Does Blue Cross Blue Shield of Arizona Cover Plavix

Explore Plavix coverage by Blue Cross Blue Shield of Arizona. Learn about denial reasons, coverage options, costs without insurance, and FAQs.
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Coverage for Plavix

 

  • Blue Cross Blue Shield of Arizona may cover Plavix based on the specific health plan's prescription drug benefits.
  • Coverage often requires the medication to be deemed medically necessary for conditions like heart attack prevention or stroke.
  • Plavix is generally covered under plans including prescription medication benefits.

 

Criteria and Rules

 

  • Coverage often requires prior authorization, where your healthcare provider must state the necessity of the medication.
  • Plavix may also be subject to quantity limits and step therapy protocols.
  • To ensure coverage, check your specific plan details and consult with the plan’s customer service.

 

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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 Plavix Coverage with Blue Cross Blue Shield of Arizona

 

Verify Your Plan Coverage

 

  • Log in to your Blue Cross Blue Shield of Arizona online account to check your specific plan details regarding prescription drug coverage.
  • Visit the Pharmacy Benefit section to see if Plavix is included in your formulary list or contact member services for assistance.

 

Consult with Your Doctor

 

  • Discuss with your healthcare provider about the need for Plavix and whether it is the best option for your condition.
  • Ask your doctor to check for any required prior authorizations or alternative medications if initially denied.

 

Obtain a Prescription

 

  • Request a written prescription for Plavix from your healthcare provider if it's determined you need this medication.
  • Ensure all necessary medical records and documentation are updated to support your need for Plavix.

 

Contact Blue Cross Blue Shield Customer Service

 

  • Call the customer service number on the back of your insurance card to ask about coverage specifics for Plavix.
  • Gather information on any forms, prior authorizations, or medical necessity documentation required.

 

Submit Required Documentation

 

  • Complete any required forms such as prior authorization requests or medical necessity evidence as advised by customer service.
  • Have your healthcare provider send this documentation to Blue Cross Blue Shield of Arizona on your behalf.

 

Choose an In-Network Pharmacy

 

  • Locate an in-network pharmacy using Blue Cross Blue Shield of Arizona’s online tools to ensure the best price and coverage.
  • Present your insurance card and prescription at the pharmacy to fill your prescription.

 

Follow Up on Authorization and Claims

 

  • Regularly check the status of any pending authorizations through your online account or by calling customer service.
  • If your prescription is denied, discuss appeals or alternative solutions with both your insurance and healthcare provider.

 

Review Medication Costs

 

  • Investigate if there are generic alternatives to Plavix that might reduce your out-of-pocket expense.
  • Inquire about any available manufacturer discounts or assistance programs that might apply to you.

 

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FAQs

Does Blue Cross Blue Shield of Arizona Cover Plavix

Explore Plavix coverage by Blue Cross Blue Shield of Arizona. Learn about denial reasons, coverage options, costs without insurance, and FAQs.
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Is Plavix Covered by Blue Cross Blue Shield of Arizona

 

Coverage for Plavix

 

  • Blue Cross Blue Shield of Arizona may cover Plavix based on the specific health plan's prescription drug benefits.
  • Coverage often requires the medication to be deemed medically necessary for conditions like heart attack prevention or stroke.
  • Plavix is generally covered under plans including prescription medication benefits.

 

Criteria and Rules

 

  • Coverage often requires prior authorization, where your healthcare provider must state the necessity of the medication.
  • Plavix may also be subject to quantity limits and step therapy protocols.
  • To ensure coverage, check your specific plan details and consult with the plan’s customer service.

 

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

 

Plavix Coverage Criteria by Blue Cross Blue Shield of Arizona

 

  • Coverage is provided for patients diagnosed with acute coronary syndrome (ACS), including unstable angina or non-Q-wave myocardial infarction, who require thrombosis prevention.
  •  

  • Coverage is available for patients with a history of recent myocardial infarction (MI), stroke, or established peripheral arterial disease (PAD) where antiplatelet therapy is indicated.
  •  

  • Patients who have undergone coronary artery stenting procedures and need antiplatelet agents to prevent stent thrombosis are eligible for coverage.
  •  

  • Plavix is covered for patients with established atherosclerotic vascular disease to reduce the risk of cardiovascular events.
  •  

  • Candidates for Plavix coverage should not have any contraindications to clopidogrel therapy as identified in their medical history.
  •  

  • A prescription from a licensed healthcare provider detailing the medical necessity of Plavix for the patient is required for insurance coverage approval.

 

Why Blue Cross Blue Shield of Arizona Might Deny Plavix Coverage

 

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

 

  • Plavix is being prescribed for uses that are not approved by the FDA. Off-label use of the medication may not meet the insurance coverage criteria.
  •  

  • The patient does not meet the specific medical criteria or guidelines set forth by Blue Cross Blue Shield of Arizona for Plavix coverage, such as lacking necessary medical history or condition severity.
  •  

  • The request for Plavix is not supported by adequate documentation or medical justification as required by the insurer. Without proper documentation, requests may be denied.
  •  

  • A less expensive alternative medication is available and deemed appropriate for the patient’s condition. Utilization of cost-effective alternatives may be prioritized.
  •  

  • The prescription comes from an out-of-network provider who is not covered under the patient's current insurance plan with Blue Cross Blue Shield of Arizona.
  •  

  • Plavix is being used beyond the recommended duration or dosage limit set by the insurance policy, which may lead to coverage denial.

 

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

How Much Does Plavix Cost without Insurance?

 

Approximate Cost of Plavix Without Insurance

 

  • The cost of Plavix, or its generic version clopidogrel, can vary widely depending on the pharmacy and geographical location.
  •  

  • Brand-name Plavix typically costs between $150 to $300 for a 30-day supply at retail prices.
  •  

  • The generic clopidogrel is significantly cheaper, often ranging from $5 to $50 for a 30-day supply when purchased without insurance.
  •  

  • Pricing may fluctuate based on factors such as dosage strength, promotions, or pharmacy discount programs.
  •  

  • Online or mail-order pharmacies might offer additional savings, in comparison to local pharmacies.

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 Plavix Coverage with Blue Cross Blue Shield of Arizona

 

Verify Your Plan Coverage

 

  • Log in to your Blue Cross Blue Shield of Arizona online account to check your specific plan details regarding prescription drug coverage.
  • Visit the Pharmacy Benefit section to see if Plavix is included in your formulary list or contact member services for assistance.

 

Consult with Your Doctor

 

  • Discuss with your healthcare provider about the need for Plavix and whether it is the best option for your condition.
  • Ask your doctor to check for any required prior authorizations or alternative medications if initially denied.

 

Obtain a Prescription

 

  • Request a written prescription for Plavix from your healthcare provider if it's determined you need this medication.
  • Ensure all necessary medical records and documentation are updated to support your need for Plavix.

 

Contact Blue Cross Blue Shield Customer Service

 

  • Call the customer service number on the back of your insurance card to ask about coverage specifics for Plavix.
  • Gather information on any forms, prior authorizations, or medical necessity documentation required.

 

Submit Required Documentation

 

  • Complete any required forms such as prior authorization requests or medical necessity evidence as advised by customer service.
  • Have your healthcare provider send this documentation to Blue Cross Blue Shield of Arizona on your behalf.

 

Choose an In-Network Pharmacy

 

  • Locate an in-network pharmacy using Blue Cross Blue Shield of Arizona’s online tools to ensure the best price and coverage.
  • Present your insurance card and prescription at the pharmacy to fill your prescription.

 

Follow Up on Authorization and Claims

 

  • Regularly check the status of any pending authorizations through your online account or by calling customer service.
  • If your prescription is denied, discuss appeals or alternative solutions with both your insurance and healthcare provider.

 

Review Medication Costs

 

  • Investigate if there are generic alternatives to Plavix that might reduce your out-of-pocket expense.
  • Inquire about any available manufacturer discounts or assistance programs that might apply to you.

 

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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.

Plavix FAQ

1. What is Plavix used for?

 

Uses of Plavix

 

  • Plavix, known generically as clopidogrel, is primarily used as an antiplatelet medication.
  •  

  • It helps prevent blood clots, reducing the risk of stroke and heart attack in individuals with cardiovascular conditions.
  •  

  • Often prescribed post-heart attack or stroke, it is also beneficial for patients with peripheral artery disease.
  •  

    Mechanism of Action

     

    • Plavix inhibits platelet aggregation by irreversibly binding to the P2Y12 receptor on platelets.
    •  

    • This action prevents the platelets from clumping together, reducing clot formation in blood vessels.

     

    Considerations

     

    • Plavix is typically taken orally, once a day, with or without food.
    •  

    • Regular monitoring and consultation with a healthcare provider are recommended to ensure its effectiveness and manage potential side effects.

     

2. What are the side effects of Plavix?

 

Common Side Effects of Plavix

 

  • Bleeding symptoms, such as nosebleeds or bleeding gums, are among the most frequent side effects.
  • Some individuals may experience bruising more easily than usual.

 

Less Common Side Effects

 

  • Severe allergic reactions can occur, including skin rash or itching.
  • It's possible to develop gastrointestinal issues like indigestion or abdominal pain.

 

Rare but Serious Side Effects

 

  • In rare instances, patients might experience thrombotic thrombocytopenic purpura—a serious condition affecting blood clotting.
  • Liver function abnormalities, represented by symptoms like jaundice, can also occur.

 

Precautionary Measures

 

  • Always consult a healthcare provider for symptoms that appear unexpectedly.
  • Report any unusual bleeding or symptoms to a doctor promptly.

 

3. Can I take Plavix with aspirin?

 

Combining Plavix and Aspirin

 

  • **Plavix (clopidogrel)** and **aspirin** are both antiplatelet medications. They reduce the risk of clots, lowering the chance of heart attacks or strokes.
  •  

  • This combination can enhance antiplatelet effects but raises bleeding risk.

 

Consult with Your Doctor

 

  • Your healthcare provider will evaluate your risk factors and decide if this combination benefits you.
  •  

  • Contact your doctor if unexplained bruising, prolonged bleeding, or unusual weakness occurs.

 

Special Circumstances

 

  • In certain conditions like acute coronary syndrome or after stent placement, combined use is common but should always be under medical supervision.

 

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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.

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