Does Blue Cross Blue Shield of Massachusetts Cover Forteo

Explore Forteo coverage by Blue Cross Blue Shield MA. Learn about denial reasons, coverage tips, costs without insurance, and get answers to common questions.
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Coverage Overview for Forteo by Blue Cross Blue Shield of Massachusetts

 

  • Forteo may be covered for treating osteoporosis in postmenopausal women and men who have a high risk of fracture.
  •  

  • Coverage may extend to patients with glucocorticoid-induced osteoporosis.

 

Criteria for Coverage

 

  • There must be a documented history of failure, contraindication, or intolerance to other osteoporosis therapies.
  •  

  • An approved prior authorization from Blue Cross Blue Shield of Massachusetts is typically required.

 

Basic Rules

 

  • Prescriptions must be written by a qualified healthcare provider, and proper medical records must be submitted to support the need for Forteo.
  •  

  • Coverage and criteria can vary by individual policy plans, and members are encouraged to check their specific benefits.

 

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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 Forteo Coverage with Blue Cross Blue Shield of Massachusetts

 

Contact Blue Cross Blue Shield of Massachusetts

 

  • Call the customer service number on the back of your insurance card to inquire about coverage for Forteo (teriparatide).
  •  

  • Have your policy number ready for reference during the call to streamline the process.

 

Consult with Your Doctor

 

  • Discuss with your healthcare provider about the necessity of Forteo for your condition and obtain any necessary documentation supporting its use.
  •  

  • Request your doctor to provide a letter of medical necessity, which clearly explains why Forteo is the suitable treatment for you.

 

Review Your Plan’s Prescription Benefits

 

  • Log into your Blue Cross Blue Shield of Massachusetts account online to review your plan’s coverage details regarding prescription medications.
  •  

  • Search specifically for information related to specialty drugs or hormone therapies, as Forteo might fall under these categories.

 

Submit a Prior Authorization Request

 

  • Work with your healthcare provider to submit a prior authorization request to Blue Cross Blue Shield of Massachusetts. This is often required for medications like Forteo.
  •  

  • Ensure that all necessary forms are filled correctly and include your doctor’s letter of medical necessity.

 

Follow Up on the Request

 

  • Contact Blue Cross Blue Shield of Massachusetts to verify if they have received the prior authorization request.
  •  

  • Inquire about the expected processing time and any additional information they might need.

 

Appeal if Necessary

 

  • If your initial request for Forteo coverage is denied, carefully review the denial letter for details.
  •  

  • Prepare to file an appeal along with additional supporting documentation or clarification from your healthcare provider.

 

Consider Financial Assistance Programs

 

  • If coverage for Forteo remains a challenge, investigate patient assistance programs provided by the manufacturer or third party organizations.
  •  

  • Contact your doctor or the drug manufacturer to explore any possible financial aid or discount options that can help offset costs.

 

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Does Blue Cross Blue Shield of Massachusetts Cover Forteo

Explore Forteo coverage by Blue Cross Blue Shield MA. Learn about denial reasons, coverage tips, costs without insurance, and get answers to common questions.
Curex allergy drops unboxing

Is Forteo Covered by Blue Cross Blue Shield of Massachusetts

 

Coverage Overview for Forteo by Blue Cross Blue Shield of Massachusetts

 

  • Forteo may be covered for treating osteoporosis in postmenopausal women and men who have a high risk of fracture.
  •  

  • Coverage may extend to patients with glucocorticoid-induced osteoporosis.

 

Criteria for Coverage

 

  • There must be a documented history of failure, contraindication, or intolerance to other osteoporosis therapies.
  •  

  • An approved prior authorization from Blue Cross Blue Shield of Massachusetts is typically required.

 

Basic Rules

 

  • Prescriptions must be written by a qualified healthcare provider, and proper medical records must be submitted to support the need for Forteo.
  •  

  • Coverage and criteria can vary by individual policy plans, and members are encouraged to check their specific benefits.

 

A weight management program tailored to you

Start with Curex

Blue Cross Blue Shield of Massachusetts's Approved Criteria for Forteo Coverage

 

Criteria for Forteo Coverage

 

  • The patient has a diagnosis of osteoporosis confirmed by a DEXA scan or other appropriate diagnostic measures.
  •  

  • The patient is at high risk for bone fracture, as evidenced by a history of fractures or significantly reduced bone mineral density.
  •  

  • The patient has tried and failed other osteoporosis treatments, or they are contraindicated or not tolerated.
  •  

  • A specialized healthcare provider has recommended the usage of Forteo based on the patient's specific medical condition and history.
  •  

  • Forteo is prescribed according to the FDA-approved dosing schedule and duration.
  •  

  • The patient's overall health profile supports the use of Forteo, considering risk factors and potential contraindications.
  •  

  • The patient meets any age or gender criteria specified by the insurance plan, if applicable.
  •  

  • The therapy is in alignment with the most current guidelines and best practices for the treatment of osteoporosis as recognized by professional health organizations.

 

Why Blue Cross Blue Shield of Massachusetts Might Deny Forteo Coverage

 

Exclusion Criteria for Forteo Coverage by Blue Cross Blue Shield of Massachusetts

 

  • Forteo is not covered if it is used for off-label indications that are not approved by the FDA.
  • The medication is not covered for individuals who do not meet the specific medical criteria for osteoporosis or who fail to meet the risk criteria for fractures.
  • Patients who have used anabolic therapies like Forteo for more than the lifetime limit typically set at 2 years may be denied coverage.
  • Blue Cross Blue Shield of Massachusetts does not cover Forteo in cases where the patient has a history of skeletal malignancies or other contraindicated conditions.
  • Evidence of significant improvement is required; without it, coverage may not be extended after the initial approval period.
  • Forteo is not covered for individuals who could be effectively treated with lower-cost options.

 

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

How Much Does Forteo Cost without Insurance?

 

Cost of Forteo Without Insurance

 

  • The price of Forteo (teriparatide injection) without insurance is quite substantial, typically ranging between $3,500 and $4,000 for a 28-day supply, which is a 2.4 mL pen of 600 mcg per 2.4 mL strength.
  •  

  • Keep in mind that pharmaceutical prices can vary based on the pharmacy, geographical location, and any available discounts or pharmacy-specific savings programs.
  •  

  • Patients can check with specific pharmacies for the most accurate pricing and inquire about any potential savings programs or discounts.
  •  

  • Consider contacting the manufacturer or exploring patient assistance programs, as they sometimes offer help to reduce costs for those without insurance coverage.

 

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 Forteo Coverage with Blue Cross Blue Shield of Massachusetts

 

Contact Blue Cross Blue Shield of Massachusetts

 

  • Call the customer service number on the back of your insurance card to inquire about coverage for Forteo (teriparatide).
  •  

  • Have your policy number ready for reference during the call to streamline the process.

 

Consult with Your Doctor

 

  • Discuss with your healthcare provider about the necessity of Forteo for your condition and obtain any necessary documentation supporting its use.
  •  

  • Request your doctor to provide a letter of medical necessity, which clearly explains why Forteo is the suitable treatment for you.

 

Review Your Plan’s Prescription Benefits

 

  • Log into your Blue Cross Blue Shield of Massachusetts account online to review your plan’s coverage details regarding prescription medications.
  •  

  • Search specifically for information related to specialty drugs or hormone therapies, as Forteo might fall under these categories.

 

Submit a Prior Authorization Request

 

  • Work with your healthcare provider to submit a prior authorization request to Blue Cross Blue Shield of Massachusetts. This is often required for medications like Forteo.
  •  

  • Ensure that all necessary forms are filled correctly and include your doctor’s letter of medical necessity.

 

Follow Up on the Request

 

  • Contact Blue Cross Blue Shield of Massachusetts to verify if they have received the prior authorization request.
  •  

  • Inquire about the expected processing time and any additional information they might need.

 

Appeal if Necessary

 

  • If your initial request for Forteo coverage is denied, carefully review the denial letter for details.
  •  

  • Prepare to file an appeal along with additional supporting documentation or clarification from your healthcare provider.

 

Consider Financial Assistance Programs

 

  • If coverage for Forteo remains a challenge, investigate patient assistance programs provided by the manufacturer or third party organizations.
  •  

  • Contact your doctor or the drug manufacturer to explore any possible financial aid or discount options that can help offset costs.

 

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.

Forteo FAQ

What are the common side effects of Forteo?

 

Common Side Effects of Forteo

 

  • Nausea: A frequent complaint among users, often resolves as your body adjusts to the medication.
  •  

  • Dizziness: Usually occurs after an injection, so sitting or lying down shortly afterward can help.
  •  

  • Leg Cramps: Regular stretching exercises may alleviate this discomfort.
  •  

  • Joint Pain: May be managed by over-the-counter painkillers, but consult your doctor first.
  •  

  • Injection Site Reactions: Mild redness or itching at the injection site is common, often soothed by cold compresses.

 

How does Forteo work for osteoporosis?

 

How Forteo Works

 

  • Forteo, or teriparatide, is a form of parathyroid hormone that helps stimulate new bone formation.
  •  

  • It works by increasing bone remodeling, which is crucial for improving bone density.

 

Osteoporosis Effectiveness

 

  • Used primarily for osteoporosis patients who have a high risk of fractures.
  •  

  • Improves bone microarchitecture, which enhances bone strength.

 

Administration

 

  • Administered via daily subcutaneous injection for up to 2 years.
  •  

  • Patients should follow their doctor’s instructions for the correct administration.

 

How long can you safely take Forteo?

 

Duration of Forteo Use

 

  • Forteo (teriparatide) is recommended for a maximum duration of 2 years over a patient's lifetime.
  •  

  • This limitation is based on studies that show an increased risk of osteosarcoma in rats. Though this risk hasn't been confirmed in humans, the duration is restricted for safety.

 

Considerations and Monitoring

 

  • During treatment, regular bone density scans and evaluations for potential side effects are necessary.
  •  

  • Patients should ensure they are not taking medications or have conditions that could further exacerbate potential risks.

 

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. 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?

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.

Can you prescribe Ozempic®* or Wegovy®*?

Our providers focus on personalized medications and dosages that aren’t commercially available at your local pharmacy. We don’t prescribe Ozempic®* or Wegovy®.* We may prescribe treatments containing compounded semaglutide or tirzepatide. 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.

Does Blue Cross Blue Shield of Massachusetts Cover Forteo

Explore Forteo coverage by Blue Cross Blue Shield MA. Learn about denial reasons, coverage tips, costs without insurance, and get answers to common questions.
Curex allergy drops unboxing

Does Blue Cross Blue Shield of Massachusetts Cover Forteo

 

Coverage Overview for Forteo by Blue Cross Blue Shield of Massachusetts

 

  • Forteo may be covered for treating osteoporosis in postmenopausal women and men who have a high risk of fracture.
  •  

  • Coverage may extend to patients with glucocorticoid-induced osteoporosis.

 

Criteria for Coverage

 

  • There must be a documented history of failure, contraindication, or intolerance to other osteoporosis therapies.
  •  

  • An approved prior authorization from Blue Cross Blue Shield of Massachusetts is typically required.

 

Basic Rules

 

  • Prescriptions must be written by a qualified healthcare provider, and proper medical records must be submitted to support the need for Forteo.
  •  

  • Coverage and criteria can vary by individual policy plans, and members are encouraged to check their specific benefits.

 

A weight management program tailored to you

Start with Curex

Why Blue Cross Blue Shield of Massachusetts Might Deny Forteo Coverage

 

Criteria for Forteo Coverage

 

  • The patient has a diagnosis of osteoporosis confirmed by a DEXA scan or other appropriate diagnostic measures.
  •  

  • The patient is at high risk for bone fracture, as evidenced by a history of fractures or significantly reduced bone mineral density.
  •  

  • The patient has tried and failed other osteoporosis treatments, or they are contraindicated or not tolerated.
  •  

  • A specialized healthcare provider has recommended the usage of Forteo based on the patient's specific medical condition and history.
  •  

  • Forteo is prescribed according to the FDA-approved dosing schedule and duration.
  •  

  • The patient's overall health profile supports the use of Forteo, considering risk factors and potential contraindications.
  •  

  • The patient meets any age or gender criteria specified by the insurance plan, if applicable.
  •  

  • The therapy is in alignment with the most current guidelines and best practices for the treatment of osteoporosis as recognized by professional health organizations.

 

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

Forteo FAQ

 

Exclusion Criteria for Forteo Coverage by Blue Cross Blue Shield of Massachusetts

 

  • Forteo is not covered if it is used for off-label indications that are not approved by the FDA.
  • The medication is not covered for individuals who do not meet the specific medical criteria for osteoporosis or who fail to meet the risk criteria for fractures.
  • Patients who have used anabolic therapies like Forteo for more than the lifetime limit typically set at 2 years may be denied coverage.
  • Blue Cross Blue Shield of Massachusetts does not cover Forteo in cases where the patient has a history of skeletal malignancies or other contraindicated conditions.
  • Evidence of significant improvement is required; without it, coverage may not be extended after the initial approval period.
  • Forteo is not covered for individuals who could be effectively treated with lower-cost options.

 

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 Much Does Forteo Cost without Insurance?

 

Cost of Forteo Without Insurance

 

  • The price of Forteo (teriparatide injection) without insurance is quite substantial, typically ranging between $3,500 and $4,000 for a 28-day supply, which is a 2.4 mL pen of 600 mcg per 2.4 mL strength.
  •  

  • Keep in mind that pharmaceutical prices can vary based on the pharmacy, geographical location, and any available discounts or pharmacy-specific savings programs.
  •  

  • Patients can check with specific pharmacies for the most accurate pricing and inquire about any potential savings programs or discounts.
  •  

  • Consider contacting the manufacturer or exploring patient assistance programs, as they sometimes offer help to reduce costs for those without insurance coverage.

 

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.

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.