Medication
Out-of-pocket price
Amethia Lo Generic
pack
Up to $
120
/month
Amethyst
pack
Up to $
70
/month
Balziva
pack
Up to $
45
/month
Blisovi FE 1/20
pack
Up to $
20
/month
Brand Yaz
pack
Up to $
190
/month
Medication
Out-of-pocket price
Cimetidine
Tablets
Up to $
100
/month
Dexlansoprazole DR
Tablets
Up to $
420
/month
Esomeprazole DR
Tablets
Up to $
35
/month
Lansoprazole DR
Tablets
Up to $
30
/month
Omeprazole and Sodium Carbonate
Tablets
Up to $
105
/month
Medication
Out-of-pocket price
Alomide
Up to $
235
/month
Alrex
Up to $
29
/month
Azelastine 0.15%
Up to $
72
/month
Azelastine 0.1%
Up to $
29
/month
Azelastine Hydrochloride Ophthalmic Solution
Up to $
25
/month
Medication
Out-of-pocket price
Bupropion
Up to $
30
/month
Buspirone
Up to $
26
/month
Citalopram
Up to $
35
/month
Duloxetine DR
Up to $
25
/month
Escitalopram
Up to $
19
/month
Medication
Out-of-pocket price
Advair Diskus
Inhaler
Up to $
700
/month
Advair HFA
Inhaler
Up to $
670
/month
Albuterol Sulfate HFA
Inhaler
Up to $
80
/month
Asmanex HFA
Inhaler
Up to $
280
/month
Beclomethasone Dipropionate HFA
Inhaler
Up to $
360
/month
Medication
Out-of-pocket price
Amethia Lo Generic
pack
Up to $
120
/month
Amethyst
pack
Up to $
70
/month
Annovera
ring
Up to $
2030
/month
Balziva
pack
Up to $
45
/month
Blisovi FE 1/20
pack
Up to $
20
/month
Medication
Out-of-pocket price
Valacyclovir
Tablets
Up to $
45
/month
Medication
Out-of-pocket price
Basaglar, Lantus
Pen/Syringe
Up to $
4500
/month
Glimepiride
Tablet
Up to $
40
/month
Glipizide
Tablet
Up to $
60
/month
Glyburide
Tablet
Up to $
155
/month
Humalog
Pen/Syringe
Up to $
1300
/month
Medication
Out-of-pocket price
Betamethasone valerate
Cream or ointment
Up to $
72
/month
Betamethasone Diproprionate
Cream
Up to $
75
/month
Cephalexin
Tablet or suspension
Up to $
30
/month
Clobetasol Proprionate
Foam, cream, or ointment
Up to $
240
/month
Desonide
Cream
Up to $
90
/month
Medication
Out-of-pocket price
My Way
pill
Up to $
25
/month
Medication
Out-of-pocket price
Sprintec
pack
Up to $
65
/month
Xulane Patch
box (3 patches)
Up to $
175
/month
Nuvaring
ring
Up to $
170
/month
SubQ Depo Provera
syringe
Up to $
330
/month
Norethindrone 5 mg
Tablets
Up to $
315
/month
Medication
Out-of-pocket price
Spironolactone
Tablets
Up to $
40
/month
Minoxidil
Up to $
50
/month
Medication
Out-of-pocket price
Valacyclovir (acute)
tablets
Up to $
45
/month
Valacyclovir (preventive)
Tablets
Up to $
30
/month
Medication
Out-of-pocket price
Atorvastatin
tablets
Up to $
25
/month
Colesevelam
tablets
Up to $
350
/month
Ezetimibe
tablets
Up to $
33
/month
Ezetimibe and Simvastatin
tablets
Up to $
180
/month
Fenofibrate
tablets
Up to $
40
/month
Medication
Out-of-pocket price
Latisse
Bottle
Up to $
215
/month
Bimatoprost ophthalmic solution, 0.03%
Bottle
Up to $
110
/month
Medication
Out-of-pocket price
Activella
Pill
Up to $
400
/month
Alora
Patch
Up to $
205
/month
Angeliq
Pill
Up to $
290
/month
Brisdelle
capsule
Up to $
320
/month
Climara
Patch
Up to $
215
/month
Medication
Out-of-pocket price
Frovatriptan
Tablet
Up to $
600
/month
Propranolol
Tablet
Up to $
70
/month
Sumatriptan
Syringe or tablet
Up to $
380
/month
Timolol
Tablet
Up to $
150
/month
Topiramate
Tablet
Up to $
45
/month
Medication
Out-of-pocket price
Terbinafine
Tablet
Up to $
28
/month
Ciclopirox Topical Solution
Bottle
Up to $
35
/month
Jublia
Bottle
Up to $
680
/month
Medication
Out-of-pocket price
Amethia Lo Generic
pack
Up to $
120
/month
Amethyst
pack
Up to $
70
/month
Balziva
pack
Up to $
45
/month
Blisovi FE 1/20
pack
Up to $
20
/month
Brand Yaz
pack
Up to $
190
/month
Medication
Out-of-pocket price
Nicotine Patch
Patch
Up to $
120
/month
Nicotine Patch Bundle
Patch
Up to $
260
/month
Varenicline
Tablet
Up to $
500
/month
Zyban
Tablet
Up to $
35
/month
Medication
Out-of-pocket price
Levothryoxine
tablets
Up to $
20
/month
Synthroid
tablet
Up to $
20
/month
Medication
Out-of-pocket price
Bupropion SR
Tablet
Up to $
60
/month
Contrave ER
Pill
Up to $
750
/month
Metformin (for weight-loss)
Tablet
Up to $
57
/month
Mounjaro
Pen/Syringe
Up to $
1500
/month
Ozempic
Pen/Syringe
Up to $
4000
/month
Commonly prescribed weight loss medications include: Wegovy, Zepbound, Saxenda, Contrave, Orlistat, Bupropion/naltrexone, Metformin, Topiramate, Ozempic, Mounjaro, Rybelsus, Trulicity. These may vary depending on coverage and patient condition.
Hello Alpha providers prescribe to a pharmacy that specializes in compounding semaglutide base and not semaglutide salts, which are not the same active ingredient in Ozempic and Wegovy.
Hello Alpha currently offers compounded semaglutide as multi-dose vials that require the use of a needle and syringe for weekly injections.
If your insurance company requests a prior authorization, our team and our partners at CloudTop Health will carefully compile and submit all the necessary documentation from your Alpha record.
A prior authorization can take time because your insurance company, provider, and pharmacy must all coordinate. These are the typical steps involved at Alpha:
Your pharmacy receives your prescription and tries to process it with your insurance company.
If required, your insurance company notifies your pharmacy that prior authorization is needed.
The pharmacy alerts Alpha that a prior authorization request is needed by faxing the prior authorization form to 844-640-3975. We do not accept phone calls to request a prior authorization.
Your provider works with our partners at CloudTop Health to submit documentation to your insurance company. This documentation includes your medical condition, other medications you have tried, safety, and why this medication is appropriate.
Your insurance company reviews these documents and may approve, deny, or request additional information.
If your prior authorization is approved, your insurance company will help cover the medication cost. Specific coverage depends on your plan’s benefits. A copay may still be required.
If your insurance company denies the prior authorization, they will not cover the cost of your medication. You can still choose to pay cash for the medication. You may also be able to work with your provider to try an alternative medication that is covered by your insurance benefits.
You will be notified as soon as a determination for coverage has been reached. Often you will receive notification directly from your insurance company before we contact you. If you have not received any update after 10 business days, please message us through your patient portal, and we will check on the status of your prior authorization.