Does Blue Cross Blue Shield Cover Trulicity

Explore Trulicity coverage by Blue Cross Blue Shield, reasons for denial, how to secure coverage, costs without insurance, and frequently asked questions.
Curex allergy drops unboxing
“Curex is changing the landscape of allergies in 2024”
man opening Curex packaging
man opening Curex packaging

 

Does Blue Cross Blue Shield Cover Trulicity?

 

  • Coverage for Trulicity, a medication used to treat type 2 diabetes, varies depending on your specific Blue Cross Blue Shield (BCBS) plan. It's crucial to check your policy or contact BCBS directly to verify coverage.
  •  

  • Typically, coverage is applicable when Trulicity is prescribed by a doctor to help improve blood sugar levels in individuals with type 2 diabetes who are already following an appropriate diet and exercise regimen.
  •  

  • To qualify for coverage, you may need prior authorization, which involves your healthcare provider demonstrating the medical necessity of Trulicity for your treatment.
  •  

  • Sometimes, you might be required to have tried and failed or shown lack of sufficient response to other preferred medications before BCBS authorizes Trulicity.
  •  

  • Out-of-pocket costs, such as copayments, deductibles, or coinsurance, also depend on your specific BCBS plan and benefits structure.

 

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 Trulicity Coverage with Blue Cross Blue Shield

 

Understand Your Insurance Plan

 

  • Check your current plan details to see if Trulicity falls under the list of covered medications. This information is usually available in your policy documents or the Blue Cross Blue Shield (BCBS) website.
  •  

  • Look for the formulary, which is a list of medications covered by your plan. Ensure that Trulicity is included or check if there are any specific requirements for its coverage.

 

Contact Blue Cross Blue Shield

 

  • Before proceeding with any treatments, contact BCBS directly to confirm whether Trulicity is covered under your plan. Use the customer service number found on your insurance card or the BCBS website.
  •  

  • Prepare to provide your member ID and detailed information about the medication, including dosage and prescribed frequency, during the call.

 

Consult with Your Healthcare Provider

 

  • Discuss with your healthcare provider the necessity of Trulicity for your treatment, and ensure that its use is well-documented and justified in your medical records.
  •  

  • Request a written recommendation or prior authorization if your insurance plan requires additional documentation for Trulicity coverage.

 

Submit Required Documentation

 

  • If necessary, submit a prior authorization form. This form allows your healthcare provider to justify the prescription of Trulicity directly to BCBS.
  •  

  • Your healthcare provider may also need to supply medical records, treatment plans, or a letter of medical necessity to support your request.

 

Verify Prescription Coverage

 

  • Once documentation is submitted, follow up with BCBS to confirm the approval of your Trulicity prescription coverage. This step may take several business days.
  •  

  • Be proactive in checking the status of your claim by logging into your BCBS online account or contacting customer support.

 

Visit Your Pharmacy

 

  • Once coverage is confirmed, take your prescription to a pharmacy in-network with BCBS to fill your Trulicity prescription. Present your insurance card at the pharmacy.
  •  

  • Confirm the co-pay amount or any additional cost associated with your prescription at the pharmacy. Adjustments might occur based on coverage specifics.

 

Handle Rejections and Appeals

 

  • If your request for coverage is denied, analyze the rejection reason provided by BCBS carefully.
  •  

  • Work with your healthcare provider to modify your request or submit an appeal. Make sure all documentation is updated and accurately reflects your medical needs.

 

Maintain Open Communication

 

  • Keep in touch with both BCBS and your healthcare provider throughout the process to prevent any delays.
  •  

  • Stay informed about any changes in your BCBS policy that might impact future prescriptions or coverage plans.

 

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 Blue Cross Blue Shield Cover Trulicity

Explore Trulicity coverage by Blue Cross Blue Shield, reasons for denial, how to secure coverage, costs without insurance, and frequently asked questions.
Curex allergy drops unboxing

Is Trulicity Covered by Blue Cross Blue Shield

 

Does Blue Cross Blue Shield Cover Trulicity?

 

  • Coverage for Trulicity, a medication used to treat type 2 diabetes, varies depending on your specific Blue Cross Blue Shield (BCBS) plan. It's crucial to check your policy or contact BCBS directly to verify coverage.
  •  

  • Typically, coverage is applicable when Trulicity is prescribed by a doctor to help improve blood sugar levels in individuals with type 2 diabetes who are already following an appropriate diet and exercise regimen.
  •  

  • To qualify for coverage, you may need prior authorization, which involves your healthcare provider demonstrating the medical necessity of Trulicity for your treatment.
  •  

  • Sometimes, you might be required to have tried and failed or shown lack of sufficient response to other preferred medications before BCBS authorizes Trulicity.
  •  

  • Out-of-pocket costs, such as copayments, deductibles, or coinsurance, also depend on your specific BCBS plan and benefits structure.

 

A weight management program tailored to you

Start with Curex

Blue Cross Blue Shield's Approved Criteria for Trulicity Coverage

 

Criteria for Trulicity Coverage

 

  • Members diagnosed with type 2 diabetes mellitus requiring additional glycemic control when lifestyle modifications such as diet and exercise do not suffice.
  •  

  • Requested for members who are 18 years or older.

 

Prior Authorization Requirements

 

  • A documented history of inadequate glycemic control with other diabetes medications, such as metformin or sulfonylureas, unless contraindicated.
  •  

  • Proof of stable medical history without contraindications for GLP-1 receptor agonists like Trulicity.

 

Medical Necessity

 

  • The prescribing healthcare provider must substantiate the medical necessity of Trulicity, demonstrating why alternative medications are not suitable for the patient.
  •  

  • Clear documentation of baseline A1c levels and projected therapeutic goals.

 

Renewal Criteria

 

  • Evidence of significant improvement in blood sugar levels and/or achieving HbA1c goals from the previous treatment period as compared to baseline levels.
  •  

  • No adverse reactions that would necessitate discontinuation of treatment.

 

Exclusions

 

  • Coverage not applicable unless above criteria are strictly met and documented by the healthcare provider.
  •  

  • Prescriptions outside the FDA-approved indications without substantial approval documentation and clinical support evidence.

 

Why Blue Cross Blue Shield Might Deny Trulicity Coverage

 

Reasons for Denial of Trulicity Coverage by Blue Cross Blue Shield

 

  • Lack of Medical Necessity: Coverage may be denied if Trulicity is not deemed medically necessary for the member, based on their specific medical condition and history.
  •  

  • Non-Formulary Status: Trulicity might be excluded from coverage if it is not included in the plan's formulary or preferred list of medications.
  •  

  • Prior Authorization Not Obtained: If Blue Cross Blue Shield requires prior authorization for Trulicity and it was not obtained before prescribing, coverage could be denied.
  •  

  • Step Therapy Requirements: If step therapy protocols require trying other medications first and these steps were not followed, Trulicity may not be covered.
  •  

  • Policy Exclusions: Specific policy exclusions or limitations on coverage for non-insulin diabetes medications might result in denial.
  •  

  • Dosage or Frequency Issues: Deviations from approved dosing regimens or prescribed frequency levels outside of policy guidelines can lead to non-coverage.

 

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

How Much Does Trulicity Cost without Insurance?

 

Trulicity Cost Overview

 

  • Trulicity is a brand-name medication commonly used to treat type 2 diabetes. It's administered through a weekly injection.

 

Approximate Cost Without Insurance

 

  • The price of Trulicity can vary depending on the pharmacy or location, but the average cost for one pen of 1.5 mg/0.5 mL solution might run approximately $886 to $1,100.
  • Each box typically contains four pens, which is a month's supply, resulting in the total cost being roughly $3,544 to $4,400.

 

Factors Influencing Pricing

 

  • Pharmacy: Prices may differ from one pharmacy to another, so it’s beneficial to compare costs.
  • Location: Costs may vary based on geographic location due to regional pricing strategies and pharmacy benefits.
  • Discount Programs: Some pharmacies may offer savings programs or coupons that could lower the price.

 

Additional Cost-Saving Tips

 

  • Check for manufacturer discounts or patient assistance programs, which may offer significant savings or even free medication for qualified individuals.
  • Consider discussing alternative medications with your healthcare provider to find a more affordable option suitable for your needs.
  • Utilize pharmacy discount cards or look up savings programs online that specifically cater to diabetes medications.

 

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 Trulicity Coverage with Blue Cross Blue Shield

 

Understand Your Insurance Plan

 

  • Check your current plan details to see if Trulicity falls under the list of covered medications. This information is usually available in your policy documents or the Blue Cross Blue Shield (BCBS) website.
  •  

  • Look for the formulary, which is a list of medications covered by your plan. Ensure that Trulicity is included or check if there are any specific requirements for its coverage.

 

Contact Blue Cross Blue Shield

 

  • Before proceeding with any treatments, contact BCBS directly to confirm whether Trulicity is covered under your plan. Use the customer service number found on your insurance card or the BCBS website.
  •  

  • Prepare to provide your member ID and detailed information about the medication, including dosage and prescribed frequency, during the call.

 

Consult with Your Healthcare Provider

 

  • Discuss with your healthcare provider the necessity of Trulicity for your treatment, and ensure that its use is well-documented and justified in your medical records.
  •  

  • Request a written recommendation or prior authorization if your insurance plan requires additional documentation for Trulicity coverage.

 

Submit Required Documentation

 

  • If necessary, submit a prior authorization form. This form allows your healthcare provider to justify the prescription of Trulicity directly to BCBS.
  •  

  • Your healthcare provider may also need to supply medical records, treatment plans, or a letter of medical necessity to support your request.

 

Verify Prescription Coverage

 

  • Once documentation is submitted, follow up with BCBS to confirm the approval of your Trulicity prescription coverage. This step may take several business days.
  •  

  • Be proactive in checking the status of your claim by logging into your BCBS online account or contacting customer support.

 

Visit Your Pharmacy

 

  • Once coverage is confirmed, take your prescription to a pharmacy in-network with BCBS to fill your Trulicity prescription. Present your insurance card at the pharmacy.
  •  

  • Confirm the co-pay amount or any additional cost associated with your prescription at the pharmacy. Adjustments might occur based on coverage specifics.

 

Handle Rejections and Appeals

 

  • If your request for coverage is denied, analyze the rejection reason provided by BCBS carefully.
  •  

  • Work with your healthcare provider to modify your request or submit an appeal. Make sure all documentation is updated and accurately reflects your medical needs.

 

Maintain Open Communication

 

  • Keep in touch with both BCBS and your healthcare provider throughout the process to prevent any delays.
  •  

  • Stay informed about any changes in your BCBS policy that might impact future prescriptions or coverage plans.

 

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.

Trulicity FAQ

What are the common side effects of Trulicity?

 

Common Side Effects of Trulicity

 

  • Nausea: Initially, many patients experience nausea, which often lessens over time as the body adjusts.
  •  

  • Vomiting: Some individuals may experience vomiting, particularly in the first few doses.
  •  

  • Diarrhea: Digestive disturbances such as diarrhea are commonly reported.
  •  

  • Abdominal Pain: Discomfort in the abdomen can occur, often subsiding with continued use.
  •  

  • Decreased Appetite: Patients often report a reduction in appetite.
  •  

  • Fatigue: Some individuals may feel unusually tired after starting treatment.
  •  

  • Reduced Blood Sugar: Blood sugar levels may become low, especially when used in conjunction with other diabetes medications.

 

How much weight can you lose on Trulicity?

 

Weight Loss with Trulicity

 

  • Trulicity (dulaglutide) is primarily prescribed for managing type 2 diabetes, but many patients also experience weight loss as an additional benefit.
  •  

  • Clinical trials indicate an average weight loss of around 2-6 pounds, but results differ based on individual factors such as diet, exercise, and adherence to the medication.
  •  

  • Some users report greater weight loss; however, it's important to accompany Trulicity with lifestyle changes for optimal results.
  •  

  • Consult with a healthcare provider to tailor a plan that maximizes benefits based on your health needs.

 

How does Trulicity work for type 2 diabetes?

 

How Trulicity Works

 

  • Trulicity is a GLP-1 receptor agonist, helping to regulate blood sugar levels.
  •  

  • It stimulates insulin release in response to high blood glucose.
  •  

  • It slows gastric emptying, which helps reduce post-meal glucose spikes.
  •  

  • Trulicity suppresses glucagon secretion, lowering glucose production by the liver.

 

Benefits

 

  • Easy-to-use once-weekly injection, improving adherence.
  •  

  • Not associated with causing weight gain; may even promote modest weight loss.
  •  

  • May reduce risk of cardiovascular events in patients with heart disease.

 

Considerations

 

  • May cause gastrointestinal side effects, often resolving over time.
  •  

  • Inform your doctor if you have a history of pancreatitis or gallbladder disease.
  •  

  • Monitor for signs of low blood sugar, especially if using other diabetes medications.

 

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