Does UnitedHealthcare Cover Forteo

Explore Forteo coverage under UnitedHealthcare, reasons for claim denial, strategies for approval, cost insights, and answers to common Forteo questions.
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Does UnitedHealthcare Cover Forteo?

 

  • UnitedHealthcare may cover Forteo, a prescription medication used to treat osteoporosis, depending on your specific plan and benefits.
  •  

  • Coverage typically applies to those diagnosed with osteoporosis at high risk for fracture or who cannot use other osteoporosis therapies, as determined by your doctor.
  •  

  • Prior authorization might be required, meaning your healthcare provider must verify the necessity and appropriateness of Forteo over other treatment options.
  •  

  • Patients may have to meet certain criteria, such as completing a course of bisphosphonates with inadequate response or having contraindications to other treatments.
  •  

  • It is crucial to consult your policy details or contact UnitedHealthcare directly for precise coverage information, as plans and coverage can vary widely.

 

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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 Forteo Coverage with UnitedHealthcare

 

Verify Your Coverage

 

  • Contact UnitedHealthcare directly to inquire if Forteo is included in your insurance plan. Ensure you have your member ID available.
  •  

  • Check your plan documents online or any mailed correspondence that lists covered medications to see if Forteo is included.

 

Consult with Your Healthcare Provider

 

  • Discuss your need for Forteo with your healthcare provider. Mention your insurance provider to determine if any specific documentation is required for coverage.
  •  

  • Obtain a prescription from your healthcare provider, emphasizing any medical necessity that may aid in getting coverage approval.

 

Pre-Authorization Request

 

  • Work with your healthcare provider to submit a pre-authorization request to UnitedHealthcare, which may include providing medical records or additional justification for the use of Forteo.
  •  

  • Ensure all forms and necessary documentation are accurately filled out and submitted per UnitedHealthcare's requirements.

 

Contact UnitedHealthcare Member Services

 

  • Call UnitedHealthcare Member Services to confirm receipt of the pre-authorization request and inquire about the timeline for processing.
  •  

  • Ask if any additional information or documentation is needed to expedite the process.

 

Follow Up and Appeal if Necessary

 

  • Keep track of the pre-authorization status and follow up regularly with both UnitedHealthcare and your healthcare provider.
  •  

  • If the request for Forteo coverage is denied, inquire about the appeals process and understand the steps needed to submit an appeal.
    •  

      Enlist Patient Assistance Programs

       

      • If coverage through UnitedHealthcare is denied, explore patient assistance programs offered by the manufacturer of Forteo for potential cost support.
      •  

      • Discuss alternative options with your healthcare provider if necessary to ensure you receive the appropriate treatment.

       

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Does UnitedHealthcare Cover Forteo

Explore Forteo coverage under UnitedHealthcare, reasons for claim denial, strategies for approval, cost insights, and answers to common Forteo questions.
Curex allergy drops unboxing

Is Forteo Covered by UnitedHealthcare

 

Does UnitedHealthcare Cover Forteo?

 

  • UnitedHealthcare may cover Forteo, a prescription medication used to treat osteoporosis, depending on your specific plan and benefits.
  •  

  • Coverage typically applies to those diagnosed with osteoporosis at high risk for fracture or who cannot use other osteoporosis therapies, as determined by your doctor.
  •  

  • Prior authorization might be required, meaning your healthcare provider must verify the necessity and appropriateness of Forteo over other treatment options.
  •  

  • Patients may have to meet certain criteria, such as completing a course of bisphosphonates with inadequate response or having contraindications to other treatments.
  •  

  • It is crucial to consult your policy details or contact UnitedHealthcare directly for precise coverage information, as plans and coverage can vary widely.

 

A weight management program tailored to you

Start with Curex

UnitedHealthcare's Approved Criteria for Forteo Coverage

 

Eligibility Criteria for Forteo Coverage

 

  • Patient must have a diagnosis of osteoporosis confirmed by a bone density test showing a T-score of -2.5 or lower in the lumbar spine or hip.
  •  

  • Individual should be postmenopausal or male, aged 50 or older, considered high risk for fractures due to osteoporosis.
  •  

  • Evidence of a history of osteoporotic fracture must be present, or the patient must be at increased risk for fractures based on clinical judgment and other risk factors.

 

Additional Requirements for Coverage

 

  • Patient must have tried and failed, or have a contraindication to, at least one alternative osteoporosis treatment (such as bisphosphonates or selective estrogen receptor modulators).
  •  

  • The prescribing physician must provide documentation supporting the necessity of Forteo due to the patient’s unique clinical condition and high fracture risk.
  •  

  • Coverage consideration may also require evidence that the individual cannot tolerate other osteoporosis therapies due to side effects or specific medical conditions.

 

Renewal Criteria

 

  • Renewal requests for Forteo may require updated evidence demonstrating the patient's current need for therapy based on ongoing risk of fracture.
  •  

  • Continuation of treatment should show evidence of benefit, such as increased bone mineral density or reduced incidence of fractures, as monitored by regular follow-ups with the healthcare provider.

 

Why UnitedHealthcare Might Deny Forteo Coverage

 

Reasons UnitedHealthcare Might Deny Forteo Coverage

 

  • The patient does not meet the medical criteria specified in the UnitedHealthcare policy for osteoporosis treatment. Specifically, Forteo might be denied if a patient does not exhibit a high enough level of fracture risk or severe osteoporosis as defined by their guidelines.
  •  

  • Forteo treatment is requested for an unapproved condition that does not align with UnitedHealthcare's covered indications, such as non-osteoporotic conditions or use outside of FDA-approved indications.
  •  

  • The request for Forteo comes in as the first-line therapy without documentation showing failure or contraindication to previously tried and less costly osteoporosis therapies, such as bisphosphonates.
  •  

  • The patient has a history of radiation therapy to the bones, as this may increase the risk of osteosarcoma, which could lead to denial of Forteo coverage under UnitedHealthcare’s safety concerns.
  •  

  • The prescribed duration exceeds the treatment period that UnitedHealthcare considers safe and effective for Forteo, which generally should not exceed a certain number of months according to their policies.
  •  

  • The patient already reached the total prescribed lifetime dose of Forteo, beyond which UnitedHealthcare does not offer further coverage due to potential risks and diminishing therapeutic benefits.
  •  

  • The request lacks sufficient documentation or fails to include necessary clinical information needed to justify the medical necessity of Forteo under UnitedHealthcare’s criteria.

 

Together with our partners we have changed the lives of over 300,000 patients.

How Much Does Forteo Cost without Insurance?

 

Cost of Forteo Without Insurance

 

  • The price of Forteo (teriparatide injection) without insurance is quite substantial, typically ranging between $3,500 and $4,000 for a 28-day supply, which is a 2.4 mL pen of 600 mcg per 2.4 mL strength.
  •  

  • Keep in mind that pharmaceutical prices can vary based on the pharmacy, geographical location, and any available discounts or pharmacy-specific savings programs.
  •  

  • Patients can check with specific pharmacies for the most accurate pricing and inquire about any potential savings programs or discounts.
  •  

  • Consider contacting the manufacturer or exploring patient assistance programs, as they sometimes offer help to reduce costs for those without insurance coverage.

 

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 Forteo Coverage with UnitedHealthcare

 

Verify Your Coverage

 

  • Contact UnitedHealthcare directly to inquire if Forteo is included in your insurance plan. Ensure you have your member ID available.
  •  

  • Check your plan documents online or any mailed correspondence that lists covered medications to see if Forteo is included.

 

Consult with Your Healthcare Provider

 

  • Discuss your need for Forteo with your healthcare provider. Mention your insurance provider to determine if any specific documentation is required for coverage.
  •  

  • Obtain a prescription from your healthcare provider, emphasizing any medical necessity that may aid in getting coverage approval.

 

Pre-Authorization Request

 

  • Work with your healthcare provider to submit a pre-authorization request to UnitedHealthcare, which may include providing medical records or additional justification for the use of Forteo.
  •  

  • Ensure all forms and necessary documentation are accurately filled out and submitted per UnitedHealthcare's requirements.

 

Contact UnitedHealthcare Member Services

 

  • Call UnitedHealthcare Member Services to confirm receipt of the pre-authorization request and inquire about the timeline for processing.
  •  

  • Ask if any additional information or documentation is needed to expedite the process.

 

Follow Up and Appeal if Necessary

 

  • Keep track of the pre-authorization status and follow up regularly with both UnitedHealthcare and your healthcare provider.
  •  

  • If the request for Forteo coverage is denied, inquire about the appeals process and understand the steps needed to submit an appeal.
    •  

      Enlist Patient Assistance Programs

       

      • If coverage through UnitedHealthcare is denied, explore patient assistance programs offered by the manufacturer of Forteo for potential cost support.
      •  

      • Discuss alternative options with your healthcare provider if necessary to ensure you receive the appropriate treatment.

       

Premium Medication you can trust

Our weight loss medication is delivered straight to your doorstep from a state-licensed pharmacy within our reliable network, ensuring you receive your medication when you need it.

Each pharmacy in our network undergoes rigorous third-party testing through FDA and DEA certified labs. These tests focus on four key elements, ensuring both safety and efficacy for our treatments.

Forteo FAQ

What are the common side effects of Forteo?

 

Common Side Effects of Forteo

 

  • Nausea: A frequent complaint among users, often resolves as your body adjusts to the medication.
  •  

  • Dizziness: Usually occurs after an injection, so sitting or lying down shortly afterward can help.
  •  

  • Leg Cramps: Regular stretching exercises may alleviate this discomfort.
  •  

  • Joint Pain: May be managed by over-the-counter painkillers, but consult your doctor first.
  •  

  • Injection Site Reactions: Mild redness or itching at the injection site is common, often soothed by cold compresses.

 

How does Forteo work for osteoporosis?

 

How Forteo Works

 

  • Forteo, or teriparatide, is a form of parathyroid hormone that helps stimulate new bone formation.
  •  

  • It works by increasing bone remodeling, which is crucial for improving bone density.

 

Osteoporosis Effectiveness

 

  • Used primarily for osteoporosis patients who have a high risk of fractures.
  •  

  • Improves bone microarchitecture, which enhances bone strength.

 

Administration

 

  • Administered via daily subcutaneous injection for up to 2 years.
  •  

  • Patients should follow their doctor’s instructions for the correct administration.

 

How long can you safely take Forteo?

 

Duration of Forteo Use

 

  • Forteo (teriparatide) is recommended for a maximum duration of 2 years over a patient's lifetime.
  •  

  • This limitation is based on studies that show an increased risk of osteosarcoma in rats. Though this risk hasn't been confirmed in humans, the duration is restricted for safety.

 

Considerations and Monitoring

 

  • During treatment, regular bone density scans and evaluations for potential side effects are necessary.
  •  

  • Patients should ensure they are not taking medications or have conditions that could further exacerbate potential risks.

 

Have questions left?

Get a personalized online consultation with a doctor at Curex

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:

“Curex has performed beyond my expectations. I am feeling tremendously better and look forward to continuing the treatment.”
Becky D.
"If I could give 6 stars, I would. BEST... BEST… BEST… service.”
Ferdian K.
“The Curex staff has been professional, efficient, and really focused on my individual needs.”
Ana C.

Start your
journey now

Everything you need is included:

Online consultation

Your prescription

Premium medication

Overnight shipping

Ongoing support

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. 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?

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.

Can you prescribe Ozempic®* or Wegovy®*?

Our providers focus on personalized medications and dosages that aren’t commercially available at your local pharmacy. We don’t prescribe Ozempic®* or Wegovy®.* We may prescribe treatments containing compounded semaglutide or tirzepatide. 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.

Does UnitedHealthcare Cover Forteo

Explore Forteo coverage under UnitedHealthcare, reasons for claim denial, strategies for approval, cost insights, and answers to common Forteo questions.
Curex allergy drops unboxing

Does UnitedHealthcare Cover Forteo

 

Does UnitedHealthcare Cover Forteo?

 

  • UnitedHealthcare may cover Forteo, a prescription medication used to treat osteoporosis, depending on your specific plan and benefits.
  •  

  • Coverage typically applies to those diagnosed with osteoporosis at high risk for fracture or who cannot use other osteoporosis therapies, as determined by your doctor.
  •  

  • Prior authorization might be required, meaning your healthcare provider must verify the necessity and appropriateness of Forteo over other treatment options.
  •  

  • Patients may have to meet certain criteria, such as completing a course of bisphosphonates with inadequate response or having contraindications to other treatments.
  •  

  • It is crucial to consult your policy details or contact UnitedHealthcare directly for precise coverage information, as plans and coverage can vary widely.

 

A weight management program tailored to you

Start with Curex

Why UnitedHealthcare Might Deny Forteo Coverage

 

Eligibility Criteria for Forteo Coverage

 

  • Patient must have a diagnosis of osteoporosis confirmed by a bone density test showing a T-score of -2.5 or lower in the lumbar spine or hip.
  •  

  • Individual should be postmenopausal or male, aged 50 or older, considered high risk for fractures due to osteoporosis.
  •  

  • Evidence of a history of osteoporotic fracture must be present, or the patient must be at increased risk for fractures based on clinical judgment and other risk factors.

 

Additional Requirements for Coverage

 

  • Patient must have tried and failed, or have a contraindication to, at least one alternative osteoporosis treatment (such as bisphosphonates or selective estrogen receptor modulators).
  •  

  • The prescribing physician must provide documentation supporting the necessity of Forteo due to the patient’s unique clinical condition and high fracture risk.
  •  

  • Coverage consideration may also require evidence that the individual cannot tolerate other osteoporosis therapies due to side effects or specific medical conditions.

 

Renewal Criteria

 

  • Renewal requests for Forteo may require updated evidence demonstrating the patient's current need for therapy based on ongoing risk of fracture.
  •  

  • Continuation of treatment should show evidence of benefit, such as increased bone mineral density or reduced incidence of fractures, as monitored by regular follow-ups with the healthcare provider.

 

Together with our partners we have changed the lives of over 300,000 patients.

Forteo FAQ

 

Reasons UnitedHealthcare Might Deny Forteo Coverage

 

  • The patient does not meet the medical criteria specified in the UnitedHealthcare policy for osteoporosis treatment. Specifically, Forteo might be denied if a patient does not exhibit a high enough level of fracture risk or severe osteoporosis as defined by their guidelines.
  •  

  • Forteo treatment is requested for an unapproved condition that does not align with UnitedHealthcare's covered indications, such as non-osteoporotic conditions or use outside of FDA-approved indications.
  •  

  • The request for Forteo comes in as the first-line therapy without documentation showing failure or contraindication to previously tried and less costly osteoporosis therapies, such as bisphosphonates.
  •  

  • The patient has a history of radiation therapy to the bones, as this may increase the risk of osteosarcoma, which could lead to denial of Forteo coverage under UnitedHealthcare’s safety concerns.
  •  

  • The prescribed duration exceeds the treatment period that UnitedHealthcare considers safe and effective for Forteo, which generally should not exceed a certain number of months according to their policies.
  •  

  • The patient already reached the total prescribed lifetime dose of Forteo, beyond which UnitedHealthcare does not offer further coverage due to potential risks and diminishing therapeutic benefits.
  •  

  • The request lacks sufficient documentation or fails to include necessary clinical information needed to justify the medical necessity of Forteo under UnitedHealthcare’s criteria.

 

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 Much Does Forteo Cost without Insurance?

 

Cost of Forteo Without Insurance

 

  • The price of Forteo (teriparatide injection) without insurance is quite substantial, typically ranging between $3,500 and $4,000 for a 28-day supply, which is a 2.4 mL pen of 600 mcg per 2.4 mL strength.
  •  

  • Keep in mind that pharmaceutical prices can vary based on the pharmacy, geographical location, and any available discounts or pharmacy-specific savings programs.
  •  

  • Patients can check with specific pharmacies for the most accurate pricing and inquire about any potential savings programs or discounts.
  •  

  • Consider contacting the manufacturer or exploring patient assistance programs, as they sometimes offer help to reduce costs for those without insurance coverage.

 

Premium Medication you can trust

Our weight loss medication is delivered straight to your doorstep from a state-licensed pharmacy within our reliable network, ensuring you receive your medication when you need it.

Each pharmacy in our network undergoes rigorous third-party testing through FDA and DEA certified labs. These tests focus on four key elements, ensuring both safety and efficacy for our treatments.

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:

“Curex has performed beyond my expectations. I am feeling tremendously better and look forward to continuing the treatment.”
Becky D.
"If I could give 6 stars, I would. BEST... BEST… BEST… service.”
Ferdian K.
“The Curex staff has been professional, efficient, and really focused on my individual needs.”
Ana C.

Start your
journey now

Everything you need is included:

Online consultation

Your prescription

Premium medication

Overnight shipping

Ongoing support

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.