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Does Blue Cross Blue Shield of Minnesota Cover Aimovig

Explore Aimovig coverage options with Blue Cross Blue Shield of Minnesota, costs without insurance, and answers to common FAQs in this comprehensive guide.

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Coverage Overview

Blue Cross Blue Shield of Minnesota generally covers Aimovig for migraine prevention. However, coverage is subject to specific criteria and plan details.

Basic Rules

Pre-authorization may be required to assess medical necessity.
Only available for patients aged 18 or older.

Criteria for Approval

Patient must have a diagnosis of chronic or episodic migraine.
Failed to respond to at least two preventive migraine treatments.
Aimovig must be prescribed by a neurologist or headache specialist.

Additional Considerations

Patients should verify coverage specifics with their plan as formularies and policies can change.
Cost-sharing responsibilities such as copays and deductibles will apply according to the plan.

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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.

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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.

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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 Aimovig Coverage with Blue Cross Blue Shield of Minnesota

Contact Your Healthcare Provider

Reach out to your doctor or nurse practitioner to discuss your interest in Aimovig and your specific medical needs.
Ensure that Aimovig is a suitable treatment option for your condition and obtain a prescription.

Review Blue Cross Blue Shield of Minnesota’s Coverage Policies

Visit the official website of Blue Cross Blue Shield of Minnesota or call their customer service number to obtain information about coverage requirements for Aimovig.
Determine if Aimovig is on the formulary list and note any requirements such as prior authorization, step therapy, or specific medical criteria.

Complete Any Necessary Prior Authorization Forms

Work with your healthcare provider to fill out and submit any required prior authorization forms to Blue Cross Blue Shield of Minnesota.
Ensure forms are completed accurately with all necessary information and supporting documentation, such as medical records or previous treatment history.

Verify Your Prescription Benefits

Contact Blue Cross Blue Shield of Minnesota to confirm how Aimovig is covered under your current prescription drug plan and the extent of your benefits.
Inquire about any co-pays, deductibles, or out-of-pocket costs you might incur for Aimovig.

Explore Financial Assistance Programs

Investigate if there are any manufacturer savings programs, patient assistance programs, or other third-party financial assistance options available for Aimovig.
Contact the Aimovig Ally Program or similar resources for additional guidance and support.

Keep Detailed Records

Maintain a comprehensive record of all communications and documentation related to your Aimovig coverage, including copies of forms submitted and responses from Blue Cross Blue Shield of Minnesota.
Track any changes or updates to your policy or coverage as they occur.

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FAQs

Does Blue Cross Blue Shield of Minnesota Cover Aimovig

Explore Aimovig coverage options with Blue Cross Blue Shield of Minnesota, costs without insurance, and answers to common FAQs in this comprehensive guide.

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Is Aimovig Covered by Blue Cross Blue Shield of Minnesota

Coverage Overview

Blue Cross Blue Shield of Minnesota generally covers Aimovig for migraine prevention. However, coverage is subject to specific criteria and plan details.

Basic Rules

Pre-authorization may be required to assess medical necessity.
Only available for patients aged 18 or older.

Criteria for Approval

Patient must have a diagnosis of chronic or episodic migraine.
Failed to respond to at least two preventive migraine treatments.
Aimovig must be prescribed by a neurologist or headache specialist.

Additional Considerations

Patients should verify coverage specifics with their plan as formularies and policies can change.
Cost-sharing responsibilities such as copays and deductibles will apply according to the plan.

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Blue Cross Blue Shield of Minnesota's Approved Criteria for Aimovig Coverage

Aimovig Coverage Criteria

The patient must be 18 years or older and diagnosed with migraine. The medical documentation should confirm a diagnosis of migraine headache as defined by the International Classification of Headache Disorders (ICHD) criteria.

There should be a documented history of at least four migraine days per month. This information can be derived from a headache diary or physician records substantiating the frequency of migraine attacks.

The patient must have tried and inadequately responded to at least two different classes of preventive migraine therapies. These therapies can include beta-blockers, anticonvulsants, antidepressants, or other preventive treatments deemed appropriate by a healthcare provider.

The patient must have experienced intolerance or contraindications to the preventive migraine therapies mentioned above. Intolerance or contraindications should be well-documented by the physician.

Aimovig should be prescribed by or in consultation with a neurologist or other migraine specialist familiar with the treatment of migraine.

Coverage is limited to a maximum dosage as specified in clinical guidelines, typically Aimovig 70 mg once monthly or 140 mg once monthly if required by the patient's clinical condition.

Re-evaluation for Continued Coverage

Patients should be re-evaluated for Aimovig coverage every 6 to 12 months to confirm ongoing need and efficacy of the treatment. Continued coverage requires evidence of clinically significant improvement in the frequency or severity of migraine attacks.

Documentation must indicate a reduction in the number of monthly migraine days compared to baseline.

Why Blue Cross Blue Shield of Minnesota Might Deny Aimovig Coverage

Situations Where Coverage for Aimovig Is Denied

**Failure to Meet Medical Necessity Criteria:** Coverage may be denied if the use of Aimovig does not meet the company's specific medical necessity guidelines. These guidelines often require a documented diagnosis of chronic migraine following an evaluation by a specialist.

**Lack of Prior Authorization:** Aimovig coverage could be denied if prior authorization has not been obtained. Blue Cross Blue Shield of Minnesota typically requires a prior authorization process to ensure that certain criteria are met before use.

**Non-Formulary Drug Status:** If Aimovig is not listed on the approved formulary of Blue Cross Blue Shield of Minnesota, it might not be covered unless an exception is granted based on medical necessity.

**Inadequate Trial of Other Therapies:** Denial of coverage may occur if there is insufficient documentation showing an adequate trial and failure of alternative migraine preventive treatments, which may need to be exhausted before Aimovig is approved.

**Dosage Above Approved Limits:** If the prescribed dosage exceeds the maximum dosage approved by Blue Cross Blue Shield of Minnesota, coverage for Aimovig may be denied.

**Experimental or Investigational Use:** Use of Aimovig for conditions other than chronic migraines, or any usage deemed experimental or investigational by the insurer, may lead to denial of coverage.

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How Much Does Aimovig Cost without Insurance?

Understanding the Cost of Aimovig Without Insurance

Aimovig, a medication for preventing migraines, can be quite expensive without insurance coverage.
The cost of Aimovig typically ranges from $575 to $725 per month for a single dose, depending on the pharmacy and geographic location.
This price reflects the retail cost for the 70 mg dosage, which is commonly used in migraine prevention treatment.
The 140 mg dosage generally costs about the same per unit; however, as a higher dose, it could be slightly more expensive overall, since some patients might be prescribed two doses of 70 mg.

Additional Considerations

Prices can vary significantly due to factors such as pharmacy pricing policies, location, and availability.
Discount programs and pharmaceutical aid may be available for eligible patients, which can help reduce the out-of-pocket cost.
It's advisable for patients to shop around, as different pharmacies may offer various pricing or additional discounts.
Patients should also consider discussing with their healthcare provider about any available generic alternatives or other cost-effective treatment options.

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

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

Kayla Mardaga, NP

How to Get Aimovig Coverage with Blue Cross Blue Shield of Minnesota

Contact Your Healthcare Provider

Reach out to your doctor or nurse practitioner to discuss your interest in Aimovig and your specific medical needs.
Ensure that Aimovig is a suitable treatment option for your condition and obtain a prescription.

Review Blue Cross Blue Shield of Minnesota’s Coverage Policies

Visit the official website of Blue Cross Blue Shield of Minnesota or call their customer service number to obtain information about coverage requirements for Aimovig.
Determine if Aimovig is on the formulary list and note any requirements such as prior authorization, step therapy, or specific medical criteria.

Complete Any Necessary Prior Authorization Forms

Work with your healthcare provider to fill out and submit any required prior authorization forms to Blue Cross Blue Shield of Minnesota.
Ensure forms are completed accurately with all necessary information and supporting documentation, such as medical records or previous treatment history.

Verify Your Prescription Benefits

Contact Blue Cross Blue Shield of Minnesota to confirm how Aimovig is covered under your current prescription drug plan and the extent of your benefits.
Inquire about any co-pays, deductibles, or out-of-pocket costs you might incur for Aimovig.

Explore Financial Assistance Programs

Investigate if there are any manufacturer savings programs, patient assistance programs, or other third-party financial assistance options available for Aimovig.
Contact the Aimovig Ally Program or similar resources for additional guidance and support.

Keep Detailed Records

Maintain a comprehensive record of all communications and documentation related to your Aimovig coverage, including copies of forms submitted and responses from Blue Cross Blue Shield of Minnesota.
Track any changes or updates to your policy or coverage as they occur.

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Aimovig FAQ

1. What are the common side effects of Aimovig?

Common Side Effects of Aimovig

**Injection site reactions**: You may experience pain, redness, or swelling where the injection was administered.

**Constipation**: This is a frequently reported side effect, which may vary in severity.

**Muscle spasms**: Some patients may encounter muscle spasms post-administration.

**Fatigue**: Feeling unusually tired or exhausted can commonly occur.

**Nausea**: A feeling of queasiness may be experienced, often mild but potentially bothersome.

Note

Consult with a healthcare provider if side effects persist or worsen.

Serious side effects are rare but should be addressed immediately with professional advice.

2. How does Aimovig work to prevent migraines?

What is Aimovig?

Aimovig is a monoclonal antibody used for preventing migraines by targeting the CGRP pathway.

How Aimovig Works

Aimovig binds to the calcitonin gene-related peptide (CGRP) receptor, inhibiting its activity.
By blocking CGRP, Aimovig reduces vasodilation and inflammation, commonly linked to migraines.
This prevention mechanism helps decrease the frequency and intensity of migraine attacks.

Usage and Administration

Aimovig is administered through a monthly subcutaneous injection, making it convenient for most patients.
It's crucial to follow prescribed dosing and consult healthcare providers if any side effects occur.

3. How long does it take for Aimovig to start working?

How Aimovig Works

Aimovig is a monoclonal antibody that targets and inhibits the CGRP receptor, helping to prevent migraine onset.

It is specifically designed to reduce the frequency of migraine days by interfering with a key pathway in migraine pathophysiology.

Onset of Effects

Patients may begin to notice a reduction in migraine frequency as early as one week after the first injection.

Clinical trials indicate that significant reduction in migraine days is typically observed within 3 to 4 weeks of starting Aimovig.

Full therapeutic benefits can develop over subsequent months, and individual response times may vary.

Recommendations

Maintain a migraine diary to monitor changes and discuss them with your healthcare provider.

Continue regular check-ins with your doctor to assess effectiveness and make any necessary adjustments to treatment.

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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. 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 Minnesota Cover Aimovig

Explore Aimovig coverage options with Blue Cross Blue Shield of Minnesota, costs without insurance, and answers to common FAQs in this comprehensive guide.

Achieve Your Goals Faster with Curex