Does Blue Cross Blue Shield of Arizona Cover Ozempic

Explore Blue Cross Blue Shield of Arizona's coverage for Ozempic, reasons for denial, steps to secure coverage, costs without insurance, and FAQs.
Curex allergy drops unboxing
“Curex is changing the landscape of allergies in 2024”
man opening Curex packaging
man opening Curex packaging

 

Coverage for Ozempic

 

  • Blue Cross Blue Shield of Arizona may cover Ozempic for individuals with Type 2 diabetes, primarily for blood sugar management.
  •  

  • Coverage is typically contingent upon prior authorization, ensuring Ozempic is medically necessary and aligns with specific criteria outlined by the insurer.
  •  

 

Basic Rules and Criteria

 

  • Patients often need to demonstrate a clear medical necessity for Ozempic, as outlined by their healthcare provider.
  •  

  • Evidence may be required showing that alternative treatments have been ineffective or inappropriate.
  •  

  • Prescriptions must generally align with FDA approvals and recommended dosages.
  •  

  • Members should verify their specific benefits plan, as coverage can vary based on individual policy terms and conditions.
  •  

 

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 Ozempic Coverage with Blue Cross Blue Shield of Arizona

 

Start with Understanding Your Coverage

 

  • Contact Blue Cross Blue Shield of Arizona (BCBSAZ) customer service to confirm whether Ozempic is covered under your current health plan.
  •  

  • Review your policy documents for details regarding prescription medications coverage, particularly for diabetes management drugs like Ozempic.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Ozempic and obtain a prescription if medically necessary.
  •  

  • Ask your provider to supply any medical documentation that may support your need for Ozempic, which might be required by BCBSAZ.

 

Complete a Medication Request or Prior Authorization Form

 

  • Obtain a Medication Request Form or Prior Authorization Form from Blue Cross Blue Shield of Arizona either online or through customer service.
  •  

  • Fill out the form with the necessary information, ensuring your healthcare provider includes any documentation that supports the prescription of Ozempic.

 

Submit the Form to BCBSAZ

 

  • Send the completed Medication Request or Prior Authorization Form to BCBSAZ via the specified methods—fax, mail, or through your provider’s electronic submission service.
  •  

  • Ensure you keep copies of all submitted documents for your records and follow up with BCBSAZ to confirm receipt.

 

Await Approval and Follow Up

 

  • Wait for a response from Blue Cross Blue Shield of Arizona regarding the approval status of your Ozempic coverage request. This can take a few days to a few weeks.
  •  

  • If necessary, follow up with BCBSAZ customer service for updates on your application status, providing them with any further documentation required.

 

Understand the Appeals Process

 

  • If your request for Ozempic coverage is denied, familiarize yourself with the appeals process as outlined by Blue Cross Blue Shield of Arizona.
  •  

  • Work with your healthcare provider to gather and submit any additional information or documentation that may strengthen your appeal.

 

Explore Additional Assistance Programs

 

  • If coverage is not approved, consider exploring manufacturer or third-party assistance programs that might help you obtain Ozempic at a reduced cost.
  •  

  • Speak with your provider or BCBSAZ for recommendations on programs that may be available to you.

 

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 of Arizona Cover Ozempic

Explore Blue Cross Blue Shield of Arizona's coverage for Ozempic, reasons for denial, steps to secure coverage, costs without insurance, and FAQs.
Curex allergy drops unboxing

Is Ozempic Covered by Blue Cross Blue Shield of Arizona

 

Coverage for Ozempic

 

  • Blue Cross Blue Shield of Arizona may cover Ozempic for individuals with Type 2 diabetes, primarily for blood sugar management.
  •  

  • Coverage is typically contingent upon prior authorization, ensuring Ozempic is medically necessary and aligns with specific criteria outlined by the insurer.
  •  

 

Basic Rules and Criteria

 

  • Patients often need to demonstrate a clear medical necessity for Ozempic, as outlined by their healthcare provider.
  •  

  • Evidence may be required showing that alternative treatments have been ineffective or inappropriate.
  •  

  • Prescriptions must generally align with FDA approvals and recommended dosages.
  •  

  • Members should verify their specific benefits plan, as coverage can vary based on individual policy terms and conditions.
  •  

 

A weight management program tailored to you

Start with Curex

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

 

Eligibility Criteria for Ozempic Coverage

 

  • Members must have a diagnosis of Type 2 diabetes mellitus.
  •  

  • The medication must be prescribed by, or in consultation with, an endocrinologist or a provider specializing in diabetes management.

 

Previous Treatment Requirements

 

  • Documentation of inadequate control of blood sugar levels despite holding a trial of lifestyle modifications such as diet and exercise.
  •  

  • Members need to have tried a first-line oral therapy such as metformin at the maximum tolerated dose, unless contraindicated.

 

Dosage and Administration

 

  • Ozempic coverage is generally for a standard starting dose, followed by titration as per the treating physician’s guidelines and manufacturer recommendations.
  •  

  • Continued coverage requires evidence of therapeutic benefit, such as improved glycemic control as documented by hemoglobin A1c reductions.

 

Clinical Monitoring

 

  • Regular follow-up visits for monitoring response to therapy are required. Documentation should show periodic adjustments to the treatment plan based on monitored results.
  •  

  • Evaluation of potential adverse effects or need for treatment modifications based on laboratory and clinical assessments must be conducted.

 

Special Considerations

 

  • Prior authorization may be required, including submission of relevant medical records and clinical documentation supporting the medical necessity.
  •  

  • Consideration for coverage extends to members with established cardiovascular disease or high cardiovascular risk, in line with clinical guidelines emphasizing medication as part of an overall cardiovascular risk reduction strategy.

 

Why Blue Cross Blue Shield of Arizona Might Deny Ozempic Coverage

 

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

 

  • Coverage for Ozempic is denied if the medication is prescribed for conditions other than those approved by the FDA, such as weight loss. Ozempic is specifically approved for the management of type 2 diabetes, and off-label use may not be covered.
  •  

  • The plan may not cover Ozempic if the patient does not meet the specific medical necessity criteria set by Blue Cross Blue Shield of Arizona. This could include failure to document inadequate control of blood sugar levels with other medications specified in the policy.
  •  

  • There may be denial of coverage if there is a lack of required prior authorization or if the details provided do not meet prior authorization requisites set by Blue Cross Blue Shield of Arizona.
  •  

  • Coverage is often not provided if the patient does not adhere to formulary guidelines. This includes failure to try alternative formulary diabetes medications prior to Ozempic, unless clinical justification is provided.
  •  

  • Patients who are prescribed Ozempic beyond the recommended dosage may face coverage denial, as the insurance may not cover dosages that do not align with treatment guidelines or clear medical justification.
  •  

  • The insurer may refuse coverage if the prescribed Ozempic does not align with age restrictions or specific demographic requirements outlined in the coverage policy.
  •  

 

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

How Much Does Ozempic Cost without Insurance?

 

Cost of Ozempic Without Insurance

 

  • The approximate cost of Ozempic without insurance is between $800 and $900 for a month's supply. This price can vary based on the pharmacy location and any available manufacturer discounts or special pharmacy promotions.
  •  

  • It's important to note that prices can fluctuate, so checking with multiple pharmacies or online services could provide more precise current pricing.
  •  

  • Patients may also consider enrolling in patient assistance programs offered by the manufacturer, Novo Nordisk, which may provide discounts or support for eligible individuals.

 

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 Ozempic Coverage with Blue Cross Blue Shield of Arizona

 

Start with Understanding Your Coverage

 

  • Contact Blue Cross Blue Shield of Arizona (BCBSAZ) customer service to confirm whether Ozempic is covered under your current health plan.
  •  

  • Review your policy documents for details regarding prescription medications coverage, particularly for diabetes management drugs like Ozempic.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Ozempic and obtain a prescription if medically necessary.
  •  

  • Ask your provider to supply any medical documentation that may support your need for Ozempic, which might be required by BCBSAZ.

 

Complete a Medication Request or Prior Authorization Form

 

  • Obtain a Medication Request Form or Prior Authorization Form from Blue Cross Blue Shield of Arizona either online or through customer service.
  •  

  • Fill out the form with the necessary information, ensuring your healthcare provider includes any documentation that supports the prescription of Ozempic.

 

Submit the Form to BCBSAZ

 

  • Send the completed Medication Request or Prior Authorization Form to BCBSAZ via the specified methods—fax, mail, or through your provider’s electronic submission service.
  •  

  • Ensure you keep copies of all submitted documents for your records and follow up with BCBSAZ to confirm receipt.

 

Await Approval and Follow Up

 

  • Wait for a response from Blue Cross Blue Shield of Arizona regarding the approval status of your Ozempic coverage request. This can take a few days to a few weeks.
  •  

  • If necessary, follow up with BCBSAZ customer service for updates on your application status, providing them with any further documentation required.

 

Understand the Appeals Process

 

  • If your request for Ozempic coverage is denied, familiarize yourself with the appeals process as outlined by Blue Cross Blue Shield of Arizona.
  •  

  • Work with your healthcare provider to gather and submit any additional information or documentation that may strengthen your appeal.

 

Explore Additional Assistance Programs

 

  • If coverage is not approved, consider exploring manufacturer or third-party assistance programs that might help you obtain Ozempic at a reduced cost.
  •  

  • Speak with your provider or BCBSAZ for recommendations on programs that may be available to you.

 

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.

Ozempic FAQ

What are the common side effects of Ozempic?

 

Common Side Effects of Ozempic

 

  • Nausea: The most common side effect, often decreasing over time.
  •  

  • Vomiting: Can occur, especially at higher doses.
  •  

  • Diarrhea: May lead to dehydration; ensure adequate fluid intake.
  •  

  • Stomach (Abdominal) Pain: Often mild but can be bothersome.
  •  

  • Constipation: Can occur; manage with diet and hydration.
  •  

  • Reduced Appetite: May assist in weight loss but monitor nutritional intake.
  •  

  • Fatigue: Generally mild; ensure rest and hydration.
  •  

  • Dizziness: Monitor blood pressure and hydration levels.
  •  

  • Injection Site Reactions: Such as redness or irritation, usually temporary.

 

Ensure to discuss persistent or severe side effects with a healthcare provider.

Can Ozempic help with weight loss?

 

How Ozempic Aids Weight Loss

 

  • Ozempic contains semaglutide, a GLP-1 receptor agonist which enhances insulin release and suppresses appetite, facilitating weight loss.
  •  

  • The medication slows gastric emptying, increasing feelings of fullness and reducing calorie intake.

 

Considerations and Benefits

 

  • Clinical studies demonstrate significant weight reduction in people taking Ozempic, often used adjunctly with diet and exercise.
  •  

  • It can also help manage blood sugar levels, making it beneficial for individuals with type 2 diabetes.

 

Potential Side Effects

 

  • Common side effects include nausea, diarrhea, and vomiting, often decreasing over time.
  •  

  • Discuss with your healthcare provider to determine suitability, considering any existing conditions.

 

How does Ozempic work for diabetes?

 

How Ozempic Works for Diabetes

 

  • **Mechanism of Action:** Ozempic is a GLP-1 receptor agonist that mimics the incretin hormone, which decreases blood sugar levels by enhancing insulin secretion.
  •  

  • **Reducing Glucagon Levels:** It lowers glucagon release when blood glucose levels are high, which helps to reduce glucose production by the liver.
  •  

  • **Slows Gastric Emptying:** By delaying stomach emptying, it reduces the rapid spikes in blood glucose after meals.
  •  

  • **Increases Satiety:** It can suppress appetite, leading to possible weight loss, which is beneficial for type 2 diabetes management.

 

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