Does Blue Cross Blue Shield of Texas Cover Diethylpropion (Tenuate)

Explore Diethylpropion coverage with Blue Cross Blue Shield of Texas and learn how to get coverage, costs without insurance, and more in our comprehensive guide.
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Coverage for Diethylpropion (Tenuate)

 

  • Blue Cross Blue Shield of Texas typically provides coverage for medications like Diethylpropion under specific health plans, but it's important to confirm coverage details directly with them as they can vary.
  •  

 

When is Coverage Available?

 

  • Coverage may be available for patients diagnosed with a specific medical condition, such as obesity, when other weight loss methods have failed.
  •  

  • Prescriptions for Diethylpropion are usually covered when deemed medically necessary by a healthcare provider.

 

Basic Rules and Criteria

 

  • A prior authorization might be required to assess the necessity of the medication.
  •  

  • Each prescription might need documentation proving that other treatments have been tried without success.
  •  

  • Patients might need to meet certain criteria, such as a specific Body Mass Index (BMI) requirement.

 

Next Steps

 

  • To ensure coverage, consult with your healthcare provider and contact Blue Cross Blue Shield of Texas for exact plan details.
  •  

  • Review your health plan’s drug formulary for information on prescription drug coverage.

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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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Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

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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 Diethylpropion (Tenuate) Coverage with Blue Cross Blue Shield of Texas

 

Verify Your Eligibility

 

  • Contact Blue Cross Blue Shield of Texas (BCBSTX) customer service to confirm if your policy includes prescription drug coverage for medications like Diethylpropion (Tenuate).
  •  

  • Review your policy documents to understand the terms, limitations, and coverage rules concerning weight management medications.

 

Consult Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Diethylpropion (Tenuate) and see if it is an appropriate treatment for your condition.
  •  

  • Your healthcare provider may need to provide a prescription along with relevant medical history and rationale for recommending this medication.
  •  

  • Ask your healthcare provider whether a prior authorization is required for Diethylpropion and how it can be completed effectively.

 

Initiate Prior Authorization

 

  • If prior authorization is necessary, have your healthcare provider submit the required forms to BCBSTX, including your medical need for Diethylpropion.
  •  

  • Ensure that all necessary documentation, such as your medical records and prescription details, are included to avoid delays.

 

Follow Up with BCBSTX

 

  • Contact BCBSTX to confirm receipt of the prior authorization request and inquire about the estimated time for processing.
  •  

  • Keep records of all interactions with BCBSTX, noting down representative names and reference numbers for future reference.

 

Wait for the Approval Decision

 

  • Once the review is complete, BCBSTX will notify you and your healthcare provider of the decision. If approved, confirm the coverage details, such as copay amounts and any coverage limits.
  •  

  • If denied, review the explanation provided and discuss with your healthcare provider whether any additional information is needed for an appeal or another course of action is required.

 

Appeal a Denied Claim

 

  • If applicable, work with your healthcare provider to prepare and submit an appeal to BCBSTX, including any additional documentation or evidence supporting the medical necessity of Diethylpropion.
  •  

  • Stay informed about your appeals process timeline, maintaining communication with BCBSTX representatives as needed.

 

Fill Your Prescription

 

  • Once approved, take your prescription to a pharmacy that accepts BCBSTX insurance for processing Diethylpropion (Tenuate).
  •  

  • Verify with the pharmacist that the insurance is being applied correctly and confirm the copay you need to provide.

 

Monitor Future Coverage

 

  • Stay updated on any policy changes from BCBSTX regarding prescription drug coverage or weight management medications.
  •  

  • Periodically verify with BCBSTX to ensure continued coverage for Diethylpropion in case of policy updates.

 

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FAQs

Does Blue Cross Blue Shield of Texas Cover Diethylpropion (Tenuate)

Explore Diethylpropion coverage with Blue Cross Blue Shield of Texas and learn how to get coverage, costs without insurance, and more in our comprehensive guide.
Curex allergy drops unboxing

Is Diethylpropion (Tenuate) Covered by Blue Cross Blue Shield of Texas

 

Coverage for Diethylpropion (Tenuate)

 

  • Blue Cross Blue Shield of Texas typically provides coverage for medications like Diethylpropion under specific health plans, but it's important to confirm coverage details directly with them as they can vary.
  •  

 

When is Coverage Available?

 

  • Coverage may be available for patients diagnosed with a specific medical condition, such as obesity, when other weight loss methods have failed.
  •  

  • Prescriptions for Diethylpropion are usually covered when deemed medically necessary by a healthcare provider.

 

Basic Rules and Criteria

 

  • A prior authorization might be required to assess the necessity of the medication.
  •  

  • Each prescription might need documentation proving that other treatments have been tried without success.
  •  

  • Patients might need to meet certain criteria, such as a specific Body Mass Index (BMI) requirement.

 

Next Steps

 

  • To ensure coverage, consult with your healthcare provider and contact Blue Cross Blue Shield of Texas for exact plan details.
  •  

  • Review your health plan’s drug formulary for information on prescription drug coverage.

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Start with Curex

Blue Cross Blue Shield of Texas's Approved Criteria for Diethylpropion (Tenuate) Coverage

 

Eligibility Criteria for Diethylpropion (Tenuate) Coverage

 

  • Individual must be 16 years or older to qualify for coverage of Diethylpropion (Tenuate).

 

Body Mass Index (BMI) Requirements

 

  • Individual must have a BMI of 30 kg/m² or higher for those without associated risk factors, or a BMI of 27 kg/m² or higher with at least one of the following risk factors: hypertension, type 2 diabetes, or hyperlipidemia.

 

Documentation Requirements

 

  • A recent medical evaluation documenting obesity-related comorbidities, if applicable, and BMI measurements.
  •  

  • Detailed patient history indicating that previous attempts at weight reduction through non-pharmacologic means (such as diet and exercise) have not resulted in significant weight loss.

 

Monitoring and Follow-up

 

  • Commitment to regular follow-up appointments with a healthcare provider to monitor progress, side effects, and reevaluate the necessity of continued treatment with Diethylpropion (Tenuate).
  •  

  • Documentation of weight loss success or failure at each follow-up visit, as ongoing treatment coverage may depend on documented efficacy.

 

Prescription Requirements

 

  • Diethylpropion (Tenuate) must be prescribed by a healthcare provider who has evaluated the individual for obesity management.
  •  

  • Initial prescription coverage may be limited to a finite period (e.g., 12 weeks), with continuation based on demonstrated effectiveness and adherence to the treatment plan.

 

Exclusions and Limitations

 

  • Individuals with a history of drug abuse, cardiovascular disease, or other contraindications as specified by the prescribing information are generally not eligible.
  •  

  • Specific exclusions may apply based on individual policy terms and conditions.

 

Why Blue Cross Blue Shield of Texas Might Deny Diethylpropion (Tenuate) Coverage

 

Exclude Non-Covered Situations for Diethylpropion (Tenuate)

 

  • Diethylpropion is not covered if the prescribed use is for a condition where it is not deemed medically necessary.
  •  

  • The medication is denied if it is intended for off-label uses not recognized by FDA-approved labeling.
  •  

  • Coverage is not provided if the medication is not prescribed in conjunction with a comprehensive behavioral modification program.
  •  

  • The drug is denied if used for cosmetic weight loss rather than treatment of obesity-related health conditions.
  •  

  • Diethylpropion is not covered when there is a lack of documentation indicating a necessity for the patient based on clinical evidence.
  •  

  • Coverage is not provided if the patient does not meet the minimum body mass index (BMI) requirements as specified by Blue Cross Blue Shield of Texas policy guidelines.

 

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How Much Does Diethylpropion (Tenuate) Cost without Insurance?

 

Approximate Cost of Diethylpropion (Tenuate) Without Insurance

 

  • The cost of Diethylpropion (Tenuate), a prescription medication used for weight loss, can vary widely depending on the pharmacy location and any available discounts or generic alternatives.
  •  

  • On average, the price for a supply of 30, 75 mg controlled-release tablets can range from $50 to $100 without insurance.
  •  

  • For the immediate-release version, the cost for a supply of 30, 25 mg tablets is typically around $30 to $70 without insurance.
  •  

  • Prices can fluctuate due to factors such as location, manufacturer pricing, and availability of alternative generic options.
  •  

  • It's often beneficial to check with different pharmacies for any potential coupons or discounts that may further reduce the cost.

 

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 Diethylpropion (Tenuate) Coverage with Blue Cross Blue Shield of Texas

 

Verify Your Eligibility

 

  • Contact Blue Cross Blue Shield of Texas (BCBSTX) customer service to confirm if your policy includes prescription drug coverage for medications like Diethylpropion (Tenuate).
  •  

  • Review your policy documents to understand the terms, limitations, and coverage rules concerning weight management medications.

 

Consult Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Diethylpropion (Tenuate) and see if it is an appropriate treatment for your condition.
  •  

  • Your healthcare provider may need to provide a prescription along with relevant medical history and rationale for recommending this medication.
  •  

  • Ask your healthcare provider whether a prior authorization is required for Diethylpropion and how it can be completed effectively.

 

Initiate Prior Authorization

 

  • If prior authorization is necessary, have your healthcare provider submit the required forms to BCBSTX, including your medical need for Diethylpropion.
  •  

  • Ensure that all necessary documentation, such as your medical records and prescription details, are included to avoid delays.

 

Follow Up with BCBSTX

 

  • Contact BCBSTX to confirm receipt of the prior authorization request and inquire about the estimated time for processing.
  •  

  • Keep records of all interactions with BCBSTX, noting down representative names and reference numbers for future reference.

 

Wait for the Approval Decision

 

  • Once the review is complete, BCBSTX will notify you and your healthcare provider of the decision. If approved, confirm the coverage details, such as copay amounts and any coverage limits.
  •  

  • If denied, review the explanation provided and discuss with your healthcare provider whether any additional information is needed for an appeal or another course of action is required.

 

Appeal a Denied Claim

 

  • If applicable, work with your healthcare provider to prepare and submit an appeal to BCBSTX, including any additional documentation or evidence supporting the medical necessity of Diethylpropion.
  •  

  • Stay informed about your appeals process timeline, maintaining communication with BCBSTX representatives as needed.

 

Fill Your Prescription

 

  • Once approved, take your prescription to a pharmacy that accepts BCBSTX insurance for processing Diethylpropion (Tenuate).
  •  

  • Verify with the pharmacist that the insurance is being applied correctly and confirm the copay you need to provide.

 

Monitor Future Coverage

 

  • Stay updated on any policy changes from BCBSTX regarding prescription drug coverage or weight management medications.
  •  

  • Periodically verify with BCBSTX to ensure continued coverage for Diethylpropion in case of policy updates.

 

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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.

Diethylpropion (Tenuate) FAQ

What are the common side effects of Diethylpropion?

 

Common Side Effects of Diethylpropion

 

  • Diethylpropion may cause dizziness and drowsiness; avoid driving or operating heavy machinery if affected.
  •  

  • Patients often report headaches and insomnia. Adjust usage to early daytime to help mitigate insomnia.
  •  

  • It can lead to digestive issues like nausea, dry mouth, and constipation; drinking ample water and maintaining a balanced diet may assist.
  •  

  • Commonly, users experience increased heart rate or palpitations; seek medical advice if severe or persistent.
  •  

  • Nervousness and restlessness are possible; managing stress and limiting caffeine can be beneficial.

 

How effective is Diethylpropion for weight loss?

 

Effectiveness of Diethylpropion for Weight Loss

 

  • Diethylpropion is an appetite suppressant, aiding in short-term obesity management.
  •  

  • Primarily effective when combined with a structured diet and exercise plan.
  •  

  • Clinical studies show a modest weight reduction on average, typically around 3-4% body weight over 12 weeks.
  •  

  • Most beneficial in the initial phase of a weight loss program, stimulating early weight loss which can motivate further progress.
  •  

  • Advantages can diminish over time as appetite levels adjust, necessitating lifestyle modifications for sustained loss.
  •  

 

Considerations

 

  • Prescribed for short periods due to potential side effects and risk of dependency.
  •  

  • Not suitable for individuals with specific health conditions, such as cardiovascular disease or uncontrolled hypertension.

 

Is Diethylpropion similar to phentermine?

 

Overview of Diethylpropion and Phentermine

 

  • Both Diethylpropion and Phentermine are prescription medications classified as appetite suppressants and sympathomimetic amines.
  •  

  • They are primarily used to assist weight loss in individuals who are obese and have related risk factors such as diabetes or high blood pressure.

 

Mechanism of Action

 

  • Diethylpropion and Phentermine stimulate the central nervous system, increasing heart rate and blood pressure while decreasing appetite by affecting hypothalamic neurotransmitters.
  •  

  • Though they function similarly, Phentermine typically has a stronger effect and longer duration than Diethylpropion.

 

Potential Side Effects

 

  • Common side effects of both drugs include increased heart rate, dry mouth, insomnia, dizziness, and constipation.
  •  

  • Due to their stimulant properties, they pose a risk of dependency or abuse.

 

Usage Considerations

 

  • Both medications are intended for short-term use and should be accompanied by lifestyle changes like diet and exercise.
  •  

  • It's crucial to evaluate each individual's health status and history for a safe and effective treatment plan.

 

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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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