Does Blue Cross Blue Shield of Arizona Cover Diethylpropion (Tenuate)

Explore coverage details, costs, and appeal steps for Diethylpropion with Blue Cross Blue Shield of Arizona plus FAQs in this essential guide.
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Diethylpropion (Tenuate) Coverage by BCBS of Arizona

 

  • Blue Cross Blue Shield of Arizona may cover Diethylpropion (Tenuate) if considered medically necessary, often for short-term treatment of obesity.
  •  

  • Coverage usually requires prior authorization. A physician must demonstrate necessity and that the patient meets specific criteria, such as a BMI threshold.
  •  

  • Patients may need to show documentation of failed attempts with other weight loss methods. Compliance with specific guidelines fixed by the insurance plan is crucial.
  •  

  • The plan may cover only certain dosages or forms of Diethylpropion, and ongoing coverage may depend on continued medical necessity and evidence of efficacy and safety.

 

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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.

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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 Diethylpropion (Tenuate) Coverage with Blue Cross Blue Shield of Arizona

 

Verify Your Insurance Plan

 

  • Review your specific Blue Cross Blue Shield of Arizona insurance plan details. Look for information on prescription drug coverage and whether Diethylpropion (Tenuate) is listed under covered medications.
  •  

  • Check the formulary, which is the list of covered drugs, on the Blue Cross Blue Shield of Arizona website or in your plan documentation.
  •  

  • If necessary, contact customer service to confirm if Diethylpropion (Tenuate) is covered under your plan and any requirements that must be met for coverage.

 

Consult Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss whether Diethylpropion (Tenuate) is an appropriate treatment option for you.
  •  

  • Ensure your healthcare provider is aware of any prerequisites your insurance may require, such as prior authorization or step therapy, to prescribe Diethylpropion.

 

Obtain Prior Authorization if Required

 

  • If prior authorization is required for Diethylpropion coverage, your healthcare provider will need to submit a request on your behalf to Blue Cross Blue Shield of Arizona.
  •  

  • Ensure your provider includes all necessary medical documentation and justification for the medication in the prior authorization request.
  •  

  • Follow up with your provider or directly with Blue Cross Blue Shield of Arizona to track the status of the prior authorization.

 

Explore Alternative Medications

 

  • If Diethylpropion (Tenuate) is not covered or the prior authorization is denied, discuss alternative medications that may be covered with your healthcare provider.
  •  

  • Review with them the possibility of prescribing a similar medication that treats the same condition but is included in your plan’s formulary.

 

Appeal Denied Coverage

 

  • If coverage for Diethylpropion is denied, you have the option to file an appeal with Blue Cross Blue Shield of Arizona.
  •  

  • Work with your healthcare provider to provide any additional information or documentation that could support your appeal.
  •  

  • Submit the appeal documentation as per the guidelines provided by Blue Cross Blue Shield of Arizona, and make sure to monitor the appeal status.

 

Utilize Customer Service Support

 

  • Contact Blue Cross Blue Shield of Arizona customer service for assistance throughout this process, especially if any issues or questions arise regarding coverage of Diethylpropion (Tenuate).
  •  

  • Use the customer service representatives as a resource to better understand your prescription benefits and options.

 

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FAQs

Does Blue Cross Blue Shield of Arizona Cover Diethylpropion (Tenuate)

Explore coverage details, costs, and appeal steps for Diethylpropion with Blue Cross Blue Shield of Arizona plus FAQs in this essential guide.
Curex allergy drops unboxing

Is Diethylpropion (Tenuate) Covered by Blue Cross Blue Shield of Arizona

 

Diethylpropion (Tenuate) Coverage by BCBS of Arizona

 

  • Blue Cross Blue Shield of Arizona may cover Diethylpropion (Tenuate) if considered medically necessary, often for short-term treatment of obesity.
  •  

  • Coverage usually requires prior authorization. A physician must demonstrate necessity and that the patient meets specific criteria, such as a BMI threshold.
  •  

  • Patients may need to show documentation of failed attempts with other weight loss methods. Compliance with specific guidelines fixed by the insurance plan is crucial.
  •  

  • The plan may cover only certain dosages or forms of Diethylpropion, and ongoing coverage may depend on continued medical necessity and evidence of efficacy and safety.

 

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Blue Cross Blue Shield of Arizona's Approved Criteria for Diethylpropion (Tenuate) Coverage

 

Criteria for Coverage of Diethylpropion (Tenuate)

 

  • **Medical Necessity**: The prescription for Diethylpropion (Tenuate) must be deemed medically necessary by a licensed healthcare provider. The healthcare provider should document why the medication is needed for the patient.
  •  

  • **Diagnosis of Obesity**: Coverage is available for individuals diagnosed with obesity. A Body Mass Index (BMI) of 30 kg/m2 or greater typically fulfills this criterion, or a BMI of 27 kg/m2 with associated comorbid conditions such as hypertension or diabetes.
  •  

  • **Age Restrictions**: The individual must be within the age range indicated in the medication’s prescribing information, typically reserved for adult use.
  •  

  • **Previous Treatment Attempts**: The patient should have documented attempts to lose weight through diet and exercise before considering medication as an option.
  •  

  • **Monitoring by Healthcare Provider**: Ongoing supervision by a healthcare provider is required to monitor the effectiveness and any potential side effects of the medication.
  •  

  • **Duration of Therapy**: Coverage is generally limited to short-term use, reflecting its approved duration for use as stated in the prescribing information.
  •  

  • **Exclusions Based on Drug Interactions**: The provider must confirm there are no contraindications or significant drug interactions with the patient's current medication regimen.
  •  

  • **Compliance with FDA Guidelines**: The prescription must comply with FDA guidelines and regulatory approvals regarding the use and distribution of Diethylpropion (Tenuate).

 

Why Blue Cross Blue Shield of Arizona Might Deny Diethylpropion (Tenuate) Coverage

 

Situations Where Blue Cross Blue Shield of Arizona May Deny Diethylpropion (Tenuate) Coverage

 

  • Diethylpropion is prescribed for a condition other than the approved weight reduction in patients with an initial body mass index (BMI) of 30 or more, or 27 or more with other risk factors.
  •  

  • The patient does not meet the minimum age requirement set by the insurer for prescription use, often due to safety and efficacy concerns.
  •  

  • The prescribing physician is not a part of the approved network of healthcare providers, or the prescription process does not follow outlined protocols.
  •  

  • Renewal or continuation of Diethylpropion is requested without demonstrating adequate weight reduction during initial use, which shows ineffectiveness.
  •  

  • Prescriptions exceed the dosage limits specified by Blue Cross Blue Shield of Arizona or deviate from recommended treatment duration without proper justification.
  •  

  • There is a lack of documentation demonstrating the necessity for Diethylpropion, such as prior unsuccessful attempts with other weight management strategies.
  •  

  • Coverage is sought for an off-label use that is not supported by adequate medical evidence or FDA approval.
  •  

  • Prescription is attempted to be filled in a location or pharmacy not covered under the patient's specific insurance plan.

 

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How Much Does Diethylpropion (Tenuate) Cost without Insurance?

 

Approximate Cost of Diethylpropion (Tenuate) Without Insurance

 

  • The cost of Diethylpropion (Tenuate), a prescription medication used for weight loss, can vary widely depending on the pharmacy location and any available discounts or generic alternatives.
  •  

  • On average, the price for a supply of 30, 75 mg controlled-release tablets can range from $50 to $100 without insurance.
  •  

  • For the immediate-release version, the cost for a supply of 30, 25 mg tablets is typically around $30 to $70 without insurance.
  •  

  • Prices can fluctuate due to factors such as location, manufacturer pricing, and availability of alternative generic options.
  •  

  • It's often beneficial to check with different pharmacies for any potential coupons or discounts that may further reduce the cost.

 

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 Diethylpropion (Tenuate) Coverage with Blue Cross Blue Shield of Arizona

 

Verify Your Insurance Plan

 

  • Review your specific Blue Cross Blue Shield of Arizona insurance plan details. Look for information on prescription drug coverage and whether Diethylpropion (Tenuate) is listed under covered medications.
  •  

  • Check the formulary, which is the list of covered drugs, on the Blue Cross Blue Shield of Arizona website or in your plan documentation.
  •  

  • If necessary, contact customer service to confirm if Diethylpropion (Tenuate) is covered under your plan and any requirements that must be met for coverage.

 

Consult Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss whether Diethylpropion (Tenuate) is an appropriate treatment option for you.
  •  

  • Ensure your healthcare provider is aware of any prerequisites your insurance may require, such as prior authorization or step therapy, to prescribe Diethylpropion.

 

Obtain Prior Authorization if Required

 

  • If prior authorization is required for Diethylpropion coverage, your healthcare provider will need to submit a request on your behalf to Blue Cross Blue Shield of Arizona.
  •  

  • Ensure your provider includes all necessary medical documentation and justification for the medication in the prior authorization request.
  •  

  • Follow up with your provider or directly with Blue Cross Blue Shield of Arizona to track the status of the prior authorization.

 

Explore Alternative Medications

 

  • If Diethylpropion (Tenuate) is not covered or the prior authorization is denied, discuss alternative medications that may be covered with your healthcare provider.
  •  

  • Review with them the possibility of prescribing a similar medication that treats the same condition but is included in your plan’s formulary.

 

Appeal Denied Coverage

 

  • If coverage for Diethylpropion is denied, you have the option to file an appeal with Blue Cross Blue Shield of Arizona.
  •  

  • Work with your healthcare provider to provide any additional information or documentation that could support your appeal.
  •  

  • Submit the appeal documentation as per the guidelines provided by Blue Cross Blue Shield of Arizona, and make sure to monitor the appeal status.

 

Utilize Customer Service Support

 

  • Contact Blue Cross Blue Shield of Arizona customer service for assistance throughout this process, especially if any issues or questions arise regarding coverage of Diethylpropion (Tenuate).
  •  

  • Use the customer service representatives as a resource to better understand your prescription benefits and options.

 

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Diethylpropion (Tenuate) FAQ

What are the common side effects of Diethylpropion?

 

Common Side Effects of Diethylpropion

 

  • Diethylpropion may cause dizziness and drowsiness; avoid driving or operating heavy machinery if affected.
  •  

  • Patients often report headaches and insomnia. Adjust usage to early daytime to help mitigate insomnia.
  •  

  • It can lead to digestive issues like nausea, dry mouth, and constipation; drinking ample water and maintaining a balanced diet may assist.
  •  

  • Commonly, users experience increased heart rate or palpitations; seek medical advice if severe or persistent.
  •  

  • Nervousness and restlessness are possible; managing stress and limiting caffeine can be beneficial.

 

How effective is Diethylpropion for weight loss?

 

Effectiveness of Diethylpropion for Weight Loss

 

  • Diethylpropion is an appetite suppressant, aiding in short-term obesity management.
  •  

  • Primarily effective when combined with a structured diet and exercise plan.
  •  

  • Clinical studies show a modest weight reduction on average, typically around 3-4% body weight over 12 weeks.
  •  

  • Most beneficial in the initial phase of a weight loss program, stimulating early weight loss which can motivate further progress.
  •  

  • Advantages can diminish over time as appetite levels adjust, necessitating lifestyle modifications for sustained loss.
  •  

 

Considerations

 

  • Prescribed for short periods due to potential side effects and risk of dependency.
  •  

  • Not suitable for individuals with specific health conditions, such as cardiovascular disease or uncontrolled hypertension.

 

Is Diethylpropion similar to phentermine?

 

Overview of Diethylpropion and Phentermine

 

  • Both Diethylpropion and Phentermine are prescription medications classified as appetite suppressants and sympathomimetic amines.
  •  

  • They are primarily used to assist weight loss in individuals who are obese and have related risk factors such as diabetes or high blood pressure.

 

Mechanism of Action

 

  • Diethylpropion and Phentermine stimulate the central nervous system, increasing heart rate and blood pressure while decreasing appetite by affecting hypothalamic neurotransmitters.
  •  

  • Though they function similarly, Phentermine typically has a stronger effect and longer duration than Diethylpropion.

 

Potential Side Effects

 

  • Common side effects of both drugs include increased heart rate, dry mouth, insomnia, dizziness, and constipation.
  •  

  • Due to their stimulant properties, they pose a risk of dependency or abuse.

 

Usage Considerations

 

  • Both medications are intended for short-term use and should be accompanied by lifestyle changes like diet and exercise.
  •  

  • It's crucial to evaluate each individual's health status and history for a safe and effective treatment plan.

 

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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.

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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.

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