Does Blue Cross Blue Shield of Texas Cover Dulera

Explore why Dulera may not be covered by BCBS Texas, steps to secure coverage, its cost without insurance, and FAQs in this detailed guide.
Curex allergy drops unboxing
“Curex is changing the landscape of allergies in 2024”
man opening Curex packaging
man opening Curex packaging

 

Coverage for Dulera by Blue Cross Blue Shield of Texas

 

  • Blue Cross Blue Shield of Texas (BCBSTX) may cover Dulera, a prescription medication for asthma, under certain conditions.
  •  

  • Coverage generally depends on your specific plan's formulary, which lists approved medications. It's crucial to verify if Dulera is included.
  •  

  • Obtaining coverage typically requires a valid prescription from a healthcare provider and may necessitate prior authorization to confirm medical necessity.
  •  

  • You might need to try other medications on the formulary first, known as step therapy, before Dulera is approved.
  •  

  • Copayments, coinsurance, and deductible requirements vary based on your plan, so review your policy details or contact BCBSTX for precise information.
  •  

  • Consult with your healthcare provider and BCBSTX customer service to understand all criteria and ensure Dulera is covered for your situation.

 

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.

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 Dulera Coverage with Blue Cross Blue Shield of Texas

 

Review Your Current Health Insurance Plan

 

  • Log into your Blue Cross Blue Shield of Texas account to view your current policy details. Familiarize yourself with your plan's prescription drug coverage section.
  •  

  • Confirm if Dulera is already covered under your current plan by checking the formulary list, which details medications covered under your insurance.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss the necessity of Dulera for your treatment plan. Ensure that they understand your insurance requirements and coverage parameters.
  •  

  • Request that your healthcare provider submits a prior authorization request to Blue Cross Blue Shield of Texas if necessary, explaining the medical necessity for Dulera.

 

Contact Blue Cross Blue Shield of Texas

 

  • Call the customer service number found on the back of your insurance card to inquire about Dulera coverage. Prepare to provide specific details of your plan and the medication.
  •  

  • Ask if any specific conditions or steps, like a prior authorization or step therapy, need to be met before Dulera can be covered under your plan.

 

Understand Prior Authorization Requirements

 

  • If prior authorization is required, confirm the documents or information needed. Work closely with your healthcare provider to gather and submit the required documents to Blue Cross Blue Shield of Texas.
  •  

  • Follow up with both your healthcare provider and the insurance company to ensure a timely review of your prior authorization request.

 

File an Appeal if Necessary

 

  • If your request for Dulera coverage is denied, ask for clarification on the denial reasons, and understand your right to appeal this decision.
  •  

  • Work with your healthcare provider to submit an appeal. Include supporting documentation that details the necessity of Dulera for your treatment plan.

 

Explore Discount Programs

 

  • If coverage is denied or partially covered, research discount programs or savings cards that might offer financial assistance for purchasing Dulera. Some pharmaceutical companies offer discount programs for their medications.
  •  

  • Discuss with your pharmacist about possible generic alternatives or financial solutions through the pharmacy's network that can help reduce costs.

 

Stay Informed

 

  • Regularly review updates or changes to your insurance policy that might affect future coverage of medications, including Dulera. Insurance companies occasionally update their formularies annually.
  •  

  • Consider attending informational webinars or reading newsletters from Blue Cross Blue Shield of Texas to keep informed about any changes in the coverage policies.

 

Curex allergy drops unboxing

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?

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 Texas Cover Dulera

Explore why Dulera may not be covered by BCBS Texas, steps to secure coverage, its cost without insurance, and FAQs in this detailed guide.
Curex allergy drops unboxing

Is Dulera Covered by Blue Cross Blue Shield of Texas

 

Coverage for Dulera by Blue Cross Blue Shield of Texas

 

  • Blue Cross Blue Shield of Texas (BCBSTX) may cover Dulera, a prescription medication for asthma, under certain conditions.
  •  

  • Coverage generally depends on your specific plan's formulary, which lists approved medications. It's crucial to verify if Dulera is included.
  •  

  • Obtaining coverage typically requires a valid prescription from a healthcare provider and may necessitate prior authorization to confirm medical necessity.
  •  

  • You might need to try other medications on the formulary first, known as step therapy, before Dulera is approved.
  •  

  • Copayments, coinsurance, and deductible requirements vary based on your plan, so review your policy details or contact BCBSTX for precise information.
  •  

  • Consult with your healthcare provider and BCBSTX customer service to understand all criteria and ensure Dulera is covered for your situation.

 

A weight management program tailored to you

Start with Curex

Blue Cross Blue Shield of Texas's Approved Criteria for Dulera Coverage

 

Criteria for Coverage of Dulera by Blue Cross Blue Shield of Texas

 

  • Dulera is approved for individuals diagnosed with asthma who require a maintenance treatment combining a corticosteroid and a long-acting beta agonist. Documentation from a healthcare provider confirming the diagnosis is required.
  •  

  • Patients must have had inadequate control of asthma symptoms with standard therapies, such as the use of inhaled corticosteroids or other treatments. Evidence of treatment attempts and their outcomes may be requested.
  •  

  • The coverage is generally available for individuals aged 12 years and older, aligning with the approved indications for Dulera. Prescribing physician must confirm patient’s age appropriateness for treatment.
  •  

  • Individuals must demonstrate adherence to previous asthma management plans, including prescribed medications and lifestyle adjustments. Consistent refill history and compliance with prescribed treatments are often evaluated.
  •  

  • The prescribing healthcare provider should be a specialist in allergy or pulmonary medicine, or the patient's primary care physician in collaboration with a specialist recommendation.
  •  

  • A comprehensive asthma action plan should be in place, provided by the healthcare provider, detailing medication regimen and monitoring strategies for safe and effective use of Dulera.
  •  

 

Why Blue Cross Blue Shield of Texas Might Deny Dulera Coverage

 

Reasons for Denial of Dulera Coverage

 

  • **Non-Compliance with Formulary Guidelines:** Dulera might not be included in the formulary, or preferred list of medications, meaning it may only be covered under specific conditions not met by the patient.
  •  

  • **Lack of Preauthorization:** If Blue Cross Blue Shield of Texas requires prior approval or preauthorization and it has not been obtained before prescription fill, coverage may be denied.
  •  

  • **Step Therapy Requirements:** Coverage may be denied if the patient has not tried and failed with a lower-cost or generic medication that is required as a first step before Dulera.
  •  

  • **Failure to Meet Medical Necessity Criteria:** Dulera may be denied if Blue Cross Blue Shield of Texas determines it's not medically necessary according to their criteria, which may require documented evidence of certain conditions or treatment history.
  •  

  • **Duplicate Therapy:** Coverage can be denied if there is evidence that the patient is already receiving a similar or identical medication that serves the same purpose, indicating duplicate therapy.
  •  

  • **Off-Label Usage:** If Dulera is prescribed for a condition that is not an FDA-approved use and Blue Cross Blue Shield of Texas has specific restrictions on off-label usage, it may not be covered.
  •  

  • **Exceeding Quantity Limits:** Dulera coverage may be denied if the prescription exceeds the quantity limits set by the insurance plan, and no exception has been granted.
  •  

  • **Network Restrictions:** If the Dulera prescription is filled at a pharmacy that is not within the approved network, coverage may be denied unless there’s an approved out-of-network exception.

 

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

How Much Does Dulera Cost without Insurance?

 

Approximate Cost of Dulera Without Insurance

 

  • The cost of Dulera, which is used to help control symptoms of asthma, can vary depending on the pharmacy and location. However, the typical price for a one-month supply (inhaler) of Dulera without insurance is approximately $250 to $350.
  •  

  • This price may differ based on dosage strength, and whether you're purchasing a brand name or a generic version if available.
  •  

  • Prices can fluctuate, and it is advisable to check with different pharmacies or consider using discount cards or coupons that might be available to reduce the cost.
  •  

  • Additionally, some pharmaceutical companies offer patient assistance programs for those who qualify, which can significantly lower the cost of Dulera.

 

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 Dulera Coverage with Blue Cross Blue Shield of Texas

 

Review Your Current Health Insurance Plan

 

  • Log into your Blue Cross Blue Shield of Texas account to view your current policy details. Familiarize yourself with your plan's prescription drug coverage section.
  •  

  • Confirm if Dulera is already covered under your current plan by checking the formulary list, which details medications covered under your insurance.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss the necessity of Dulera for your treatment plan. Ensure that they understand your insurance requirements and coverage parameters.
  •  

  • Request that your healthcare provider submits a prior authorization request to Blue Cross Blue Shield of Texas if necessary, explaining the medical necessity for Dulera.

 

Contact Blue Cross Blue Shield of Texas

 

  • Call the customer service number found on the back of your insurance card to inquire about Dulera coverage. Prepare to provide specific details of your plan and the medication.
  •  

  • Ask if any specific conditions or steps, like a prior authorization or step therapy, need to be met before Dulera can be covered under your plan.

 

Understand Prior Authorization Requirements

 

  • If prior authorization is required, confirm the documents or information needed. Work closely with your healthcare provider to gather and submit the required documents to Blue Cross Blue Shield of Texas.
  •  

  • Follow up with both your healthcare provider and the insurance company to ensure a timely review of your prior authorization request.

 

File an Appeal if Necessary

 

  • If your request for Dulera coverage is denied, ask for clarification on the denial reasons, and understand your right to appeal this decision.
  •  

  • Work with your healthcare provider to submit an appeal. Include supporting documentation that details the necessity of Dulera for your treatment plan.

 

Explore Discount Programs

 

  • If coverage is denied or partially covered, research discount programs or savings cards that might offer financial assistance for purchasing Dulera. Some pharmaceutical companies offer discount programs for their medications.
  •  

  • Discuss with your pharmacist about possible generic alternatives or financial solutions through the pharmacy's network that can help reduce costs.

 

Stay Informed

 

  • Regularly review updates or changes to your insurance policy that might affect future coverage of medications, including Dulera. Insurance companies occasionally update their formularies annually.
  •  

  • Consider attending informational webinars or reading newsletters from Blue Cross Blue Shield of Texas to keep informed about any changes in the coverage policies.

 

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.

Dulera FAQ

What are the side effects of Dulera?

 

Common Side Effects of Dulera

 

  • Headache
  • Sore throat
  • Sinus pain
  • Nosebleed
  • Oral thrush (fungal infection)

 

Serious Side Effects

 

  • Wheezing or breathing problems
  • Severe allergic reactions (rash, itching/swelling)
  • Vision problems
  • Reduced bone density with long-term use

 

Monitoring and Precautions

 

  • Regularly check bone health and eye exams
  • Rinse mouth after inhalation to prevent oral infections
  • Consult your doctor if side effects worsen or persist

 

How does Dulera work for asthma?

 

Mechanism of Action

 

  • Dulera is a combination inhaler containing mometasone (a corticosteroid) and formoterol (a long-acting beta-agonist).
  •  

  • Mometasone reduces inflammation in the airways, minimizing swelling and irritation.
  •  

  • Formoterol relaxes bronchial muscles, improving airflow and easing breathing.

 

Benefits for Asthma

 

  • Helps prevent asthma attacks by maintaining open airways over long periods.
  •  

  • Decreases the usage frequency of rescue inhalers due to improved control of symptoms.

 

Usage Guidance

 

  • Use regularly as prescribed, even without current symptoms, for effective management.
  •  

  • Rinse mouth after inhalation to reduce risks of oral thrush from corticosteroid use.

 

Consultation Necessity

 

  • Discuss with healthcare provider if side effects occur or asthma symptoms do not improve.

 

Is Dulera a steroid inhaler?

 

Is Dulera a Steroid Inhaler?

 

  • Dulera is a combination inhaler used for asthma management, containing both formoterol, a long-acting beta-agonist (LABA), and mometasone furoate, which is a corticosteroid.
  •  

  • Corticosteroids in Dulera are used to reduce inflammation in the airways, helping to prevent and control asthma symptoms.
  •  

  • Formoterol helps in relaxing muscles around the airways, making breathing easier by widening the air passages.
  •  

  • It's essential to use Dulera regularly for it to be effective; it is not intended for relief of acute asthma attacks.
  •  

  • Patients should be aware of potential side effects like throat irritation or thrush due to the steroid component, and rinsing the mouth after use may help minimize these risks.

 

Have questions left?

Get a personalized online consultation with a doctor at Curex

Curex is one of America’s largest telehealth providers

Together with our partners we have changed the lives of over 300,000 patients. Here’s what some of them have to say:

“Curex has performed beyond my expectations. I am feeling tremendously better and look forward to continuing the treatment.”
Becky D.
"If I could give 6 stars, I would. BEST... BEST… BEST… service.”
Ferdian K.
“The Curex staff has been professional, efficient, and really focused on my individual needs.”
Ana C.

Start your
journey now

Everything you need is included:

Online consultation

Your prescription

Premium medication

Overnight shipping

Ongoing support

A weight management program tailored to you

Initial Dosage

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

Titration

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

Additional Treatments

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

Got questions? We have answers.

Do your plans include prescriptions and medications?

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

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

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

What medications do your providers prescribe?

We prioritize a personalized approach to your health. If your medical provider prescribes medication, options may include GLP-1 treatments such as compounded semaglutide (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.

Made in Webflow