$49$0.99

Does Blue Cross Blue Shield Cover Forteo

Explore why BCBS might deny Forteo, tips to secure coverage, Forteo cost without insurance, and answers to common questions in this comprehensive guide.

Treat your allergies with Curex

as seen on

“Curex is changing the landscape of allergies in 2024”

Coverage for Forteo by Blue Cross Blue Shield

Forteo is covered by Blue Cross Blue Shield (BCBS) for treating osteoporosis when the patient has a high risk of fractures.

Coverage might differ based on the specific BCBS plan, so checking your policy or contacting a representative is recommended.

Typically, BCBS requires prior authorization to ensure medical necessity before covering Forteo prescriptions.

Rules and Criteria for Coverage

Patients often need to provide documented evidence of previous fractures or a diagnosis confirming severe osteoporosis.

BCBS generally requests proof that other osteoporosis treatments have been ineffective or unsuitable for the patient.

If criteria are met, a healthcare provider typically fills out a prior authorization form to submit to BCBS for review.

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.

Start Now

Clinical Support

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 Blue Cross Blue Shield

Check Your Insurance Plan Details

Visit the official Blue Cross Blue Shield (BCBS) website or contact their customer support to confirm whether Forteo is covered under your specific health plan.
Log in to your member portal to access your policy details which can provide information about prescription drug coverage.
Review any formularies or similar documents provided by BCBS to check if Forteo is listed as a covered medication.

Consult Your Healthcare Provider

Discuss with your doctor the medical necessity for Forteo and ensure that it is documented in your medical records.
Have your doctor prepare a letter of medical necessity if required by your insurance to justify the need for Forteo.

Prior Authorization Process

Contact BCBS to inquire if a prior authorization is required for Forteo. This is a step to determine medical necessity and coverage eligibility.
Work with your doctor’s office to submit a prior authorization request to BCBS. Make sure all supporting documents are provided.
Follow up with the insurance company to check the status of your prior authorization request.

Verify Coverage and Costs

Once approved, confirm the details of the coverage including any co-payments, deductibles, or out-of-pocket expenses.
Review any limitations, such as timeframes for the coverage or specific pharmacy requirements.

Filling the Prescription

Locate an in-network pharmacy that accepts your BCBS plan for filling your Forteo prescription.
Provide the pharmacy with your insurance information and any authorization details to process your prescription.

Appeal Denied Claims

If your claim or prior authorization request is denied, contact BCBS to understand the reason for denial.
Work with your healthcare provider to submit an appeal. Include additional medical documentation or evidence of necessity if available.

Happy Customers

We love helping people!

Allie, Nevada

"I have two cats I can finally cuddle!"
‍

Cat and dog allergies

Zachary, Texas

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

Dust and mold allergies

Erika, New York

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

Tree and grass allergies

Richard, Texas

I love the convenience!
‍

Tree and cat allergies

We Treat Allergies

Food Allergies

Weed Pollens

Cat Allergies

Dog Allergies

Dust Mites

Molds

Tree Pollens

curex user showing allergy treatment kit

a male patient showing allergy drops vial

50,000+ users have overcome their allergies

Am I eligible?

At-home Immunotherapy

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

Treatment prescribed
by clinician

Clinicaly made allergen extracts are customized for your allergies

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

FAQs

Does Blue Cross Blue Shield Cover Forteo

Explore why BCBS might deny Forteo, tips to secure coverage, Forteo cost without insurance, and answers to common questions in this comprehensive guide.

Achieve Your Goals Faster with Curex

Is Forteo Covered by Blue Cross Blue Shield

Coverage for Forteo by Blue Cross Blue Shield

Forteo is covered by Blue Cross Blue Shield (BCBS) for treating osteoporosis when the patient has a high risk of fractures.

Coverage might differ based on the specific BCBS plan, so checking your policy or contacting a representative is recommended.

Typically, BCBS requires prior authorization to ensure medical necessity before covering Forteo prescriptions.

Rules and Criteria for Coverage

Patients often need to provide documented evidence of previous fractures or a diagnosis confirming severe osteoporosis.

BCBS generally requests proof that other osteoporosis treatments have been ineffective or unsuitable for the patient.

If criteria are met, a healthcare provider typically fills out a prior authorization form to submit to BCBS for review.

A weight management program tailored to you

Start with Curex

Blue Cross Blue Shield's Approved Criteria for Forteo Coverage

Eligibility Criteria for Forteo Coverage

Patient must have a confirmed diagnosis of osteoporosis. This should be either postmenopausal osteoporosis in women or primary osteoporosis in men, and must be accompanied by a high risk of fracture.

Patient should have experienced a previous osteoporotic fracture or have multiple risk factors for fracture.

Documentation of a bone mineral density (BMD) score of at least -2.5 or lower, indicating osteoporosis.

Evidence of failure, contraindication, or intolerance to alternative osteoporosis therapies is required.

Specific Conditions for High-Risk Patients

Individuals diagnosed with glucocorticoid-induced osteoporosis must have chronic use of glucocorticoids, equivalent to a daily dose of prednisone 5 mg or more, and a BMD T-score of -2.0 or lower.

Men with primary or hypogonadal osteoporosis with a BMD score of -2.0 or lower and an increased risk of fracture may qualify for coverage.

Limitations and Requirements

Forteo therapy is approved for a maximum duration of 24 months in a patient's lifetime due to the associated risk of osteosarcoma.

Prior authorization is typically required to verify the presence of a qualifying diagnosis and adherence to initial therapy prerequisites.

Continuous re-evaluation of the patient's response to Forteo is often mandated to ensure the treatment's efficacy and to determine the necessity for continuation.

Documentation and Supporting Evidence

Comprehensive patient history and physical examination findings must be provided.

Bone density measurements and previous medical records detailing osteoporosis-related fractures or treatments should be included.

Notes from previous therapies, indicating failure or contraindications, are necessary as evidence for needing Forteo.

Why Blue Cross Blue Shield Might Deny Forteo Coverage

Reasons for Denial of Forteo Coverage by Blue Cross Blue Shield

**Off-Label Use**: Forteo may not be covered if it is prescribed for conditions or uses not approved by the FDA or not supported by sufficient clinical evidence.

**Lack of Medical Necessity**: Coverage might be denied if the patient’s medical records do not clearly indicate a medical necessity for Forteo, according to Blue Cross Blue Shield’s criteria.

**Alternate Treatments**: If there are other less expensive treatment options available that are considered effective according to the plan’s guidelines, Forteo might not be covered.

**Quantity Limits**: Exceeding the maximum allowable quantity set by the insurance policy could lead to a denial of coverage.

**Pre-existing Conditions**: Forteo might not be covered if the patient has certain pre-existing conditions that are contraindications for the use of Forteo according to Blue Cross Blue Shield’s policy.

**Non-compliance with Guidelines**: Failure to follow specific pre-authorization or step-therapy guidelines could result in a denial of coverage for Forteo.

**Policy Exclusions**: If Forteo is explicitly excluded from the patient’s insurance policy, coverage will not be provided.

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

Join Curex

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.

Clinical Support

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

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

Kayla Mardaga, NP

How to Get Forteo Coverage with Blue Cross Blue Shield

Check Your Insurance Plan Details

Visit the official Blue Cross Blue Shield (BCBS) website or contact their customer support to confirm whether Forteo is covered under your specific health plan.
Log in to your member portal to access your policy details which can provide information about prescription drug coverage.
Review any formularies or similar documents provided by BCBS to check if Forteo is listed as a covered medication.

Consult Your Healthcare Provider

Discuss with your doctor the medical necessity for Forteo and ensure that it is documented in your medical records.
Have your doctor prepare a letter of medical necessity if required by your insurance to justify the need for Forteo.

Prior Authorization Process

Contact BCBS to inquire if a prior authorization is required for Forteo. This is a step to determine medical necessity and coverage eligibility.
Work with your doctor’s office to submit a prior authorization request to BCBS. Make sure all supporting documents are provided.
Follow up with the insurance company to check the status of your prior authorization request.

Verify Coverage and Costs

Once approved, confirm the details of the coverage including any co-payments, deductibles, or out-of-pocket expenses.
Review any limitations, such as timeframes for the coverage or specific pharmacy requirements.

Filling the Prescription

Locate an in-network pharmacy that accepts your BCBS plan for filling your Forteo prescription.
Provide the pharmacy with your insurance information and any authorization details to process your prescription.

Appeal Denied Claims

If your claim or prior authorization request is denied, contact BCBS to understand the reason for denial.
Work with your healthcare provider to submit an appeal. Include additional medical documentation or evidence of necessity if available.

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

Learn More

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

Button Text

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 Blue Cross Blue Shield Cover Forteo

Explore why BCBS might deny Forteo, tips to secure coverage, Forteo cost without insurance, and answers to common questions in this comprehensive guide.

Achieve Your Goals Faster with Curex