Does Blue Cross Blue Shield of Minnesota Cover Farxiga

Explore Farxiga coverage with Blue Cross Blue Shield Minnesota, potential coverage issues, costs without insurance, and FAQs.
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Coverage for Farxiga Under Blue Cross Blue Shield of Minnesota

 

  • Coverage for Farxiga, a medication used for Type 2 diabetes and heart failure, depends on the specific Blue Cross Blue Shield of Minnesota plan you have.
  •  

  • You may need pre-authorization, which involves your healthcare provider submitting a request to show medical necessity.
  •  

  • Coverage often considers factors like diagnosis, treatment history, and adherence to recommended dosing.
  •  

  • Ensure Farxiga is part of your plan’s formulary, which includes approved and covered medications.
  •  

  • Out-of-pocket costs, such as copayments, may apply depending on your insurance policy.
  •  

  • Contact Blue Cross Blue Shield of Minnesota's customer service for more precise details regarding your specific plan and Farxiga coverage.

 

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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.

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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.

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 Farxiga Coverage with Blue Cross Blue Shield of Minnesota

 

Verify Your Prescription

 

  • Ensure that your healthcare provider has prescribed Farxiga for a condition covered under your plan, such as type 2 diabetes or heart failure.
  • Check that the prescription is filled out correctly, with the necessary dosage and frequency as prescribed by your healthcare provider.

 

Check Formulary Status

 

  • Access the Blue Cross Blue Shield of Minnesota formulary list online or request a copy by contacting their customer service.
  • Look for Farxiga on the formulary list to verify if it is included and covered under your specific plan.
  • Note any restrictions, such as prior authorization or quantity limits, that may apply to Farxiga coverage.

 

Contact Customer Service

 

  • Call the customer service number on the back of your insurance card for direct communication with Blue Cross Blue Shield of Minnesota.
  • Inquire about the specific details of your coverage for Farxiga, including any required copayments or deductibles.
  • Ask about the process for obtaining prior authorization if needed and gather any necessary forms or information.

 

Work with Your Healthcare Provider

 

  • Discuss with your healthcare provider the importance of Farxiga for your treatment plan and ensure they are aware of any requirements from Blue Cross Blue Shield of Minnesota.
  • If prior authorization is necessary, have your provider's office submit the required documentation to the insurance company.
  • Your healthcare provider may need to provide additional medical documentation or a statement of medical necessity to support the authorization request.

 

Submit Prior Authorization

 

  • Complete any required forms or paperwork for prior authorization, which may include information from both you and your healthcare provider.
  • Submit all required documentation to Blue Cross Blue Shield of Minnesota as part of the prior authorization process.
  • Follow up with both your healthcare provider and insurance company to ensure the authorization request is processed in a timely manner.

 

Visit the Pharmacy

 

  • Once prior authorization is approved, if applicable, fill your prescription for Farxiga at a pharmacy that accepts Blue Cross Blue Shield of Minnesota.
  • Bring your insurance card and any necessary paperwork indicating prior authorization approval with you to the pharmacy.
  • Be prepared to pay any copayments or deductibles required under your plan at the time of pickup.

 

Appeal if Necessary

 

  • If coverage for Farxiga is denied, request details about the denial reason from Blue Cross Blue Shield of Minnesota.
  • Work with your healthcare provider to provide additional documentation or justification for the need for Farxiga.
  • File an appeal with Blue Cross Blue Shield of Minnesota, adhering to their specified process and timeline for appeals.

 

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FAQs

Does Blue Cross Blue Shield of Minnesota Cover Farxiga

Explore Farxiga coverage with Blue Cross Blue Shield Minnesota, potential coverage issues, costs without insurance, and FAQs.
Curex allergy drops unboxing

Is Farxiga Covered by Blue Cross Blue Shield of Minnesota

 

Coverage for Farxiga Under Blue Cross Blue Shield of Minnesota

 

  • Coverage for Farxiga, a medication used for Type 2 diabetes and heart failure, depends on the specific Blue Cross Blue Shield of Minnesota plan you have.
  •  

  • You may need pre-authorization, which involves your healthcare provider submitting a request to show medical necessity.
  •  

  • Coverage often considers factors like diagnosis, treatment history, and adherence to recommended dosing.
  •  

  • Ensure Farxiga is part of your plan’s formulary, which includes approved and covered medications.
  •  

  • Out-of-pocket costs, such as copayments, may apply depending on your insurance policy.
  •  

  • Contact Blue Cross Blue Shield of Minnesota's customer service for more precise details regarding your specific plan and Farxiga coverage.

 

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

 

Criteria for Coverage of Farxiga by Blue Cross Blue Shield of Minnesota

 

  • **Diagnosis of Type 2 Diabetes Mellitus**:
    • Patient must have a confirmed diagnosis of type 2 diabetes mellitus.
    • Documentation must include the patient's A1C levels.
  •  

  • **Failure of Lifestyle Modifications Alone**:
    • Patient must have attempted lifestyle interventions such as diet and exercise for glycemic control.
    • Evidence of failure, as defined by inadequate glycemic control, must be documented.
  •  

  • **Use in Combination Therapy**:
    • Farxiga is to be used in combination with other antidiabetic agents such as metformin unless contraindicated.
    • Documentation of other pharmacological treatments attempted must be provided.
  •  

  • **Eligibility Based on Heart Failure**:
    • Farxiga may be covered for patients with heart failure, with or without type 2 diabetes.
    • Clinical documentation supporting heart failure diagnosis must be submitted.
  •  

  • **Chronic Kidney Disease (CKD) Coverage**:
    • Eligible for patients with CKD who may benefit from slowing progression of renal impairment.
    • Documentation of CKD diagnosis or eGFR levels as per guideline recommendations is required.

 

Additional Requirements

 

  • **Prescriber's Specialty**:
    • Prescriptions must be written by or in consultation with a specialist in diabetes, nephrology, or cardiology when appropriate.
  •  

  • **Patient Monitoring and Compliance**:
    • Ongoing monitoring and documentation of the patient's response to therapy must be maintained.
    • The insurer may require evidence of compliance to continue coverage.

 

Approval Duration and Renewal Criteria

 

  • Coverage is subject to periodic review and approval for continuation based on documented patient outcomes and response to treatment.
  • Renewal submissions must include recent clinical data reflecting treatment efficacy and safety.

 

Why Blue Cross Blue Shield of Minnesota Might Deny Farxiga Coverage

 

Reasons for Denial of Farxiga Coverage

 

  • Farxiga is not approved for the specific condition for which it is being prescribed, if it falls outside the FDA-approved indications.
  •  

  • The patient does not meet the specified medical criteria or guidelines set by Blue Cross Blue Shield of Minnesota for Farxiga coverage.
  •  

  • An alternative, cost-effective medication or treatment is available that the patient has not yet tried.
  •  

  • The prescription of Farxiga is deemed not medically necessary after an individual assessment.
  •  

  • The patient has a history of reactions or contraindications that aren’t satisfactorily addressed by medical documentation.
  •  

  • Prior authorization requirements were not completed or were denied based on the information provided.
  •  

  • Farxiga falls under a plan's exclusion list, meaning it is not part of the covered formulary unless specific exceptions are made.
  •  

 

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How Much Does Farxiga Cost without Insurance?

 

Estimated Cost of Farxiga Without Insurance

 

  • Farxiga, a medication used primarily for the management of type 2 diabetes and certain forms of heart failure, can be quite costly without insurance coverage.
  •  

  • The cash price for Farxiga typically ranges between $500 and $550 for a 30-day supply, depending on the pharmacy and location.
  •  

  • Some pharmacies may offer discount programs or cards that can slightly lower this cost, but significant savings are usually only available through insurance coverage.
  •  

  • Always consider checking with multiple pharmacies or online services where discounts might be more prevalent.

 

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 Farxiga Coverage with Blue Cross Blue Shield of Minnesota

 

Verify Your Prescription

 

  • Ensure that your healthcare provider has prescribed Farxiga for a condition covered under your plan, such as type 2 diabetes or heart failure.
  • Check that the prescription is filled out correctly, with the necessary dosage and frequency as prescribed by your healthcare provider.

 

Check Formulary Status

 

  • Access the Blue Cross Blue Shield of Minnesota formulary list online or request a copy by contacting their customer service.
  • Look for Farxiga on the formulary list to verify if it is included and covered under your specific plan.
  • Note any restrictions, such as prior authorization or quantity limits, that may apply to Farxiga coverage.

 

Contact Customer Service

 

  • Call the customer service number on the back of your insurance card for direct communication with Blue Cross Blue Shield of Minnesota.
  • Inquire about the specific details of your coverage for Farxiga, including any required copayments or deductibles.
  • Ask about the process for obtaining prior authorization if needed and gather any necessary forms or information.

 

Work with Your Healthcare Provider

 

  • Discuss with your healthcare provider the importance of Farxiga for your treatment plan and ensure they are aware of any requirements from Blue Cross Blue Shield of Minnesota.
  • If prior authorization is necessary, have your provider's office submit the required documentation to the insurance company.
  • Your healthcare provider may need to provide additional medical documentation or a statement of medical necessity to support the authorization request.

 

Submit Prior Authorization

 

  • Complete any required forms or paperwork for prior authorization, which may include information from both you and your healthcare provider.
  • Submit all required documentation to Blue Cross Blue Shield of Minnesota as part of the prior authorization process.
  • Follow up with both your healthcare provider and insurance company to ensure the authorization request is processed in a timely manner.

 

Visit the Pharmacy

 

  • Once prior authorization is approved, if applicable, fill your prescription for Farxiga at a pharmacy that accepts Blue Cross Blue Shield of Minnesota.
  • Bring your insurance card and any necessary paperwork indicating prior authorization approval with you to the pharmacy.
  • Be prepared to pay any copayments or deductibles required under your plan at the time of pickup.

 

Appeal if Necessary

 

  • If coverage for Farxiga is denied, request details about the denial reason from Blue Cross Blue Shield of Minnesota.
  • Work with your healthcare provider to provide additional documentation or justification for the need for Farxiga.
  • File an appeal with Blue Cross Blue Shield of Minnesota, adhering to their specified process and timeline for appeals.

 

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Farxiga FAQ

What are the side effects of Farxiga?

 

Common Side Effects of Farxiga

 

  • Increased urination due to its diuretic effect, which may lead to dehydration. Maintain adequate hydration.
  • Potential urinary tract infections or yeast infections in genital areas, due to changes in the urinary environment.

 

Metabolic Effects

 

  • Weight loss can occur, linked to its mechanism of expelling glucose via urine.
  • Electrolyte imbalances, such as elevated potassium levels in blood, may appear in some cases.

 

Serious Reactions

 

  • Ketoacidosis risk: Watch for symptoms like nausea, vomiting, or abdominal pain.
  • Rarely, serious infections like Fournier's gangrene can develop. Seek immediate attention if you notice pain, redness, or swelling in genital or anal areas.

 

Can Farxiga help with weight loss?

 

Can Farxiga Aid Weight Loss?

 

  • Farxiga (dapagliflozin) is primarily a medication for managing type 2 diabetes and heart failure. It helps control blood sugar by promoting the excretion of glucose through urine.
  •  

  • Though not prescribed primarily for weight loss, some patients experience weight reduction as a secondary benefit.
  •  

  • Weight loss occurs because Farxiga facilitates the removal of excess calories in the form of glucose. However, the effect is usually modest and not guaranteed for everyone.
  •  

  • Consult a healthcare professional to understand if Farxiga is suitable for your condition and weight management goals.

 

Is Farxiga used for heart failure treatment?

 

Farxiga for Heart Failure

 

  • Farxiga (dapagliflozin) is primarily a SGLT2 inhibitor, initially developed to treat type 2 diabetes by helping the kidneys excrete glucose.
  •  

  • Recent studies have shown Farxiga's efficacy in heart failure management, particularly heart failure with reduced ejection fraction (HFrEF), by reducing hospitalizations and improving cardiovascular outcomes.
  •  

  • The medication works by decreasing fluid overload and blood pressure, lessening the heart's workload.
  •  

  • Farxiga is approved for heart failure treatment regardless of diabetes status, broadening its use in cardiology.
  •  

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Initial Dosage

Your initial medication and dosage are carefully determined by doctors, taking into account your unique health profile. This ensures a personalized and safe treatment plan tailored to your specific needs.

Titration

We gradually adjust your dosage to reach the optimal therapeutic level, ensuring maximum effectiveness while minimizing potential side effects.

Additional Treatments

Our providers may also recommend medications such as metformin or supplements such as vitamin B12. We recognize the importance of managing side effects, so your care plan may include medication to alleviate them.

Got questions? We have answers.

Do your plans include prescriptions and medications?

Curex plans cover everything from reviewing your medical intake to providing prescription medications, with free shipping included. There are no extra or hidden charges. Prescriptions are issued only after a medical provider reviews your information to confirm that the medication is suitable for you. Our service includes continuous support and regular follow-ups to ensure your treatment stays on track.

Our clinicians may order labs and additional medications for you, which would not be covered by the plan but for which you can use your insurance.

Please note: Compounded medications are tailored to individual needs or used in case of shortages, but they are not FDA-approved for safety or effectiveness. A prescription is required. Results may vary from person to person.

What medications do your providers prescribe?

We prioritize a personalized approach to your health. If your medical provider prescribes medication, options may include GLP-1 treatments such as compounded semaglutide (the active ingredient in Wegovy®* and Ozempic®*). Our providers prescribe only combination treatments not available at your local pharmacy that may include vitamin B12, etc. to help you achieve your goals faster.

Depending on your treatment goals, other medications such as metformin may also be considered. We recognize the importance of managing side effects, so your care plan might include medication to ease symptoms like nausea. Your well-being is always our top priority!

Please note that compounded medications are customized to meet individual patient needs and are not FDA-approved for safety or effectiveness. A prescription is necessary. Results may vary from person to person.

Curex and its pharmacy partners do not have any association with Novo Nordisk.

Will I be prescribed semaglutide if I sign up?

Your health journey is unique, and we tailor our care to match. Any prescriptions, including semaglutide, will be based on the expert assessment of the medical provider matched with you through our platform. You can trust that your treatment plan will be personalized to fit your specific needs. And if semaglutide is not prescribed, we will provide a full refund.

What is compounded medication?

Compounding involves creating customized medications to meet the specific needs of individual patients. For instance, a patient may require a liquid version of a medication that is only available in tablet form. Pharmacies can also compound medications using FDA-approved drugs that are on the FDA’s shortage list.

These compounded medications are made by state-licensed pharmacies that follow both federal and state regulations, including quality standards. However, when compounded in accordance with these laws, these medications are not subject to FDA approval and are not evaluated for safety or effectiveness.

Is compounded medication the same as generic medication?

Compounded medications differ from generic drugs. Generics require FDA approval by demonstrating bio-equivalence to the brand-name drug. In contrast, compounded medications are not FDA-approved. They are made based on a personalized prescription that may not be commercially available elsewhere or when a drug appears on the FDA’s shortage list. Compounding pharmacies must have the proper licensed facilities and comply with state and federal regulations before dispensing these medications.

Is insurance required?

No, Curex doesn’t require insurance. We offer clear and simple pricing, along with affordable medication options, making it easy and accessible to take care of your health.

Can I pay with an FSA or HSA card?

Yes! You can pay with your HSA or FSA card.

How much does treatment cost?

Semaglutide Injections:

Prices for semaglutide start at only $149 per month for weekly doses of 0.25mg and 0.5mg. You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 1mg, 1.7mg and 2.4mg of semaglutide for an additional $50 per month for each plan.

Tirzepatide Injections:

Prices for tirzepatide start at only $249 per month for weekly doses of 2.5mg and 5mg of tirzepatide.You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 7.5mg, 10mg and 12.5mg of tirzepatide for an additional $100 per month for each plan.

Semaglutide Tablets:

Prices for semaglutide tablets start at only $149 per month for daily doses of 2mg. You can cancel anytime. Some people experience weight loss at this dose and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 4mg and 8mg of semaglutide daily for an additional $50 per month for each plan.

Tirzepatide Tablets:

Prices for tirzepatide start at only $199 per month for daily dosees of 3mg of tirzepatide. You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 6mg and 12 mg of tirzepatide daily for an additional $100 per month for each plan.

Can you prescribe Ozempic®* or Wegovy®*?

Our providers focus on personalized medications and dosages that aren’t commercially available at your local pharmacy. While we don’t prescribe Ozempic®* or Wegovy®* directly, we may prescribe treatments containing the same active ingredient. These medications are specially compounded for you by a licensed pharmacy to meet your specific needs.

Are video visits with a provider required?

Our providers will review your information 100% online. Depending on where you live and the specifics of your medical history, our providers may require you to have a video visit or asynchronous visit via text message. If prescribed, you’ll get unlimited online access to message your provider as needed for follow-ups, adjustments, and answers to your questions.

What states do you serve?

Currently, we do not serve Arkansas, Connecticut, and New Mexico. However, we are always working to expand our reach, so stay in touch with us at hi@getcurex.com.

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