Does Blue Cross Blue Shield of Massachusetts Cover Benzphetamine (Didrex)

Learn why BCBS Massachusetts may deny Benzphetamine coverage, how to secure it, and costs without insurance. Plus, get answers to common Benzphetamine FAQs.
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Benzphetamine Coverage by Blue Cross Blue Shield of Massachusetts

 

  • Benzphetamine (Didrex) may be covered under certain conditions and specific medical criteria set by Blue Cross Blue Shield of Massachusetts.
  •  

  • Coverage is generally considered for patients who have a documented diagnosis of obesity with related comorbidities and have not achieved weight loss through lifestyle modifications alone.
  •  

  • Prescriptions must be written by a healthcare provider indicating medical necessity, and the patient may need to have a documented failed attempt with alternative therapies first.
  •  

  • Prior authorization is typically required. This involves the healthcare provider submitting clinical information for review to ensure the prescription meets the plan's medical guidelines.
  •  

  • It's crucial for beneficiaries to check their specific plan documents or contact Blue Cross Blue Shield of Massachusetts directly for precise coverage details and to confirm whether benzphetamine is included in their pharmacy benefit.

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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 Benzphetamine (Didrex) Coverage with Blue Cross Blue Shield of Massachusetts

 

Verify Benzphetamine (Didrex) Coverage Policy

 

  • Contact Blue Cross Blue Shield of Massachusetts customer service to inquire about the coverage policy for Benzphetamine (Didrex). You can find the contact information on their official website or on your insurance card.
  •  

  • Ask for a copy of your plan's formulary, which is the list of medications covered under your plan. Check whether Benzphetamine (Didrex) is included.
  •  

  • Inquire about any necessary prior authorizations or specific criteria that need to be met for coverage approval.

 

Obtain a Prescription

 

  • Schedule an appointment with your healthcare provider to discuss your need for Benzphetamine (Didrex).
  •  

  • Ensure your healthcare provider understands your insurance requirements and requests a prior authorization if needed.

 

Submit a Prior Authorization Request

 

  • Work with your healthcare provider to complete a prior authorization form, which may be required by Blue Cross Blue Shield of Massachusetts to cover Benzphetamine (Didrex).
  •  

  • Your healthcare provider may need to provide clinical justifications, such as medical necessity and detailed treatment plans, to support the prior authorization.
  •  

  • Submit the completed prior authorization form through the appropriate channel specified by Blue Cross Blue Shield of Massachusetts.

 

Check the Status of Your Request

 

  • Follow up with Blue Cross Blue Shield of Massachusetts to check the status of your prior authorization request. This can often be done online or by calling customer service.
  •  

  • Ask for expected timelines for processing prior authorizations and what to do if additional information is required.

 

Address Denials or Appeals

 

  • If your request is denied, review the denial notice for the specific reasons and required next steps.
  •  

  • Discuss with your healthcare provider possible alternatives or additional documentation that might support an appeal.
  •  

  • File an appeal through the official Blue Cross Blue Shield of Massachusetts process, adhering strictly to their instructions and deadlines.

 

Fill Your Prescription

 

  • Upon approval, go to your preferred pharmacy to fill the prescription for Benzphetamine (Didrex).
  •  

  • Present your Blue Cross Blue Shield of Massachusetts member ID card and inform the pharmacy staff of the prior authorization approval.

 

Maintain Communication

 

  • Keep in regular contact with both your healthcare provider and the insurance company to ensure that all required paperwork and processes are managed.
  •  

  • Stay informed about any changes to your insurance plan that might affect medication coverage in the future.

 

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FAQs

Does Blue Cross Blue Shield of Massachusetts Cover Benzphetamine (Didrex)

Learn why BCBS Massachusetts may deny Benzphetamine coverage, how to secure it, and costs without insurance. Plus, get answers to common Benzphetamine FAQs.
Curex allergy drops unboxing

Is Benzphetamine (Didrex) Covered by Blue Cross Blue Shield of Massachusetts

 

Benzphetamine Coverage by Blue Cross Blue Shield of Massachusetts

 

  • Benzphetamine (Didrex) may be covered under certain conditions and specific medical criteria set by Blue Cross Blue Shield of Massachusetts.
  •  

  • Coverage is generally considered for patients who have a documented diagnosis of obesity with related comorbidities and have not achieved weight loss through lifestyle modifications alone.
  •  

  • Prescriptions must be written by a healthcare provider indicating medical necessity, and the patient may need to have a documented failed attempt with alternative therapies first.
  •  

  • Prior authorization is typically required. This involves the healthcare provider submitting clinical information for review to ensure the prescription meets the plan's medical guidelines.
  •  

  • It's crucial for beneficiaries to check their specific plan documents or contact Blue Cross Blue Shield of Massachusetts directly for precise coverage details and to confirm whether benzphetamine is included in their pharmacy benefit.

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Blue Cross Blue Shield of Massachusetts's Approved Criteria for Benzphetamine (Didrex) Coverage

 

Approved Criteria for Benzphetamine (Didrex) Coverage

 

  • The medication is prescribed for the treatment of exogenous obesity as an adjunct to a reduced-calorie diet.
  •  

  • The patient is 12 years of age or older.
  •  

  • The patient has a Body Mass Index (BMI) of 30 kg/m² or higher, or 27 kg/m² or higher in presence of other risk factors (such as diabetes, hypertension, or hyperlipidemia).
  •  

  • The patient's obesity has not responded sufficiently to an adequate trial of diet and exercise alone.
  •  

  • The prescribing physician is a specialist in obesity or a healthcare provider with expertise in managing patients with obesity.
  •  

  • The patient has been evaluated and monitored for possible contraindications or potential side effects of the medication.
  •  

  • Documentation of treatment goals and a comprehensive plan for weight management, including diet and exercise, is provided and aligned with the prescription.
  •  

  • Regular follow-up visits are scheduled to monitor the patient’s weight reduction and overall health status throughout the treatment period.

 

Why Blue Cross Blue Shield of Massachusetts Might Deny Benzphetamine (Didrex) Coverage

 

Reasons for Coverage Denial of Benzphetamine (Didrex)

 

  • Prescription for non-FDA approved uses: Blue Cross Blue Shield of Massachusetts does not cover Benzphetamine if it is prescribed for purposes not approved by the FDA.
  •  

  • Lack of medical necessity: If it is determined that the use of Benzphetamine is not medically necessary based on the patient's health condition, coverage may be denied.
  •  

  • Failure to meet clinical guideline criteria: The insurer may deny coverage if the patient does not meet specific clinical guidelines or criteria established for safe and effective use of Benzphetamine.
  •  

  • Alternative treatments: Coverage might be denied if there are other proven and less costly therapies available that have not been attempted or considered.
  •  

  • Inadequate documentation: Insufficient or lack of appropriate documentation supporting the necessity or safety of Benzphetamine use can result in denial.
  •  

  • Policy exclusions: Any specific exclusions in the insurance policy regarding appetite suppressants or similar medications might lead to non-coverage.

 

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How Much Does Benzphetamine (Didrex) Cost without Insurance?

 

Understanding Benzphetamine (Didrex) Cost

 

  • Benzphetamine, commonly known by the brand name Didrex, is a prescription medication used as a short-term adjunct in weight reduction therapy.
  •  

  • The cost of Benzphetamine without insurance can vary significantly depending on the pharmacy and the dosage prescribed.
  •  

  • On average, the cost for a 30-day supply of Benzphetamine (50 mg tablets) can range from $40 to $70.
  •  

  • Prices may be higher or lower, depending on location, pharmacy pricing policies, and available discounts or coupons.
  •  

  • Pharmacy discount programs and generic versions of the drug may offer cost savings.

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 Benzphetamine (Didrex) Coverage with Blue Cross Blue Shield of Massachusetts

 

Verify Benzphetamine (Didrex) Coverage Policy

 

  • Contact Blue Cross Blue Shield of Massachusetts customer service to inquire about the coverage policy for Benzphetamine (Didrex). You can find the contact information on their official website or on your insurance card.
  •  

  • Ask for a copy of your plan's formulary, which is the list of medications covered under your plan. Check whether Benzphetamine (Didrex) is included.
  •  

  • Inquire about any necessary prior authorizations or specific criteria that need to be met for coverage approval.

 

Obtain a Prescription

 

  • Schedule an appointment with your healthcare provider to discuss your need for Benzphetamine (Didrex).
  •  

  • Ensure your healthcare provider understands your insurance requirements and requests a prior authorization if needed.

 

Submit a Prior Authorization Request

 

  • Work with your healthcare provider to complete a prior authorization form, which may be required by Blue Cross Blue Shield of Massachusetts to cover Benzphetamine (Didrex).
  •  

  • Your healthcare provider may need to provide clinical justifications, such as medical necessity and detailed treatment plans, to support the prior authorization.
  •  

  • Submit the completed prior authorization form through the appropriate channel specified by Blue Cross Blue Shield of Massachusetts.

 

Check the Status of Your Request

 

  • Follow up with Blue Cross Blue Shield of Massachusetts to check the status of your prior authorization request. This can often be done online or by calling customer service.
  •  

  • Ask for expected timelines for processing prior authorizations and what to do if additional information is required.

 

Address Denials or Appeals

 

  • If your request is denied, review the denial notice for the specific reasons and required next steps.
  •  

  • Discuss with your healthcare provider possible alternatives or additional documentation that might support an appeal.
  •  

  • File an appeal through the official Blue Cross Blue Shield of Massachusetts process, adhering strictly to their instructions and deadlines.

 

Fill Your Prescription

 

  • Upon approval, go to your preferred pharmacy to fill the prescription for Benzphetamine (Didrex).
  •  

  • Present your Blue Cross Blue Shield of Massachusetts member ID card and inform the pharmacy staff of the prior authorization approval.

 

Maintain Communication

 

  • Keep in regular contact with both your healthcare provider and the insurance company to ensure that all required paperwork and processes are managed.
  •  

  • Stay informed about any changes to your insurance plan that might affect medication coverage in the future.

 

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Benzphetamine (Didrex) FAQ

What are the side effects of Benzphetamine (Didrex)?

 

Common Side Effects

 

  • Insomnia
  • Nervousness
  • Dizziness
  • Dry Mouth
  • Headache
  • Constipation

 

Severe Side Effects

 

  • Increased Blood Pressure
  • Heart Palpitations
  • Seizures
  • Severe Mood Changes
  • Chest Pain
  • Breathing Difficulties

 

Important Considerations

 

  • If you experience severe side effects, seek medical attention immediately.
  • Use cautiously if you have a history of cardiovascular conditions.
  • Avoid usage in individuals with a history of drug abuse.
  • Always follow the prescribed dosage to minimize risks.
  • Inform your doctor of any existing health conditions or medications.

 

How does Benzphetamine help with weight loss?

 

Mechanism of Action

 

  • Benzphetamine is an appetite suppressant. It stimulates the central nervous system, which increases heart rate and blood pressure.
  •  
  • This leads to a reduced appetite and a feeling of fullness, helping individuals to control their caloric intake.

 

Usage Guidelines

 

  • It should be used as part of a comprehensive weight loss plan, including diet, exercise, and behavioral modification.
  •  
  • Typically prescribed for short-term use to jump-start weight loss efforts.

 

Precautions

 

  • Not suitable for individuals with a history of cardiovascular diseases, hyperthyroidism, or glaucoma.
  •  
  • It may cause side effects such as insomnia, dizziness, and dry mouth.

Is Benzphetamine similar to Phentermine?

 

Similarity between Benzphetamine and Phentermine

 

  • Benzphetamine (Didrex) and Phentermine are both stimulant medications primarily used to treat obesity.
  •  

  • They function as appetite suppressants by affecting the central nervous system.
  •  

  • Both are chemically related to amphetamines but are not classified as amphetamines themselves.

 

Differences

 

  • Benzphetamine is a prodrug and metabolizes into amphetamine and methamphetamine, while Phentermine does not convert into amphetamine derivatives.
  •  

  • Phentermine is generally preferred due to a more established safety profile and fewer side effects compared to Benzphetamine.
  •  

  • Phentermine is typically dosed once daily, whereas Benzphetamine might require multiple doses.

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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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