Curex logo black
A modern clinic for at-home treatments
(857) 240-1080
Am I eligible?
Pricing
Am I eligible?
Refer a friend
MyCurex
Login
Logout
Am I eligible?
(857) 240-1080
(857) 240-1080
Am I eligible?
Holiday Sale! Get started today for only

$49$4.99

Get started today

Does Blue Cross Blue Shield of Massachusetts Cover Lyrica

Explore Lyrica coverage with BCBS Massachusetts, reasons for denial, steps to secure coverage, costs without insurance, and common questions answered.
Treat your allergies with Curex
Curex allergy drops unboxing
as seen on
“Curex is changing the landscape of allergies in 2024”
man opening Curex packaging
man opening Curex packaging

 

Coverage of Lyrica

 

  • Blue Cross Blue Shield of Massachusetts (BCBSMA) typically covers Lyrica (pregabalin) when it is prescribed for approved conditions such as diabetic nerve pain, fibromyalgia, and epilepsy.

    •  

  • Coverage may depend on the specific plan and medical necessity as determined by the insurer's guidelines.

 

Criteria for Approval

 

  • A prescription from a licensed healthcare provider clearly stating a diagnosis that aligns with BCBSMA's indications for Lyrica coverage.

    •  

  • Completion of a prior authorization process might be required to assess the necessity and appropriateness of the medication.

    •  

  • Documentation showing that alternative treatments have been considered or tried without satisfactory results.

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.

Start Now
Clinical Support

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 Lyrica Coverage with Blue Cross Blue Shield of Massachusetts

 

Verify Your Prescription Coverage

 

  • Start by checking your Blue Cross Blue Shield of Massachusetts plan documentation to see if Lyrica (pregabalin) is included in your list of covered medications.

    •  

  • Access the Member Services portal on the Blue Cross Blue Shield website to find specific details about your prescription coverage.

    •  

  • If you cannot find information online, contact their customer service to inquire directly about Lyrica coverage.

 

Consult with Your Healthcare Provider

 

  • Schedule a consultation with your doctor to discuss the necessity for Lyrica. Your doctor may need to provide documentation or justification for its medical necessity.

    •  

  • Request that your healthcare provider assist with any prior authorization forms, as this can speed up the approval process.

 

Submit Prior Authorization if Required

 

  • If Lyrica requires prior authorization, your healthcare provider must initiate this process. Ensure you provide all necessary information promptly to your provider.

    •  

  • Follow up with both your provider and Blue Cross Blue Shield to ensure the documents are submitted correctly and on time.

 

Review Formulary Alternatives

 

  • Examine if there are alternative medications within the same category as Lyrica that do not require prior authorization or offer better coverage.

    •  

  • Discuss these alternatives with your doctor, as they might be viable substitutes based on your medical needs.

 

Understand Your Out-of-Pocket Costs

 

  • Calculate potential out-of-pocket expenses for Lyrica using the plan's co-pay or coinsurance structure to financially prepare for obtaining this medication.

    •  

  • If Lyrica isn't covered or costs are prohibitive, ask about available financial assistance programs, either through Blue Cross Blue Shield or the manufacturer.

 

Appeal if Coverage is Denied

 

  • In cases where Lyrica coverage is denied, learn the appeals process by reviewing your plan's Summary of Benefits and Coverage.

    •  

  • Work closely with your healthcare provider to provide additional evidence or documentation needed to support your appeal for coverage approval.

 

Curex allergy drops unboxing
Happy Customers

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?
At-home Immunotherapy

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 Massachusetts Cover Lyrica

Explore Lyrica coverage with BCBS Massachusetts, reasons for denial, steps to secure coverage, costs without insurance, and common questions answered.
Achieve Your Goals Faster with Curex
Curex allergy drops unboxing

Is Lyrica Covered by Blue Cross Blue Shield of Massachusetts

 

Coverage of Lyrica

 

  • Blue Cross Blue Shield of Massachusetts (BCBSMA) typically covers Lyrica (pregabalin) when it is prescribed for approved conditions such as diabetic nerve pain, fibromyalgia, and epilepsy.

    •  

  • Coverage may depend on the specific plan and medical necessity as determined by the insurer's guidelines.

 

Criteria for Approval

 

  • A prescription from a licensed healthcare provider clearly stating a diagnosis that aligns with BCBSMA's indications for Lyrica coverage.

    •  

  • Completion of a prior authorization process might be required to assess the necessity and appropriateness of the medication.

    •  

  • Documentation showing that alternative treatments have been considered or tried without satisfactory results.

A weight management program tailored to you

Start with Curex

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

 

Lyrica Coverage Requirements

 

  • The member must have a documented diagnosis consistent with a covered indication for Lyrica (pregabalin), such as neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, or fibromyalgia.

    •  

  • There must be documented evidence of inadequate response, intolerance, or contraindication to first-line therapies or generic alternatives if available.

    •  

  • The prescribing physician must provide a complete and current clinical rationale for the use of Lyrica for the specific condition.

    •  

  • Documentation must show that the member is receiving regular follow-up and continued treatment evaluation by the healthcare provider.

 

Healthcare Provider Requirements

 

  • The prescribing healthcare provider must be a specialist in the field related to the member’s condition or have communicated with such a specialist to ensure the prescription aligns with the current medical guidelines.

    •  

  • The healthcare provider is required to submit accurate and comprehensive medical records that justify the need for Lyrica based on the member’s condition and previous treatment history.

 

Trial and Failure Criteria

 

  • The member must have trialed and had an inadequate response or experienced adverse effects from an appropriate duration of treatment with alternative therapies or generic versions.

    •  

  • For postherpetic neuralgia, patients must show documented failure or contraindication to gabapentin and either a tricyclic antidepressant or a serotonin-norepinephrine reuptake inhibitor (SNRI).

 

Dosage and Duration Considerations

 

  • The dosage of Lyrica prescribed must be within the FDA-approved guidelines for the specific condition being treated.

    •  

  • Approval for coverage typically aligns with the course of therapy recommended in clinical guidelines, with periodic re-evaluation of the treatment effectiveness required.

 

Why Blue Cross Blue Shield of Massachusetts Might Deny Lyrica Coverage

 

Situations Where Lyrica is Not Covered

 

  • **Off-Label Use:** Blue Cross Blue Shield of Massachusetts may deny coverage if Lyrica is prescribed for a condition not approved by the FDA. Any usage that does not align with FDA guidelines could result in non-coverage.

    •  

  • **Lack of Prior Authorization:** If the provider hasn't obtained the necessary prior authorization, coverage may be denied. Prior authorization ensures that the use of Lyrica is medically necessary and meets specific criteria.

    •  

  • **Non-Formulary Medication:** If Lyrica is not on the approved formulary list by Blue Cross Blue Shield of Massachusetts, it may not be covered. Patients might be required to use alternative medications that are on the formulary list.

    •  

  • **Failure to Use Step Therapy:** Coverage may be denied if the patient has not tried and failed other first-line medications before Lyrica. Blue Cross Blue Shield may require patients to follow a step therapy protocol, using other, possibly generic, medications first.

    •  

  • **Exceeding Prescribed Limits:** If a prescription exceeds the recommended dosage or quantity limits set by Blue Cross Blue Shield of Massachusetts, coverage can be denied. Insurance policies might have predefined limits on how much medication can be dispensed at one time.

    •  

  • **Policy Exclusions or Restrictions:** Depending on the individual policy, there could be specific exclusions or restrictions that apply to Lyrica, resulting in denied claims. Coverage can vary significantly between different insurance plans and policyholders.

 

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

Join Curex

How Much Does Lyrica Cost without Insurance?

 

Cost of Lyrica Without Insurance

 

  • The price of Lyrica without insurance can vary significantly depending on the pharmacy, geographic location, dosage, and quantity. On average, the cost can range between $460 to $720 for a 30-day supply when filling a common dosage such as 150 mg capsules.

    •  

  • Generic versions of Lyrica, known as pregabalin, are often significantly cheaper. The average cost for the generic version might be closer to $30 to $70 for a similar quantity and dosage.

    •  

  • Prices may also vary due to manufacturer's discounts, pharmacy membership programs, or coupon usage, which can help reduce the overall cost.

    •  

  • Comparing prices between local pharmacies or using online price comparison tools can help find the most affordable option.

 

Clinical Support

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 Lyrica Coverage with Blue Cross Blue Shield of Massachusetts

 

Verify Your Prescription Coverage

 

  • Start by checking your Blue Cross Blue Shield of Massachusetts plan documentation to see if Lyrica (pregabalin) is included in your list of covered medications.

    •  

  • Access the Member Services portal on the Blue Cross Blue Shield website to find specific details about your prescription coverage.

    •  

  • If you cannot find information online, contact their customer service to inquire directly about Lyrica coverage.

 

Consult with Your Healthcare Provider

 

  • Schedule a consultation with your doctor to discuss the necessity for Lyrica. Your doctor may need to provide documentation or justification for its medical necessity.

    •  

  • Request that your healthcare provider assist with any prior authorization forms, as this can speed up the approval process.

 

Submit Prior Authorization if Required

 

  • If Lyrica requires prior authorization, your healthcare provider must initiate this process. Ensure you provide all necessary information promptly to your provider.

    •  

  • Follow up with both your provider and Blue Cross Blue Shield to ensure the documents are submitted correctly and on time.

 

Review Formulary Alternatives

 

  • Examine if there are alternative medications within the same category as Lyrica that do not require prior authorization or offer better coverage.

    •  

  • Discuss these alternatives with your doctor, as they might be viable substitutes based on your medical needs.

 

Understand Your Out-of-Pocket Costs

 

  • Calculate potential out-of-pocket expenses for Lyrica using the plan's co-pay or coinsurance structure to financially prepare for obtaining this medication.

    •  

  • If Lyrica isn't covered or costs are prohibitive, ask about available financial assistance programs, either through Blue Cross Blue Shield or the manufacturer.

 

Appeal if Coverage is Denied

 

  • In cases where Lyrica coverage is denied, learn the appeals process by reviewing your plan's Summary of Benefits and Coverage.

    •  

  • Work closely with your healthcare provider to provide additional evidence or documentation needed to support your appeal for coverage approval.

 

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.

Lyrica FAQ

What are the common side effects of Lyrica?

 

Common Side Effects of Lyrica

 

  • Dizziness: Frequently reported, often occurring shortly after starting treatment.
  • Sleepiness: Commonly affects daily activities due to its sedative effects.
  • Weight Gain: Notable for some, monitoring weight is advised.
  • Swelling: Particularly in hands and feet; may require medical attention if severe.
  • Blurred Vision: Usually temporary but should be reported if persistent.
  • Dry Mouth: Sometimes improved with increased fluid intake.
  • Difficulty concentrating: Can affect mental clarity and focus.

 

Is Lyrica the same as gabapentin?

 

Differences Between Lyrica and Gabapentin

 

  • Classification: Both are anticonvulsants but with different active ingredients. Lyrica contains pregabalin, while gabapentin itself is the active substance in gabapentin medications.

    •  

  • FDA Approval: Lyrica is approved for treating fibromyalgia, neuropathic pain, seizures, and generalized anxiety disorder in certain regions. Gabapentin's primary uses are for seizures and nerve pain.

    •  

  • Potency and Dosing: Lyrica is often considered more potent, requiring lower doses to achieve similar effects compared to gabapentin.

    •  

  • Side Effects: Both can cause dizziness and fatigue, but the severity and other side effects can vary between individuals.

 

Can Lyrica help with anxiety?

 

Understanding Lyrica and Anxiety

 

  • Lyrica (pregabalin) is primarily approved for treating nerve pain, fibromyalgia, and seizures.

    •  

  • Although not FDA-approved for anxiety, it has been used off-label to help some patients manage anxiety symptoms, especially in generalized anxiety disorder (GAD).

 

Mechanism and Effectiveness

 

  • Lyrica works by calming hyper-excited nerves, which may reduce anxiety symptoms by stabilizing neuronal activity.

    •  

  • Clinical studies suggest it can reduce anxiety more effectively than a placebo and comparable to some anxiety medications.

 

Considerations and Side Effects

 

  • Possible side effects include dizziness, sleepiness, and weight gain, which should be considered before off-label use.

    •  

  • Consult your doctor to assess if Lyrica aligns with your specific health needs and to discuss alternate anxiety treatments.

 

Have questions left?

‍

Get a personalized online consultation with a doctor at Curex

Learn More

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

Button Text

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.

Learn
Immunotherapy 101
Allergy Immunotherapy
Science
Allergy Drops
Allergy Shots
Allergy Clinic
Allergy Medicine
Allergy Testing
Allergy ImmunotherapyAllergy Immunotherapy
CostsFood Allergy ImmunotherapyCat Allergy ImmunotherapySublingual ImmunotherapyWyndly ReviewCurex ReviewsAbout CurexBlogCitiesAllergensFAQAllergy Immunotherapy Insights & ResearchesInsurance directoryDrug reviewsFood AllergiesAllergy SymptomsWeight Loss BlogsDiabetes BlogBeauty Products AllergiesAllergy to Pets 101Exercises for Weight Loss
Contact

Call/text us at:

(857) 240-1080

Email us at:

hi@getcurex.com

777 Brickell Ave #500-95053
Miami, FL 33131

PRIVACY POLICY
TERMS OF USE
INFORMED CONSENT
WE COVER ALL STATES
NOTICE OF PRIVACY PRACTICES
Curex provides allergy care plans for allergies, asthma, eczema and pet allergies.

Curex providers may prescribe sublingual allergy drops that contain the same ingredients as allergy shots but are more convenient & affordable.
‍
Curex-affiliated medical practices are independently owned and operated by licensed physicians who provide services using the Curex telehealth platform.

Compounded medications have not been approved by the FDA and the FDA has not evaluated their safety or efficacy.

2025 Curex, Inc. All rights reserved.
Made in Webflow