Does SelectHealth Cover Victoza

Explore Victoza coverage by SelectHealth, reasons for denial, steps to get coverage, costs without insurance, and FAQs in this detailed guide.
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Coverage of Victoza

 

  • SelectHealth may cover Victoza for the treatment of type 2 diabetes when used as part of a comprehensive diabetes management plan.
  •  

  • Coverage typically requires a prescription from a healthcare provider and may involve prior authorization.

 

Criteria for Coverage

 

  • The patient must be diagnosed with type 2 diabetes and have tried other diabetes medications without sufficient control of blood glucose levels.
  •  

  • Adherence to SelectHealth's formulary guidelines and step therapy protocols might be necessary.

 

Basic Rules

 

  • Approval may depend on the patient meeting specific clinical criteria and having no contraindications to using Victoza.
  •  

  • Patients should consult with their healthcare provider and refer to their plan's formulary for detailed coverage guidelines.

 

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Dr. Neeta Ogden, MD

Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

Dr. Ravi Patel, VP Telemedicine

At Curex, our mission is to help people improve their health and quality of life by understanding their allergies and treating them at their source.We provide more than individualized prescription treatments; we provide individualized care.

Jill Hamburg, PA - C

Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

Dr. Chet Tharpe, Medical Director

Curex has set the standard for the virtual allergy experience. From the comfort of their home, patients nationwide are able to receive a personalized treatment plan from an experienced clinician, aimed at treating the source of their allergies, not just the symptoms.

Kayla Mardaga, NP

Curex offers convenient at-home allergy testing options. Our goal is to determine if a patient would benefit from immunotherapy and then customize a treatment plan that can reduce both the symptoms and the reliance on allergy medications.

How to Get Victoza Coverage with SelectHealth

 

Check Your Insurance Plan

 

  • Log into your SelectHealth member account online to access your plan details.
  •  

  • Review your prescription drug coverage section to determine if Victoza is listed under covered medications.
  •  

  • Contact SelectHealth customer service to confirm Victoza coverage and any requirements like prior authorization or step therapy.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss the need for Victoza as part of your treatment plan.
  •  

  • Ask your provider to document the medical necessity of Victoza if it is required by your insurance plan.
  •  

  • Ensure your provider is aware of any prior authorization forms or documentation needed by SelectHealth.

 

Initiate the Prior Authorization Process

 

  • Contact SelectHealth to obtain the necessary prior authorization forms for Victoza.
  •  

  • Have your healthcare provider fill out the prior authorization form and submit it to SelectHealth on your behalf.
  •  

  • Follow up with your provider and SelectHealth to ensure the submission has been received and is being processed.

 

Verify Coverage and Copayment Information

 

  • Once prior authorization is approved, verify the details of your Victoza coverage, including copayment or coinsurance amounts.
  •  

  • If your copayment seems unaffordable, inquire about SelectHealth's assistance programs or explore manufacturer savings programs.
  •  

  • Ensure your pharmacy is in-network with SelectHealth to avoid higher out-of-pocket costs.

 

Fill Your Prescription

 

  • Take your prescription to an in-network pharmacy to have Victoza filled.
  •  

  • Inform the pharmacist of your SelectHealth insurance coverage to apply it to your prescription.
  •  

  • Check for any additional approvals or documentation needed if there's an issue processing your prescription.

 

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Apply treatments in minutes from the comfort of your own home with under-the-tongue applications instead of shots or pills

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Sublingual immunotherapy delivers a higher dose of allergens over the course of treatment.

Potential for results in as few as 6 months

Individual results vary but some users have reported a noticeable difference in as few as 6-12 months since starting treatments

Excellent safety profile

Studies that have been reviewed by certified physicians show that sublingual immunotherapy is a safe treatment option
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FAQs

Does SelectHealth Cover Victoza

Explore Victoza coverage by SelectHealth, reasons for denial, steps to get coverage, costs without insurance, and FAQs in this detailed guide.
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Is Victoza Covered by SelectHealth

 

Coverage of Victoza

 

  • SelectHealth may cover Victoza for the treatment of type 2 diabetes when used as part of a comprehensive diabetes management plan.
  •  

  • Coverage typically requires a prescription from a healthcare provider and may involve prior authorization.

 

Criteria for Coverage

 

  • The patient must be diagnosed with type 2 diabetes and have tried other diabetes medications without sufficient control of blood glucose levels.
  •  

  • Adherence to SelectHealth's formulary guidelines and step therapy protocols might be necessary.

 

Basic Rules

 

  • Approval may depend on the patient meeting specific clinical criteria and having no contraindications to using Victoza.
  •  

  • Patients should consult with their healthcare provider and refer to their plan's formulary for detailed coverage guidelines.

 

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SelectHealth's Approved Criteria for Victoza Coverage

 

Criteria for Victoza Coverage

 

  • The patient must have a diagnosis of Type 2 Diabetes Mellitus.
  •  

  • The patient is 18 years of age or older.
  •  

  • Victoza is prescribed by a healthcare provider specializing in endocrinology or diabetes.
  •  

  • The patient has evidence of suboptimal blood glucose control, indicated by an HbA1c level of 7.0% or higher on their current diabetic regimen.
  •  

  • There must be a documented trial and failure, contraindication, or intolerance to metformin therapy, unless otherwise specifically contraindicated for the patient.
  •  

  • For patients with cardiovascular disease, documentation indicating that Victoza therapy is to reduce the risk of major adverse cardiovascular events is required.
  •  

  • Victoza is used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.
  •  

  • Documentation must include the patient’s current medications, indicating adherence, and any necessary lifestyle changes suggested to promote the success of Victoza therapy.
  •  

 

Why SelectHealth Might Deny Victoza Coverage

 

Reasons for Victoza Coverage Denial by SelectHealth

 

  • Victoza is not prescribed for a condition that is covered under the patient's specific SelectHealth plan. Coverage may be denied if the prescription is for a condition not specifically listed in the policy.
  •  

  • The patient does not meet the necessary clinical criteria as outlined by SelectHealth for Victoza approval. This may include certain diagnostic requirements or prior treatments that need to be tried first.
  •  

  • Prescription is not written by an in-network healthcare provider, or the prescribing provider does not meet certain credentialing requirements outlined by the insurance policy.
  •  

  • Documentation submitted does not adequately justify the medical necessity of Victoza according to SelectHealth's guidelines, leading to denial based on insufficient evidence of need.
  •  

  • Use of Victoza for non-FDA approved indications (off-label use) that are not accepted under SelectHealth's coverage policy may result in denial.
  •  

  • The patient's health plan requires prior authorization and this was not obtained before the prescription was filled, resulting in automatic denial.
  •  

  • Victoza may be excluded under the specific plan details, as each plan varies in its coverage of medications and may restrict certain drugs regardless of medical necessity.

 

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How Much Does Victoza Cost without Insurance?

 

Understanding Victoza Costs Without Insurance

 

  • The cost of Victoza without insurance can vary depending on the pharmacy and location, but typically it ranges from $900 to $1,200 for a 30-day supply.
  •  

  • Prices can fluctuate slightly due to different pharmacy pricing policies, geographic location, and available discounts or membership programs.
  •  

  • It's advisable to check with multiple pharmacies for the most accurate and competitive pricing if paying out-of-pocket.
  •  

  • Some pharmacies or pharmaceutical discount programs might offer lower prices or savings cards, so it could be beneficial to explore these options.

 

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 Victoza Coverage with SelectHealth

 

Check Your Insurance Plan

 

  • Log into your SelectHealth member account online to access your plan details.
  •  

  • Review your prescription drug coverage section to determine if Victoza is listed under covered medications.
  •  

  • Contact SelectHealth customer service to confirm Victoza coverage and any requirements like prior authorization or step therapy.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss the need for Victoza as part of your treatment plan.
  •  

  • Ask your provider to document the medical necessity of Victoza if it is required by your insurance plan.
  •  

  • Ensure your provider is aware of any prior authorization forms or documentation needed by SelectHealth.

 

Initiate the Prior Authorization Process

 

  • Contact SelectHealth to obtain the necessary prior authorization forms for Victoza.
  •  

  • Have your healthcare provider fill out the prior authorization form and submit it to SelectHealth on your behalf.
  •  

  • Follow up with your provider and SelectHealth to ensure the submission has been received and is being processed.

 

Verify Coverage and Copayment Information

 

  • Once prior authorization is approved, verify the details of your Victoza coverage, including copayment or coinsurance amounts.
  •  

  • If your copayment seems unaffordable, inquire about SelectHealth's assistance programs or explore manufacturer savings programs.
  •  

  • Ensure your pharmacy is in-network with SelectHealth to avoid higher out-of-pocket costs.

 

Fill Your Prescription

 

  • Take your prescription to an in-network pharmacy to have Victoza filled.
  •  

  • Inform the pharmacist of your SelectHealth insurance coverage to apply it to your prescription.
  •  

  • Check for any additional approvals or documentation needed if there's an issue processing your prescription.

 

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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.

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.

Victoza FAQ

What are the common side effects of Victoza?

 

Common Side Effects of Victoza

 

  • Gastrointestinal Issues: Nausea, vomiting, diarrhea, and constipation are frequent side effects, typically subsiding after a few weeks.
  •  

  • Headaches: Some individuals may experience mild to moderate headaches.
  •  

  • Fatigue: Feeling tired or weak can occur, especially during initial treatment.
  •  

  • Hypoglycemia: Though rarer, low blood sugar may happen, particularly if combined with other diabetes medications.
  •  

  • Injection Site Reactions: Redness, itching, or swelling at the site of injection can arise.

 

Note

 

  • Consult your healthcare provider if side effects persist or worsen.

 

How does Victoza help with weight loss?

 

How Victoza Assists in Weight Reduction

 

  • Appetite Suppression: Victoza (liraglutide), a GLP-1 receptor agonist, influences brain regions that regulate appetite, reducing hunger and food intake.
  •  

  • Delayed Gastric Emptying: It slows stomach emptying, contributing to prolonged feelings of fullness after meals, which helps reduce calorie consumption.
  •  

  • Improved Insulin Sensitivity: Enhances insulin efficiency, promoting better glucose utilization and reduced fat storage, supporting weight loss.
  •  

  • Fat Metabolism: Encourages the breakdown of stored fat for energy usage, facilitating gradual weight reduction.

 

Can Victoza be used for type 1 diabetes?

 

Can Victoza Be Used for Type 1 Diabetes?

 

  • Victoza (liraglutide) is primarily prescribed for Type 2 diabetes management. It works by stimulating insulin secretion and delaying gastric emptying.
  •  

  • For Type 1 diabetes, the body doesn't produce insulin, making Victoza ineffective as a sole treatment. Patients require insulin replacement therapy.
  •  

  • Some studies explore adjunctive use of GLP-1 receptor agonists like Victoza to improve glycemic control and reduce insulin doses in Type 1, but it's not standard.

 

Recommendation

 

  • Consult a healthcare provider before considering Victoza for Type 1 diabetes, focusing on its potential benefits and risks within individual treatment plans.

 

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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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