Does Blue Cross Blue Shield of Arizona Cover Dulera

Learn about Dulera coverage with Blue Cross Blue Shield of Arizona, reasons for denial, costs without insurance, and FAQs. Get informed on your options today.
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Coverage Overview

 

  • Blue Cross Blue Shield of Arizona (BCBSAZ) may cover Dulera as a prescribed medication for individuals diagnosed with asthma or similar respiratory conditions.
  •  

  • Coverage typically depends on the specific health plan you have with BCBSAZ, and Dulera might be covered under either a pharmacy benefit or a medical benefit.

 

Eligibility Criteria

 

  • Patients must have a confirmed diagnosis that meets the plan’s criteria for Dulera use. Prior authorization might be needed to justify its medical necessity.
  •  

  • BCBSAZ might require that generic alternatives or other medications have been tried first before covering Dulera.

 

Steps to Ensure Coverage

 

  • Consult with healthcare providers to obtain necessary documentation supporting the use of Dulera for your condition.
  •  

  • Contact BCBSAZ to verify specific coverage details, like copayment, deductibles, or formulary placement, for Dulera under your plan.

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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.

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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.

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 Dulera Coverage with Blue Cross Blue Shield of Arizona

 

Contact Blue Cross Blue Shield of Arizona

 

  • Call the customer service number on the back of your BCBS card to inquire if Dulera is included in your current prescription drug plan.
  •  

  • Visit the BCBS of Arizona website and log into your member account to review your current coverage plan details.

 

Verify Prescription Drug Coverage

 

  • Check your plan's formulary, a list of prescription drugs covered, to see if Dulera is included. You can often find this information online or request a copy from BCBS of Arizona.
  •  

  • If Dulera is not on your formulary, contact BCBS to ask about alternative medications that are covered, or inquire if there is a tier exception program for Dulera.

 

Consult with Your Healthcare Provider

 

  • Discuss with your physician whether Dulera is medically necessary for your treatment and if they can provide documentation to support a coverage exception if needed.
  •  

  • Your healthcare provider can help you understand if there are alternative medications covered under your plan that may also meet your needs.

 

Request Prior Authorization

 

  • If Dulera requires prior authorization, your doctor will need to submit a request to BCBS of Arizona, providing medical necessity details.
  •  

  • Ensure that the request includes all necessary documentation and follow up with BCBS to confirm receipt and progress.

 

Appeal a Denial

 

  • If coverage is denied, gather all supporting documents including your doctor’s notes and submit an appeal through BCBS of Arizona’s official process.
  •  

  • You can appeal the decision by writing a letter or submitting online through your member account, and following up with customer service for any further information.

 

Review Drug Alternatives

 

  • If Dulera coverage is not obtained, discuss with your doctor whether any covered alternatives can work for you.
  •  

  • Check if a different plan offered by BCBS might cover Dulera fully and consider switching plans during open enrollment if deemed necessary.

 

Regularly Monitor Updates

 

  • Keep an eye on changes in your coverage annually, as formularies update and may affect the availability of Dulera in the future.
  •  

  • Stay informed about any policy changes through BCBS communication channels.

 

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FAQs

Does Blue Cross Blue Shield of Arizona Cover Dulera

Learn about Dulera coverage with Blue Cross Blue Shield of Arizona, reasons for denial, costs without insurance, and FAQs. Get informed on your options today.
Curex allergy drops unboxing

Is Dulera Covered by Blue Cross Blue Shield of Arizona

 

Coverage Overview

 

  • Blue Cross Blue Shield of Arizona (BCBSAZ) may cover Dulera as a prescribed medication for individuals diagnosed with asthma or similar respiratory conditions.
  •  

  • Coverage typically depends on the specific health plan you have with BCBSAZ, and Dulera might be covered under either a pharmacy benefit or a medical benefit.

 

Eligibility Criteria

 

  • Patients must have a confirmed diagnosis that meets the plan’s criteria for Dulera use. Prior authorization might be needed to justify its medical necessity.
  •  

  • BCBSAZ might require that generic alternatives or other medications have been tried first before covering Dulera.

 

Steps to Ensure Coverage

 

  • Consult with healthcare providers to obtain necessary documentation supporting the use of Dulera for your condition.
  •  

  • Contact BCBSAZ to verify specific coverage details, like copayment, deductibles, or formulary placement, for Dulera under your plan.

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Blue Cross Blue Shield of Arizona's Approved Criteria for Dulera Coverage

 

Criteria for Dulera Coverage

 

  • Must be prescribed by a licensed healthcare provider for the treatment of asthma in patients aged 12 years and above.
  •  

  • The patient should have a documented diagnosis of asthma that is not adequately controlled with inhaled corticosteroids alone.
  •  

  • The prescriber must provide evidence of trials with other asthma medications, such as inhaled corticosteroids and long-acting beta-agonists, which have not sufficiently controlled symptoms.
  •  

  • There should be a specific documented reason why a combination therapy like Dulera is necessary over the use of higher doses of alternative medications.
  •  

  • Renewal of coverage requires documentation of improvement in asthma control, such as reduced frequency or severity of asthma attacks.
  •  

 

Why Blue Cross Blue Shield of Arizona Might Deny Dulera Coverage

 

Reasons for Denial of Dulera Coverage by Blue Cross Blue Shield of Arizona

 

  • The prescription of Dulera is inconsistent with the specified medical guidelines set by Blue Cross Blue Shield of Arizona.
  •  

  • The patient does not meet the medical necessity criteria outlined for Dulera usage, possibly due to the availability of alternative treatments.
  •  

  • Prescriptions that do not adhere to the step therapy protocol, which requires trying designated first line medications before Dulera.
  •  

  • Absence of prior authorization, which is a prerequisite before Dulera can be covered by the insurer.
  •  

  • Non-compliance with formulary restrictions which could require specific criteria to be met that are not fulfilled in the patient's case.
  •  

  • Prescription quantity or dosage that falls outside the approved limits without justification from the healthcare provider.
  •  

  • The request for Dulera is for an off-label use that has not been approved by Blue Cross Blue Shield of Arizona.
  •  

 

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How Much Does Dulera Cost without Insurance?

 

Approximate Cost of Dulera Without Insurance

 

  • The cost of Dulera, which is used to help control symptoms of asthma, can vary depending on the pharmacy and location. However, the typical price for a one-month supply (inhaler) of Dulera without insurance is approximately $250 to $350.
  •  

  • This price may differ based on dosage strength, and whether you're purchasing a brand name or a generic version if available.
  •  

  • Prices can fluctuate, and it is advisable to check with different pharmacies or consider using discount cards or coupons that might be available to reduce the cost.
  •  

  • Additionally, some pharmaceutical companies offer patient assistance programs for those who qualify, which can significantly lower the cost of Dulera.

 

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 Dulera Coverage with Blue Cross Blue Shield of Arizona

 

Contact Blue Cross Blue Shield of Arizona

 

  • Call the customer service number on the back of your BCBS card to inquire if Dulera is included in your current prescription drug plan.
  •  

  • Visit the BCBS of Arizona website and log into your member account to review your current coverage plan details.

 

Verify Prescription Drug Coverage

 

  • Check your plan's formulary, a list of prescription drugs covered, to see if Dulera is included. You can often find this information online or request a copy from BCBS of Arizona.
  •  

  • If Dulera is not on your formulary, contact BCBS to ask about alternative medications that are covered, or inquire if there is a tier exception program for Dulera.

 

Consult with Your Healthcare Provider

 

  • Discuss with your physician whether Dulera is medically necessary for your treatment and if they can provide documentation to support a coverage exception if needed.
  •  

  • Your healthcare provider can help you understand if there are alternative medications covered under your plan that may also meet your needs.

 

Request Prior Authorization

 

  • If Dulera requires prior authorization, your doctor will need to submit a request to BCBS of Arizona, providing medical necessity details.
  •  

  • Ensure that the request includes all necessary documentation and follow up with BCBS to confirm receipt and progress.

 

Appeal a Denial

 

  • If coverage is denied, gather all supporting documents including your doctor’s notes and submit an appeal through BCBS of Arizona’s official process.
  •  

  • You can appeal the decision by writing a letter or submitting online through your member account, and following up with customer service for any further information.

 

Review Drug Alternatives

 

  • If Dulera coverage is not obtained, discuss with your doctor whether any covered alternatives can work for you.
  •  

  • Check if a different plan offered by BCBS might cover Dulera fully and consider switching plans during open enrollment if deemed necessary.

 

Regularly Monitor Updates

 

  • Keep an eye on changes in your coverage annually, as formularies update and may affect the availability of Dulera in the future.
  •  

  • Stay informed about any policy changes through BCBS communication channels.

 

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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.

Dulera FAQ

What are the side effects of Dulera?

 

Common Side Effects of Dulera

 

  • Headache
  • Sore throat
  • Sinus pain
  • Nosebleed
  • Oral thrush (fungal infection)

 

Serious Side Effects

 

  • Wheezing or breathing problems
  • Severe allergic reactions (rash, itching/swelling)
  • Vision problems
  • Reduced bone density with long-term use

 

Monitoring and Precautions

 

  • Regularly check bone health and eye exams
  • Rinse mouth after inhalation to prevent oral infections
  • Consult your doctor if side effects worsen or persist

 

How does Dulera work for asthma?

 

Mechanism of Action

 

  • Dulera is a combination inhaler containing mometasone (a corticosteroid) and formoterol (a long-acting beta-agonist).
  •  

  • Mometasone reduces inflammation in the airways, minimizing swelling and irritation.
  •  

  • Formoterol relaxes bronchial muscles, improving airflow and easing breathing.

 

Benefits for Asthma

 

  • Helps prevent asthma attacks by maintaining open airways over long periods.
  •  

  • Decreases the usage frequency of rescue inhalers due to improved control of symptoms.

 

Usage Guidance

 

  • Use regularly as prescribed, even without current symptoms, for effective management.
  •  

  • Rinse mouth after inhalation to reduce risks of oral thrush from corticosteroid use.

 

Consultation Necessity

 

  • Discuss with healthcare provider if side effects occur or asthma symptoms do not improve.

 

Is Dulera a steroid inhaler?

 

Is Dulera a Steroid Inhaler?

 

  • Dulera is a combination inhaler used for asthma management, containing both formoterol, a long-acting beta-agonist (LABA), and mometasone furoate, which is a corticosteroid.
  •  

  • Corticosteroids in Dulera are used to reduce inflammation in the airways, helping to prevent and control asthma symptoms.
  •  

  • Formoterol helps in relaxing muscles around the airways, making breathing easier by widening the air passages.
  •  

  • It's essential to use Dulera regularly for it to be effective; it is not intended for relief of acute asthma attacks.
  •  

  • Patients should be aware of potential side effects like throat irritation or thrush due to the steroid component, and rinsing the mouth after use may help minimize these risks.

 

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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.

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