Does SelectHealth Cover Chantix

Explore SelectHealth's coverage for Chantix, potential denial reasons, securing coverage, cost insights, and FAQs for informed healthcare decisions.
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Does SelectHealth Cover Chantix?

 

  • SelectHealth may cover Chantix as part of its prescription drug benefits, subject to the specific plan and pharmacy benefit manager (PBM) policies.
  •  

  • Coverage often requires Chantix to be classified within an approved formulary tier, and may necessitate prior authorization to establish medical necessity.
  •  

  • Members should consult their specific plan details or contact SelectHealth customer service to confirm Chantix coverage and determine any copayment or coinsurance obligations.
  •  

  • Eligibility for Chantix coverage might include participation in a smoking cessation program, as this aligns with SelectHealth's preventive health measures.
  •  

  • Members may need to follow step therapy protocols, trying alternative medications before Chantix is approved, depending on the plan requirements.

 

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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 Chantix Coverage with SelectHealth

 

Verify Your SelectHealth Plan Coverage

 

  • Check your current SelectHealth plan documents to see if Chantix (varenicline), a smoking cessation aid, is included in the list of covered medications.
  •  
  • Contact SelectHealth customer service directly to confirm whether Chantix is covered under your specific health plan.
  •  
  • If Chantix is not covered, inquire about alternative smoking cessation aids that might be included in your plan.

 

Meet the Criteria for Chantix Coverage

 

  • Ensure you have a valid prescription from your healthcare provider for Chantix.
  •  
  • Verify if SelectHealth requires any pre-authorization for Chantix, and if so, work with your healthcare provider to obtain it if necessary.
  •  
  • Check if there are specific conditions or criteria you need to meet for coverage, such as participation in a smoking cessation program.

 

Enroll in a Smoking Cessation Program, if Required

 

  • If your SelectHealth plan requires enrollment in a smoking cessation program for Chantix coverage, identify a program that meets their requirements.
  •  
  • Complete the necessary enrollment procedures and follow the guidelines set forth by the program.
  •  
  • Maintain documentation of your participation and progress in the cessation program, as this may be required by SelectHealth.

 

Submit Claims and Documentation

 

  • Collect all necessary documentation, including your Chantix prescription and any required pre-authorization forms.
  •  
  • Submit a claim to SelectHealth for the Chantix prescription, ensuring all forms are accurately completed and include any supporting documents.
  •  
  • Keep copies of all submitted forms and any correspondence with SelectHealth for your records.

 

Follow Up with SelectHealth

 

  • Monitor the status of your claim by checking online through the SelectHealth member portal or contacting customer service.
  •  
  • If your claim is denied, review the denial notice to understand the reasons and inquire about the appeals process.
  •  
  • Submit an appeal with the necessary documentation if you believe your coverage was improperly denied.

 

Explore Additional Support Options

 

  • Contact SelectHealth's customer service for guidance on additional resources or programs that support smoking cessation efforts.
  •  
  • Discuss with your healthcare provider any alternative medications or treatments that may be available if Chantix coverage is not possible.

 

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FAQs

Does SelectHealth Cover Chantix

Explore SelectHealth's coverage for Chantix, potential denial reasons, securing coverage, cost insights, and FAQs for informed healthcare decisions.
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Is Chantix Covered by SelectHealth

 

Does SelectHealth Cover Chantix?

 

  • SelectHealth may cover Chantix as part of its prescription drug benefits, subject to the specific plan and pharmacy benefit manager (PBM) policies.
  •  

  • Coverage often requires Chantix to be classified within an approved formulary tier, and may necessitate prior authorization to establish medical necessity.
  •  

  • Members should consult their specific plan details or contact SelectHealth customer service to confirm Chantix coverage and determine any copayment or coinsurance obligations.
  •  

  • Eligibility for Chantix coverage might include participation in a smoking cessation program, as this aligns with SelectHealth's preventive health measures.
  •  

  • Members may need to follow step therapy protocols, trying alternative medications before Chantix is approved, depending on the plan requirements.

 

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SelectHealth's Approved Criteria for Chantix Coverage

 

SelectHealth's Approved Criteria for Chantix Coverage

 

  • The patient must be an adult (18 years or older) seeking assistance for smoking cessation.
  •  

  • Documentation must show that the patient has a history of nicotine dependence.
  •  

  • Prior unsuccessful attempts to quit smoking using over-the-counter products or counseling are required before coverage is considered.
  •  

  • A healthcare provider must prescribe Chantix as part of a comprehensive quit-smoking program that includes counseling and follow-up visits.
  •  

  • The patient should not have any contraindications to Chantix, such as known hypersensitivity to varenicline or any of its components.
  •  

  • Consideration for coverage may require a discussion of risk factors and benefits with the patient, documented by the healthcare provider.
  •  

  • Coverage may include an initial prescription and renewals if progress and effectiveness are documented by a healthcare provider.
  •  

  • The prescription must comply with any dosage and duration limitations as outlined in SelectHealth's prescription drug policy.

 

Why SelectHealth Might Deny Chantix Coverage

 

Situations Where SelectHealth Might Deny Chantix Coverage

 

  • The prescription for Chantix is not deemed medically necessary according to SelectHealth's specific criteria. This might include situations where other smoking cessation methods have not been attempted first.
  •  

  • The patient does not meet the age restrictions or demographic criteria set by SelectHealth for coverage eligibility.
  •  

  • Chantix is prescribed for uses that are beyond the approved labeling or for conditions that are not recognized by SelectHealth's guidelines.
  •  

  • Prescriptions written by non-network providers may be denied if SelectHealth requires the prescription to be issued by an in-network physician.
  •  

  • There is insufficient documentation provided that supports the use of Chantix as required by SelectHealth's evaluation process.
  •  

  • The patient has exceeded any quantity limits or duration of therapy limits set by SelectHealth for Chantix without prior authorization or override approval.
  •  

  • The coverage is denied based on a formulary exclusion, with Chantix not listed as a covered medication under the patient's specific plan.
  •  

  • The patient has not completed any necessary prerequisite programs or alternative treatments that SelectHealth mandates before approving Chantix.

 

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How Much Does Chantix Cost without Insurance?

 

Chantix Cost without Insurance

 

  • The cost of Chantix, a medication used to help adults stop smoking, can vary depending on the pharmacy and location. However, without insurance, the average price for a month's supply of Chantix is typically between $400 to $500.
  •  

  • Discounts or coupons may be available through certain pharmacies or websites, which can lower the out-of-pocket cost for those without insurance.
  •  

  • It's important to check with individual pharmacies for the most accurate pricing, as costs can differ significantly. Consider asking if they offer any in-house saving programs or discounts for cash payments.

 

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 Chantix Coverage with SelectHealth

 

Verify Your SelectHealth Plan Coverage

 

  • Check your current SelectHealth plan documents to see if Chantix (varenicline), a smoking cessation aid, is included in the list of covered medications.
  •  
  • Contact SelectHealth customer service directly to confirm whether Chantix is covered under your specific health plan.
  •  
  • If Chantix is not covered, inquire about alternative smoking cessation aids that might be included in your plan.

 

Meet the Criteria for Chantix Coverage

 

  • Ensure you have a valid prescription from your healthcare provider for Chantix.
  •  
  • Verify if SelectHealth requires any pre-authorization for Chantix, and if so, work with your healthcare provider to obtain it if necessary.
  •  
  • Check if there are specific conditions or criteria you need to meet for coverage, such as participation in a smoking cessation program.

 

Enroll in a Smoking Cessation Program, if Required

 

  • If your SelectHealth plan requires enrollment in a smoking cessation program for Chantix coverage, identify a program that meets their requirements.
  •  
  • Complete the necessary enrollment procedures and follow the guidelines set forth by the program.
  •  
  • Maintain documentation of your participation and progress in the cessation program, as this may be required by SelectHealth.

 

Submit Claims and Documentation

 

  • Collect all necessary documentation, including your Chantix prescription and any required pre-authorization forms.
  •  
  • Submit a claim to SelectHealth for the Chantix prescription, ensuring all forms are accurately completed and include any supporting documents.
  •  
  • Keep copies of all submitted forms and any correspondence with SelectHealth for your records.

 

Follow Up with SelectHealth

 

  • Monitor the status of your claim by checking online through the SelectHealth member portal or contacting customer service.
  •  
  • If your claim is denied, review the denial notice to understand the reasons and inquire about the appeals process.
  •  
  • Submit an appeal with the necessary documentation if you believe your coverage was improperly denied.

 

Explore Additional Support Options

 

  • Contact SelectHealth's customer service for guidance on additional resources or programs that support smoking cessation efforts.
  •  
  • Discuss with your healthcare provider any alternative medications or treatments that may be available if Chantix coverage is not possible.

 

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Chantix FAQ

What are the side effects of Chantix?

 

Common Side Effects of Chantix

 

  • Nausea, which is often dose-related and may decrease over time.
  • Insomnia or abnormal dreams, such as vivid or unusual dreams.
  • Constipation and gas due to changes in the digestive process.
  • Headaches, a frequent but generally mild occurrence.

 

Less Frequent but Serious Side Effects

 

  • Mood changes like depression or anxiety, warranting immediate medical attention.
  • Seizures, although rare, can occur and should be immediately addressed.
  • Heart issues, including an increased risk of cardiovascular events.

 

Additional Precautions

 

  • Monitor for allergic reactions, such as rash, itching, or swelling.
  • Use caution when consuming alcohol, as interactions might increase intoxication.
  • Consult a healthcare provider before use if there is a history of mental health issues.

 

How does Chantix help you quit smoking?

 

How Chantix Works

 

  • Chantix (varenicline) binds to nicotine receptors, reducing cravings by partially stimulating dopamine release to lessen withdrawal symptoms.
  •  

  • It acts as a partial agonist and antagonist, effectively blocking nicotine receptors; hence, smoking provides less pleasure.

 

Effective Usage

 

  • Start Chantix a week before quitting smoking to allow it to build up in your system.
  •  

  • Follow the prescribed plan: typically 0.5 mg once daily for three days, then twice daily, increasing to 1 mg twice daily.

 

Combine with Support

 

  • Chantix is more effective when used alongside behavioral support and counseling.
  •  

  • Seek support from healthcare providers or quit lines to enhance success rates.

 

Is Chantix available over the counter?

 

Is Chantix Available Over the Counter?

 

  • Chantix, known generically as varenicline, is a prescription medication. It is not available over-the-counter (OTC) in the United States. You will need a prescription from a healthcare provider to obtain it.
  •  

  • This medication is primarily used to help people quit smoking by reducing withdrawal symptoms and cigarette cravings.
  •  

  • Availability can vary by country, so it’s important to check local regulations regarding prescription requirements.
  •  

  • Always consult a healthcare professional before starting Chantix to understand potential side effects and interactions with other medications you may be taking.

 

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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.

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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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