

 

  • If there are any issues or denials with the coverage, contact Security Health Plan promptly to resolve them. You may need to provide additional information or appeal the decision.
  •  

  • Regularly review your coverage and benefits to ensure continual access to Trulicity as prescribed by your healthcare provider.

 

Maintain Records

 

  • Keep copies of all communications, filings, and receipts related to your Trulicity coverage and purchase. This is important for any future claims or disputes.
  •  

  • Monitor your insurance statements to verify that the charges and coverage are consistent with your understanding.

 

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FAQs

Does Security Health Plan Cover Trulicity

Learn if Security Health Plan covers Trulicity, why coverage might be denied, how to secure coverage, cost without insurance, and FAQs.
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Is Trulicity Covered by Security Health Plan

 

Security Health Plan Coverage for Trulicity

 

  • Trulicity coverage under Security Health Plan typically caters to individuals diagnosed with Type 2 diabetes, focusing on improving blood sugar control.
  •  

  • Candidates must satisfy specific medical criteria, such as having a history of metformin use or intolerance to other antidiabetic medications.
  •  

  • Prior authorization from Security Health Plan is generally required, ensuring medical necessity and alignment with plan guidelines.
  •  

  • Ensure prescriptions are from in-network providers to facilitate a smooth approval process and minimize out-of-pocket costs.
  •  

  • Check the formulary and tier level within Security Health Plan, as coverage and copayment amounts can vary based on plan specifics.
  •  

  • Appeals may be pursued if initial coverage requests are denied, providing additional medical documentation and justification.

 

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Security Health Plan's Approved Criteria for Trulicity Coverage

 

Criteria for Trulicity Coverage

 

  • The individual must be diagnosed with type 2 diabetes mellitus.
  •  

  • The candidate should be 18 years of age or older.
  •  

  • Documentation from a healthcare provider indicating the necessity of Trulicity for the treatment and management of type 2 diabetes.
  •  

  • The patient must exhibit an inadequate response to lifestyle modifications such as diet and physical activity.
  •  

  • Evidence of recent treatment history with at least one other antidiabetic agent, excluding GLP-1 receptor agonists, reflecting an inadequate response or adverse effects.
  •  

  • Trulicity must be prescribed to be used in conjunction with a comprehensive diabetic treatment plan aimed at optimizing glycemic control.
  •  

  • Documentation that Trulicity is being used according to the Food and Drug Administration (FDA)-approved indications and dosages unless otherwise specified by clinical guidelines or published medical literature.
  •  

  • If there is a documented medical necessity (e.g., contraindication or intolerance) barring the patient from using other antidiabetic agents, this must be specified, reinforcing the necessity for Trulicity.

 

Why Security Health Plan Might Deny Trulicity Coverage

 

Situations Where Security Health Plan Might Deny Trulicity Coverage

 

  • The prescription for Trulicity does not meet the medical necessity criteria as outlined by Security Health Plan. This may include instances where alternative therapies are available and deemed adequate.
  •  

  • Trulicity is prescribed for a condition not approved by the FDA or not included in the plan’s formulary approved conditions.
  •  

  • Trulicity is requested for use at a frequency or dosage that exceeds the recommended prescribing guidelines without additional medical justification.
  •  

  • The prescribed Trulicity is for an off-label use that is not supported by sufficient medical literature or clinical evidence.
  •  

  • Lack of prior authorization from Security Health Plan before the Trulicity prescription is initiated, where such authorization is required as part of the coverage policy.
  •  

  • The patient does not meet specific age or demographic requirements set by the plan for Trulicity coverage.
  •  

  • Insufficient documentation or information to establish the medical necessity of Trulicity for the particular case submitted.
  •  

  • Duplication of therapy, where the patient is already receiving another medication in the same class as Trulicity, unless specifically warranted.
  •  

  • Trulicity is being prescribed by a provider not within the Security Health Plan network, unless prior exceptions are granted.

 

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How Much Does Trulicity Cost without Insurance?

 

Trulicity Cost Overview

 

  • Trulicity is a brand-name medication commonly used to treat type 2 diabetes. It's administered through a weekly injection.

 

Approximate Cost Without Insurance

 

  • The price of Trulicity can vary depending on the pharmacy or location, but the average cost for one pen of 1.5 mg/0.5 mL solution might run approximately $886 to $1,100.
  • Each box typically contains four pens, which is a month's supply, resulting in the total cost being roughly $3,544 to $4,400.

 

Factors Influencing Pricing

 

  • Pharmacy: Prices may differ from one pharmacy to another, so it’s beneficial to compare costs.
  • Location: Costs may vary based on geographic location due to regional pricing strategies and pharmacy benefits.
  • Discount Programs: Some pharmacies may offer savings programs or coupons that could lower the price.

 

Additional Cost-Saving Tips

 

  • Check for manufacturer discounts or patient assistance programs, which may offer significant savings or even free medication for qualified individuals.
  • Consider discussing alternative medications with your healthcare provider to find a more affordable option suitable for your needs.
  • Utilize pharmacy discount cards or look up savings programs online that specifically cater to diabetes medications.

 

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 Trulicity Coverage with Security Health Plan

 

Gather Required Information

 

  • Contact your healthcare provider for a prescription of Trulicity if needed for your condition.
  •  

  • Check the specific details of your current plan with Security Health Plan, including any deductibles, co-pays, and coverage limits for prescription medications.
  •  

  • Have your insurance card and personal information ready for any communications.

 

Consult with Your Healthcare Provider

 

  • Discuss with your healthcare provider about prescribing Trulicity and any prior authorization that might be needed.
  •  

  • Inquire if any test results or medical records are required to verify the necessity of Trulicity for your condition.

 

Review Your Policy

 

  • Log into your Security Health Plan account to access your plan's details or review your policy documents manually.
  •  

  • Look for specific information regarding coverage for diabetes medications or specialty drugs like Trulicity.
  •  

  • If unclear, contact Security Health Plan’s customer service for a better understanding of what is covered.

 

Contact Security Health Plan

 

  • Call the customer service line for Security Health Plan and inquire about Trulicity coverage.
  •  

  • Ask about any specific forms or requirements needed for coverage, including whether a prior authorization is necessary.
  •  

  • Inquire about any preferred pharmacies for filling Trulicity to ensure you get in-network coverage rates.

 

Submit Necessary Documents

 

  • Gather and submit all required documentation including the prescription from your healthcare provider and any necessary prior authorization forms.
  •  

  • Ensure all submissions have been confirmed received by Security Health Plan.

 

Fill Prescription

 

  • Once coverage is confirmed, take your prescription to a pharmacy that is considered in-network by Security Health Plan.
  •  

  • Verify your benefits with the pharmacist to determine your out-of-pocket cost for Trulicity.

 

Follow Up

 

  • If there are any issues or denials with the coverage, contact Security Health Plan promptly to resolve them. You may need to provide additional information or appeal the decision.
  •  

  • Regularly review your coverage and benefits to ensure continual access to Trulicity as prescribed by your healthcare provider.

 

Maintain Records

 

  • Keep copies of all communications, filings, and receipts related to your Trulicity coverage and purchase. This is important for any future claims or disputes.
  •  

  • Monitor your insurance statements to verify that the charges and coverage are consistent with your understanding.

 

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Trulicity FAQ

What are the common side effects of Trulicity?

 

Common Side Effects of Trulicity

 

  • Nausea: Initially, many patients experience nausea, which often lessens over time as the body adjusts.
  •  

  • Vomiting: Some individuals may experience vomiting, particularly in the first few doses.
  •  

  • Diarrhea: Digestive disturbances such as diarrhea are commonly reported.
  •  

  • Abdominal Pain: Discomfort in the abdomen can occur, often subsiding with continued use.
  •  

  • Decreased Appetite: Patients often report a reduction in appetite.
  •  

  • Fatigue: Some individuals may feel unusually tired after starting treatment.
  •  

  • Reduced Blood Sugar: Blood sugar levels may become low, especially when used in conjunction with other diabetes medications.

 

How much weight can you lose on Trulicity?

 

Weight Loss with Trulicity

 

  • Trulicity (dulaglutide) is primarily prescribed for managing type 2 diabetes, but many patients also experience weight loss as an additional benefit.
  •  

  • Clinical trials indicate an average weight loss of around 2-6 pounds, but results differ based on individual factors such as diet, exercise, and adherence to the medication.
  •  

  • Some users report greater weight loss; however, it's important to accompany Trulicity with lifestyle changes for optimal results.
  •  

  • Consult with a healthcare provider to tailor a plan that maximizes benefits based on your health needs.

 

How does Trulicity work for type 2 diabetes?

 

How Trulicity Works

 

  • Trulicity is a GLP-1 receptor agonist, helping to regulate blood sugar levels.
  •  

  • It stimulates insulin release in response to high blood glucose.
  •  

  • It slows gastric emptying, which helps reduce post-meal glucose spikes.
  •  

  • Trulicity suppresses glucagon secretion, lowering glucose production by the liver.

 

Benefits

 

  • Easy-to-use once-weekly injection, improving adherence.
  •  

  • Not associated with causing weight gain; may even promote modest weight loss.
  •  

  • May reduce risk of cardiovascular events in patients with heart disease.

 

Considerations

 

  • May cause gastrointestinal side effects, often resolving over time.
  •  

  • Inform your doctor if you have a history of pancreatitis or gallbladder disease.
  •  

  • Monitor for signs of low blood sugar, especially if using other diabetes medications.

 

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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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