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Does Security Health Plan Cover Xarelto

Explore Security Health Plan's coverage options for Xarelto, reasons for denials, costs without insurance, and FAQs. Get insights to secure your medication needs.
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Coverage for Xarelto under Security Health Plan

 

  • Security Health Plan may cover Xarelto if it is medically necessary and prescribed for specific conditions such as atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE).

    •  

  • Prior authorization might be required to determine medical necessity and appropriate use according to plan guidelines.

    •  

  • Patients might need to try and fail using other anticoagulants before Xarelto is approved, as part of step therapy protocols.

    •  

  • Copayment or coinsurance may apply depending on the specific plan a member has.

    •  

  • Coverage details can vary; it is crucial for members to check their benefit documents or contact Security Health Plan directly for verification.

 

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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 Xarelto Coverage with Security Health Plan

 

Contact Security Health Plan Customer Service

 

  • Reach out to Security Health Plan's customer service for detailed information about your coverage options for Xarelto.
  • Use the contact information available on their website to get in touch via phone or email.

 

Verify Your Plan Details

 

  • Review your current insurance plan documents to understand your pharmacy benefits and see if Xarelto is included.
  • Look for the specific tier or formulary level that applies to Xarelto, as this may affect out-of-pocket costs.

 

Consult with Your Healthcare Provider

 

  • Schedule a visit with your healthcare provider to discuss the necessity of Xarelto for your condition.
  • Request a written prescription that includes the medical justification if required by your insurance provider.

 

Request Prior Authorization

 

  • Fill out any necessary prior authorization forms required by Security Health Plan if Xarelto isn't automatically covered.
  • Submit documentation from your healthcare provider regarding the medical necessity of Xarelto along with the forms.

 

Review Formulary Exceptions

 

  • Ask Security Health Plan about the possibility of formulary exceptions if Xarelto is not covered under your current plan.
  • Provide any required documentation or recommendations from your healthcare provider to support your request for an exception.

 

Compare Alternative Medications

 

  • Discuss with your healthcare provider whether there are alternative medications covered by your plan that may be suitable as substitutes.
  • Evaluate the effectiveness and side effects of such alternatives before making any changes.

 

Appeal Denied Coverage

 

  • If coverage for Xarelto is denied, inquire about the appeal process and necessary steps to challenge the decision.
  • Collect and submit all relevant medical information and any previous correspondence regarding the denial to strengthen your appeal.

 

Monitor Changes in Plan Coverage

 

  • Stay informed about any updates or changes to your Security Health Plan coverage, especially during open enrollment periods.
  • Reassess your plan options periodically to ensure that Xarelto remains covered under your policy.

 

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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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FAQs

Does Security Health Plan Cover Xarelto

Explore Security Health Plan's coverage options for Xarelto, reasons for denials, costs without insurance, and FAQs. Get insights to secure your medication needs.
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Is Xarelto Covered by Security Health Plan

 

Coverage for Xarelto under Security Health Plan

 

  • Security Health Plan may cover Xarelto if it is medically necessary and prescribed for specific conditions such as atrial fibrillation, deep vein thrombosis (DVT), or pulmonary embolism (PE).

    •  

  • Prior authorization might be required to determine medical necessity and appropriate use according to plan guidelines.

    •  

  • Patients might need to try and fail using other anticoagulants before Xarelto is approved, as part of step therapy protocols.

    •  

  • Copayment or coinsurance may apply depending on the specific plan a member has.

    •  

  • Coverage details can vary; it is crucial for members to check their benefit documents or contact Security Health Plan directly for verification.

 

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Security Health Plan's Approved Criteria for Xarelto Coverage

 

Approved Criteria for Xarelto Coverage

 

  • Xarelto is approved for patients diagnosed with non-valvular atrial fibrillation, provided they are at risk for stroke or systemic embolism.

    •  

  • Coverage includes use for treatment of deep vein thrombosis (DVT) in patients who have had this condition diagnosed by relevant medical tests.

    •  

  • Xarelto is covered for the treatment of pulmonary embolism (PE) following a clear medical diagnosis.

    •  

  • Patients who require Xarelto for the prevention of recurrence of DVT and PE following initial management with parenteral anticoagulant therapy are covered.

    •  

  • Coverage includes patients undergoing knee or hip replacement surgery for post-operative prevention of DVT or PE.

    •  

  • Xarelto is covered for reducing the risk of major cardiovascular events such as cardiovascular death, myocardial infarction, and stroke in patients with chronic coronary artery disease (CAD) or peripheral artery disease (PAD).

    •  

  • For coverage, the prescribing physician must attest that the use of Xarelto is consistent with FDA-approved indications and current medical guidelines.

 

Why Security Health Plan Might Deny Xarelto Coverage

 

Reasons for Denial of Xarelto Coverage

 

  • The medication is being used for an off-label purpose that is not approved by Security Health Plan.

    •  

  • There is a lack of sufficient medical documentation to justify the medical necessity of Xarelto for a patient's specific condition or diagnosis.

    •  

  • The patient has not met the required criteria for prior authorization or step therapy protocols set by Security Health Plan.

    •  

  • Xarelto is deemed a non-preferred drug alternative, and the patient has not tried and failed on other preferred anticoagulant therapies that are covered.

    •  

  • The prescription does not comply with the quantity limits or dosage guidelines outlined by Security Health Plan's formulary.

    •  

  • The patient does not meet the age-related restrictions imposed by the health plan for Xarelto coverage.

    •  

 

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How Much Does Xarelto Cost without Insurance?

 

Approximate Cost of Xarelto Without Insurance

 

  • The cost for Xarelto, a prescription anticoagulant medication, can vary depending on the dosage and quantity prescribed. On average, the cost of a 30-day supply of Xarelto 20 mg tablets, without insurance, can range from $450 to $540.

    •  

  • Prices may differ at various pharmacies, and patients might find lower prices through discount programs or pharmacy discount cards.

    •  

  • Shopping around and comparing prices at different pharmacies or checking with online retailers can sometimes yield better deals or discounts.

    •  

  • Additional savings may be available through pharmaceutical assistance programs, which are offered by the manufacturer for eligible patients who meet specific criteria.

 

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 Xarelto Coverage with Security Health Plan

 

Contact Security Health Plan Customer Service

 

  • Reach out to Security Health Plan's customer service for detailed information about your coverage options for Xarelto.
  • Use the contact information available on their website to get in touch via phone or email.

 

Verify Your Plan Details

 

  • Review your current insurance plan documents to understand your pharmacy benefits and see if Xarelto is included.
  • Look for the specific tier or formulary level that applies to Xarelto, as this may affect out-of-pocket costs.

 

Consult with Your Healthcare Provider

 

  • Schedule a visit with your healthcare provider to discuss the necessity of Xarelto for your condition.
  • Request a written prescription that includes the medical justification if required by your insurance provider.

 

Request Prior Authorization

 

  • Fill out any necessary prior authorization forms required by Security Health Plan if Xarelto isn't automatically covered.
  • Submit documentation from your healthcare provider regarding the medical necessity of Xarelto along with the forms.

 

Review Formulary Exceptions

 

  • Ask Security Health Plan about the possibility of formulary exceptions if Xarelto is not covered under your current plan.
  • Provide any required documentation or recommendations from your healthcare provider to support your request for an exception.

 

Compare Alternative Medications

 

  • Discuss with your healthcare provider whether there are alternative medications covered by your plan that may be suitable as substitutes.
  • Evaluate the effectiveness and side effects of such alternatives before making any changes.

 

Appeal Denied Coverage

 

  • If coverage for Xarelto is denied, inquire about the appeal process and necessary steps to challenge the decision.
  • Collect and submit all relevant medical information and any previous correspondence regarding the denial to strengthen your appeal.

 

Monitor Changes in Plan Coverage

 

  • Stay informed about any updates or changes to your Security Health Plan coverage, especially during open enrollment periods.
  • Reassess your plan options periodically to ensure that Xarelto remains covered under your policy.

 

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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.

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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.

Xarelto FAQ

What are the common side effects of Xarelto?

 

Common Side Effects of Xarelto

 

  • Bleeding is the most common, including nasal, gum, or gastrointestinal bleeding. Be vigilant for any signs of unusual bleeding and seek medical attention if necessary.

    •  

  • Gastrointestinal issues such as nausea and stomach pain may occur. Taking Xarelto with food can help alleviate these symptoms.

    •  

  • Dizziness and fatigue can affect some individuals, especially when first starting the medication. Ensure you maintain hydration and rest as needed.

    •  

  • In rare cases, allergic reactions may manifest as rash or itching. If this occurs, consult your healthcare provider promptly.

 

Is Xarelto a blood thinner?

 

Is Xarelto a Blood Thinner?

 

  • **Xarelto (rivaroxaban)** is indeed a blood thinner, specifically an anticoagulant, which is crucial for preventing blood clots that can lead to conditions like stroke or deep vein thrombosis (DVT).

    •  

  • It works by inhibiting **factor Xa**, an essential component in the coagulation cascade, reducing the ability of blood to form clots.

    •  

  • As a **direct oral anticoagulant (DOAC)**, it provides several advantages over traditional blood thinners like warfarin, such as having fewer dietary restrictions and not requiring regular blood monitoring.

    •  

  • It's important to take it as prescribed by a healthcare provider, considering potential drug interactions and contraindications.

 

Can you drink alcohol while taking Xarelto?

 

Drinking Alcohol with Xarelto

 

  • Xarelto, a blood thinner, may increase bleeding risk, and alcohol can amplify this risk.

    •  

  • Both substances affect liver function, potentially impacting medication metabolism and effectiveness.

    •  

  • Consuming alcohol while on Xarelto may enhance side effects like dizziness, increasing injury risk.

    •  

  • It’s crucial to consult your healthcare provider to discuss allowable alcohol intake based on your health status and dosage.

    •  

 

General Recommendations

 

  • Moderation is key – if approved, limit alcohol consumption as per medical advice.

    •  

  • Avoid binge drinking, which drastically heightens risk of adverse reactions.

    •  

  • Inform your medical team about recreational activities involving alcohol.

 

Have questions left?

‍

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Curex is one of America’s largest telehealth providers

Together with our partners we have changed the lives of over 300,000 patients. Here’s what some of them have to say:

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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.
‍
Curex-affiliated medical practices are independently owned and operated by licensed physicians who provide services using the Curex telehealth platform.

Compounded medications have not been approved by the FDA and the FDA has not evaluated their safety or efficacy.

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