Does Affinity Health Plan Cover Adderall

Explore Adderall coverage with Affinity, reasons for denial, costs without insurance, and FAQs. Get tips on securing coverage effectively.
Curex allergy drops unboxing
“Curex is changing the landscape of allergies in 2024”
man opening Curex packaging
man opening Curex packaging

 

Coverage Criteria for Adderall by Affinity Health Plan

 

  • Affinity Health Plan may cover Adderall if it is prescribed for FDA-approved uses such as ADHD and narcolepsy. The prescription must be deemed medically necessary by a healthcare provider.
  •  

  • Patients might need to provide documentation or undergo prior authorization to confirm the necessity of the medication. This process ensures appropriate use and assesses the individual's specific health needs.
  •  

  • Coverage may vary depending on your specific plan. Reviewing your plan's formulary or contacting member services can provide detailed information on the extent of coverage for Adderall.
  •  

  • Drug coverage could be subject to tier pricing. Copayments or coinsurance may apply depending on whether Adderall is considered a preferred or non-preferred drug within the plan.
  •  

 

Want to try immunotherapy?

Start with Curex

Covered

Uncovered

Treat your allergies with Curex - $49  $9.99

Review your allergy test results with a Curex allergist.

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 Adderall Coverage with Affinity Health Plan

 

Verify Your Coverage

 

  • Log in to your Affinity Health Plan member portal to review your current prescription drug coverage. Adderall is typically categorized under controlled substances, which may have special coverage considerations.
  •  

  • Look for any specific details or conditions related to coverage for ADHD medications. Adderall may require prior authorization or be part of a step therapy program.
  •  

  • If needed, contact Affinity Health Plan’s customer service to clarify if Adderall is included under your prescription benefits and what requirements must be met.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Adderall. Ensure they understand that you'll be seeking insurance coverage for the medication.
  •  

  • Your provider should document your medical diagnosis clearly and ensure it's consistent with Affinity Health Plan's criteria for coverage of stimulant medications like Adderall.
  •  

  • If prior authorization is needed, your provider can assist in submitting the necessary documentation to Affinity Health Plan.

 

Submit Prior Authorization Request

 

  • Work with your healthcare provider to complete a prior authorization request if required by Affinity Health Plan. This process usually involves your provider submitting detailed information about your health condition and need for Adderall.
  •  

  • Ensure all forms are filled out completely and accurately. Missing information may delay the approval process.
  •  

  • Follow up with both your provider and Affinity Health Plan to confirm the authorization request has been submitted and is being processed.

 

Follow Up on Authorization Status

 

  • After submission, contact Affinity Health Plan to check the status of your prior authorization request. This can often be done via phone or through their member portal.
  •  

  • Be prepared to provide any additional information or documentation if requested by Affinity Health Plan to support your authorization request.
  •  

  • Once approved, make sure you understand any copayments, limits, or conditions that apply to your Adderall prescription under your plan.

 

Fill Your Prescription

 

  • Take your approved prescription to a pharmacy that partners with Affinity Health Plan. Using a network pharmacy can help reduce costs and streamline the payment process.
  •  

  • Present your Affinity Health Plan member ID at the pharmacy when dropping off your Adderall prescription.
  •  

  • Verify with the pharmacist that your prescription is covered and what your out-of-pocket cost will be, considering any copays or deductibles.

 

Curex allergy drops unboxing

We love helping people!

Allie, Nevada

five stars

"I have two cats I can finally cuddle!"

Cat and dog allergies

Zachary, Texas

five stars

“I can breathe through my nose for the first time in like 20 years!"

dust allergy
mold allergy

Dust and mold allergies

Erika, New York

five stars

“I've noticed less sneezing and shortness of breath.”

tree allergy
grass allergy

Tree and grass allergies

Richard, Texas

five stars


I love the convenience!

tree allergy

Tree and cat allergies

We Treat Food, Indoor & Outdoor Allergies

tree allergy
Tree Pollens
maple leaf icon
Weed Pollens
Cat Allergies
Dog Allergies
insect icon
Dust Mites
mold allergy
Molds
Food Allergies
 curex user showing allergy treatment kita patient showing allergy treatment boxa male patient showing allergy drops vial
50,000+ users have overcome their allergies
Am I eligible?

Benefits of Curex

At-home treatment

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

5-30x higher cumulative dose vs allergy shots

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
male medical practitioner smiling

Treatment prescribed
by clinician

1
right line icon
Curex packaging

Clinicaly made allergen extracts are customized for your allergies

2
right line icon
insect icon
grass icon
man opening Curex packaging

Your immune system gets desensitized to allergens, giving you long-term relief.

3

FAQs

Does Affinity Health Plan Cover Adderall

Explore Adderall coverage with Affinity, reasons for denial, costs without insurance, and FAQs. Get tips on securing coverage effectively.
Curex allergy drops unboxing

Is Adderall Covered by Affinity Health Plan

 

Coverage Criteria for Adderall by Affinity Health Plan

 

  • Affinity Health Plan may cover Adderall if it is prescribed for FDA-approved uses such as ADHD and narcolepsy. The prescription must be deemed medically necessary by a healthcare provider.
  •  

  • Patients might need to provide documentation or undergo prior authorization to confirm the necessity of the medication. This process ensures appropriate use and assesses the individual's specific health needs.
  •  

  • Coverage may vary depending on your specific plan. Reviewing your plan's formulary or contacting member services can provide detailed information on the extent of coverage for Adderall.
  •  

  • Drug coverage could be subject to tier pricing. Copayments or coinsurance may apply depending on whether Adderall is considered a preferred or non-preferred drug within the plan.
  •  

 

A weight management program tailored to you

Start with Curex

Affinity Health Plan's Approved Criteria for Adderall Coverage

 

Criteria for Coverage of Adderall

 

  • The patient must have a documented diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) as defined by the DSM-5 criteria.
  •  

  • Medical documentation is required to demonstrate that behavioral therapy or other non-stimulant alternatives have been considered, unless such therapies are contraindicated.
  •  

  • A thorough evaluation by a licensed healthcare professional must confirm the necessity of Adderall as part of the treatment plan.
  •  

  • For adult patients, documentation must show a history of ADHD symptoms in childhood with continued symptoms in adulthood, verified by a licensed healthcare professional.
  •  

  • Patients transitioning from pediatric to adult care may require an updated assessment to confirm ongoing treatment needs.
  •  

  • Initial coverage may require a trial period with periodic evaluations conducted by a healthcare provider to assess efficacy and safety.
  •  

  • Continued coverage of Adderall will necessitate regular follow-up visits with a healthcare provider to review treatment outcomes and adjust the dosage as necessary.
  •  

  • Coverage may also require a certain level of adherence to the prescribed medication regimen, as determined by the healthcare provider.
  •  

 

Why Affinity Health Plan Might Deny Adderall Coverage

 

Situations Where Affinity Health Plan Might Deny Adderall Coverage

 

  • Adderall is being prescribed for an off-label use that is not approved by the FDA.
  •  

  • The prescribed dose is higher than FDA-approved guidelines or the health plan's policies.
  •  

  • There is a lack of documented medical necessity or supporting clinical information in the patient's records.
  •  

  • The prescription does not comply with step therapy requirements, meaning alternative medications have not been tried first.
  •  

  • The patient has a history of substance abuse and there is concern about the potential for misuse or diversion of the medication.
  •  

  • The prescribing physician is not within the Affinity Health Plan’s network, which may impact coverage decisions.
  •  

  • Adderall is requested for a condition excluded from the plan's formulary or for which there are specific coverage restrictions.
  •  

 

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

How Much Does Adderall Cost without Insurance?

 

Approximate Cost of Adderall Without Insurance

 

  • The cost of Adderall without insurance can vary significantly depending on the pharmacy and the geographical location. Generally, for a 30-day supply of Adderall, you might expect the following costs:
  •  

  • The price for a 30-day supply of generic Adderall (amphetamine salt combo) is often between $30 and $75. This applies to typical dosages, which can range from 5 mg to 30 mg tablets.
  •  

  • Brand-name Adderall tends to be more expensive, typically ranging from $200 to $300 or more for a 30-day supply, again depending on the dosage.
  •  

  • Prices might fluctuate based on supply chain dynamics, drug manufacturer pricing, and local demand.
  •  

  • Discount programs, pharmacy memberships, and coupons can sometimes provide savings and bring the cost down, so it's 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 Adderall Coverage with Affinity Health Plan

 

Verify Your Coverage

 

  • Log in to your Affinity Health Plan member portal to review your current prescription drug coverage. Adderall is typically categorized under controlled substances, which may have special coverage considerations.
  •  

  • Look for any specific details or conditions related to coverage for ADHD medications. Adderall may require prior authorization or be part of a step therapy program.
  •  

  • If needed, contact Affinity Health Plan’s customer service to clarify if Adderall is included under your prescription benefits and what requirements must be met.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Adderall. Ensure they understand that you'll be seeking insurance coverage for the medication.
  •  

  • Your provider should document your medical diagnosis clearly and ensure it's consistent with Affinity Health Plan's criteria for coverage of stimulant medications like Adderall.
  •  

  • If prior authorization is needed, your provider can assist in submitting the necessary documentation to Affinity Health Plan.

 

Submit Prior Authorization Request

 

  • Work with your healthcare provider to complete a prior authorization request if required by Affinity Health Plan. This process usually involves your provider submitting detailed information about your health condition and need for Adderall.
  •  

  • Ensure all forms are filled out completely and accurately. Missing information may delay the approval process.
  •  

  • Follow up with both your provider and Affinity Health Plan to confirm the authorization request has been submitted and is being processed.

 

Follow Up on Authorization Status

 

  • After submission, contact Affinity Health Plan to check the status of your prior authorization request. This can often be done via phone or through their member portal.
  •  

  • Be prepared to provide any additional information or documentation if requested by Affinity Health Plan to support your authorization request.
  •  

  • Once approved, make sure you understand any copayments, limits, or conditions that apply to your Adderall prescription under your plan.

 

Fill Your Prescription

 

  • Take your approved prescription to a pharmacy that partners with Affinity Health Plan. Using a network pharmacy can help reduce costs and streamline the payment process.
  •  

  • Present your Affinity Health Plan member ID at the pharmacy when dropping off your Adderall prescription.
  •  

  • Verify with the pharmacist that your prescription is covered and what your out-of-pocket cost will be, considering any copays or deductibles.

 

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.

Adderall FAQ

1. What is Adderall used for?

 

What is Adderall Used For?

 

  • Adderall is primarily used to treat Attention Deficit Hyperactivity Disorder (ADHD), helping to increase focus, attention, and impulse control by altering certain natural substances in the brain.
  •  

  • It is also prescribed for Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and sudden sleep attacks. Adderall helps maintain alertness and enhance wakefulness in patients.
  •  

  • Adderall is a combination of amphetamine salts that work as central nervous system stimulants, affecting neurotransmitters like dopamine and norepinephrine.

 

2. How long does Adderall stay in your system?

 

Duration in the System

 

  • **Immediate-release Adderall**: Detectable in urine for approximately 1-2 days post-ingestion.
  •  

  • **Extended-release (XR) Adderall**: May remain in urine for 3-4 days.

 

Factors Affecting Duration

 

  • Metabolism: Faster metabolism can shorten detection time.
  •  

  • Dosage: Higher doses typically extend its presence in the system.
  •  

  • Frequency: Regular use can lead to accumulation, prolonging detection.

 

Testing Methods

 

  • Urine tests: Most common, showing presence for 1-4 days.
  •  

  • Blood tests: Effective within 12-24 hours post-use.
  •  

  • Saliva tests: Detectable for 1-2 days after use.
  •  

  • Hair tests: Can detect use for up to 3 months.

 

3. What are the side effects of Adderall?

 
Common Side Effects
 

  • Loss of appetite, weight loss, and dry mouth are often reported.
  • Insomnia and increased heart rate may occur, affecting sleep patterns.
  • Some individuals experience irritability, anxiety, or dizziness.
  Serious Side Effects  
  • Cardiovascular issues such as chest pain, increased blood pressure, and palpitations need immediate attention.
  • Mental health changes, including paranoia, depression, or aggressive behavior, can be serious.
  Long-term Risks  
  • Potential for addiction and dependency with misuse or without proper medical guidance.
  • Possible negative impact on growth and development in children.
 

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 (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.

Made in Webflow