Hyperlipidemia Refills

Yes. California Business and Professions Code Section 2290.5 permits licensed physicians to prescribe appropriate medications via synchronous video telehealth. TeleDirectMD\'s California-licensed board-certified Family Medicine physician reviews your most recent fasting lipid panel, LDL-C level, 10-year ASCVD risk score, and statin tolerance before authorizing refills. Statins and ezetimibe are not controlled substances and can be prescribed via California telehealth. Self pay is $79; Aetna is in-network effective April 30, 2026.

TeleDirectMD refills established statin regimens (atorvastatin, rosuvastatin, simvastatin, pravastatin, lovastatin), ezetimibe, and fibrates (fenofibrate) for stable hyperlipidemia. Medication selection follows the ACC/AHA 2018 Cholesterol Guideline and 2022 Expert Consensus. PCSK9 inhibitors (evolocumab, alirocumab) require specialist management — TeleDirectMD will facilitate a cardiology or lipidology referral.

High-intensity statins — atorvastatin 40–80 mg and rosuvastatin 20–40 mg — reduce LDL-C by 50% or more and are preferred for established ASCVD (secondary prevention), LDL-C ≥190 mg/dL, and Type 2 diabetes with high cardiovascular risk. Moderate-intensity statins — atorvastatin 10–20 mg, rosuvastatin 5–10 mg, simvastatin 20–40 mg — reduce LDL-C by 30–49% and are used for primary prevention in lower-risk adults. The physician selects intensity based on your 10-year ASCVD risk score and LDL-C target.

Generic statins are among the most affordable prescription medications in California with GoodRx coupons. Atorvastatin 40 mg/month: approximately $5–$18. Rosuvastatin 20 mg/month: approximately $12–$30. Simvastatin 40 mg/month: approximately $5–$12. Ezetimibe 10 mg/month: approximately $12–$25. Fenofibrate: approximately $15–$35 per month. Prices as of May 2026 — actual prices vary by pharmacy location and dose.

The 10-year atherosclerotic cardiovascular disease (ASCVD) risk score estimates your probability of a heart attack or stroke in the next decade, calculated using age, sex, race/ethnicity, total cholesterol, HDL, systolic blood pressure, BP treatment status, diabetes, and smoking history. Per ACC/AHA 2018 guidelines: ≥20% risk = very high-risk (high-intensity statin strongly recommended); 7.5–19.9% = intermediate-risk (statin benefit discussion recommended); 5–7.4% = borderline (risk-enhancing factors may justify statin); <5% = low-risk (focus on lifestyle). The physician calculates your ASCVD risk score at each visit.

Medi-Cal covers generic statins including atorvastatin, simvastatin, pravastatin, and lovastatin at low or no cost-sharing under the Medi-Cal formulary. Rosuvastatin and ezetimibe are also covered with prior authorization in some managed care plans. However, TeleDirectMD is not currently enrolled as a Medi-Cal provider, so Medi-Cal will not cover TeleDirectMD visits. Medi-Cal members can use the $79 self-pay rate or seek care from a Medi-Cal-enrolled provider.

The physician requires a fasting lipid panel (total cholesterol, LDL-C, HDL-C, triglycerides, non-HDL-C) within the past 12 months before authorizing a statin refill. If you are on a statin plus fenofibrate, a comprehensive metabolic panel (CMP) with liver function tests is also reviewed. If you report muscle pain or weakness, creatine kinase (CK) testing is recommended before refill. Labs available at Quest Diagnostics, LabCorp, and community health clinics throughout California.

Muscle pain (myalgia) is the most common reason for statin intolerance, affecting approximately 5–10% of statin users. If you develop new muscle pain while on a statin, the TeleDirectMD physician will review the severity, timing, and associated symptoms. Mild myalgia may be managed with dose reduction or switching to a different statin. Severe muscle pain with dark urine suggests rhabdomyolysis — a rare emergency requiring immediate in-person care and statin discontinuation. A creatine kinase (CK) lab check helps distinguish myalgia from serious myopathy.

The ACC/AHA 2022 Expert Consensus recommends adding ezetimibe when LDL-C remains ≥70 mg/dL (for ASCVD patients) or ≥100 mg/dL (for high-risk primary prevention) despite maximally tolerated statin therapy. Ezetimibe reduces intestinal cholesterol absorption and provides an additional 18–24% LDL-C reduction on top of statin therapy. Generic ezetimibe 10 mg is approximately $12–$25 per month with a GoodRx coupon at California pharmacies.

California Assembly Bill 744 (2019), codified in Insurance Code §10123.85, requires commercial health plans to reimburse telehealth services on the same basis as in-person care. Parity applies when TeleDirectMD is in-network with your plan. Aetna commercial (active April 30, 2026) and UnitedHealthcare Commercial (active May 29, 2026) are in-network in California. Anthem Blue Cross and Cigna are pending enrollment.

The ACC/AHA 2018 Cholesterol Guideline emphasizes lifestyle changes alongside medication: a heart-healthy diet (Mediterranean or DASH pattern, reducing saturated fat to <6% of total calories), regular aerobic exercise (150 minutes per week of moderate-intensity activity), smoking cessation, weight loss for overweight patients, and limiting alcohol. Diet and exercise alone can reduce LDL-C by 15–25%. The physician discusses lifestyle optimization alongside medication management at each refill visit.

No. PCSK9 inhibitors — evolocumab (Repatha) and alirocumab (Praluent) — require specialist management, step therapy documentation, and prior authorization that exceeds the scope of a telehealth refill visit. If you are a candidate for PCSK9 inhibitor therapy (familial hypercholesterolemia or established ASCVD with LDL-C ≥70 mg/dL despite maximum tolerated statin + ezetimibe), TeleDirectMD will facilitate a referral to a cardiologist or lipidologist who can manage PCSK9 therapy and prior authorization.