Does Blue Cross of Idaho Cover Phentermine (Adipex-P, Lomaira)

Explore coverage options for Phentermine under Blue Cross of Idaho. Learn about costs and appeal tips. Essential guide for patients seeking coverage.
Curex allergy drops unboxing
“Curex is changing the landscape of allergies in 2024”
man opening Curex packaging
man opening Curex packaging

 

Blue Cross of Idaho Coverage for Phentermine (Adipex-P, Lomaira)

 

  • Insurance coverage varies based on the individual plan. Not all plans cover Phentermine, so check your specific plan details.
  •  

  • Usually covers Phentermine if prescribed for medically necessary weight loss in overweight or obese patients with related health issues like diabetes or hypertension.
  •  

  • Authorization Criteria: Requires prior authorization. Providers must demonstrate the patient's prior unsuccessful weight loss attempts or health conditions related to obesity.
  •  

  • Some plans may require evidence of a structured weight management program alongside Phentermine usage.
  •  

  • Duration limits may be enforced, typically up to a few months of treatment unless extended use is deemed necessary by a healthcare provider and supported by documentation.

 

Before Applying for Coverage

 

  • Consult with your healthcare provider to discuss eligibility and submit any required documentation.
  •  

  • Contact Blue Cross of Idaho customer support for specific plan guidelines and requirements.

 

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 Phentermine (Adipex-P, Lomaira) Coverage with Blue Cross of Idaho

 

Understand Your Coverage

 

  • Review your current Blue Cross of Idaho health plan details to understand the coverage provisions related to prescription medications.
  •  

  • Check if weight loss medications, specifically Phentermine (Adipex-P, Lomaira), are included under the terms of your policy.

 

Consult with Your Healthcare Provider

 

  • Discuss your weight loss concerns and need for Phentermine with your doctor to get their professional assessment.
  •  

  • Ensure that your healthcare provider is aware of any health conditions or medications you're currently using that might affect the prescribing decision.
  •  

  • Request a prescription for Phentermine if your doctor deems it necessary for your health.

 

Contact Blue Cross of Idaho

 

  • Call the customer service number located on your insurance card for detailed inquiries about medication coverage.
  •  

  • Ask if Phentermine (Adipex-P, Lomaira) is covered under your plan and what criteria need to be met for coverage.
  •  

  • Inquire about any necessary prior authorizations or documentation required by Blue Cross of Idaho for approval.

 

Submit a Prior Authorization Request

 

  • If required, work with your healthcare provider to complete and submit any necessary prior authorization forms to Blue Cross of Idaho.
  •  

  • Ensure that the prior authorization includes any supportive documentation or justification from your doctor regarding the necessity of Phentermine.
  •  

  • Track the status of your prior authorization request via the Blue Cross of Idaho portal or customer service line.

 

Follow Up and Appeal if Necessary

 

  • If your prior authorization is denied, review the reason for denial provided by Blue Cross of Idaho.
  •  

  • Work with your healthcare provider to gather additional documentation or evidence to support the necessity of the medication.
  •  

  • File an appeal with Blue Cross of Idaho if you believe Phentermine is medically necessary and should be covered.
  •  

  • Continue to communicate with both your doctor and Blue Cross of Idaho representatives throughout the appeal process.

 

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 of Idaho Cover Phentermine (Adipex-P, Lomaira)

Explore coverage options for Phentermine under Blue Cross of Idaho. Learn about costs and appeal tips. Essential guide for patients seeking coverage.
Curex allergy drops unboxing

Is Phentermine (Adipex-P, Lomaira) Covered by Blue Cross of Idaho

 

Blue Cross of Idaho Coverage for Phentermine (Adipex-P, Lomaira)

 

  • Insurance coverage varies based on the individual plan. Not all plans cover Phentermine, so check your specific plan details.
  •  

  • Usually covers Phentermine if prescribed for medically necessary weight loss in overweight or obese patients with related health issues like diabetes or hypertension.
  •  

  • Authorization Criteria: Requires prior authorization. Providers must demonstrate the patient's prior unsuccessful weight loss attempts or health conditions related to obesity.
  •  

  • Some plans may require evidence of a structured weight management program alongside Phentermine usage.
  •  

  • Duration limits may be enforced, typically up to a few months of treatment unless extended use is deemed necessary by a healthcare provider and supported by documentation.

 

Before Applying for Coverage

 

  • Consult with your healthcare provider to discuss eligibility and submit any required documentation.
  •  

  • Contact Blue Cross of Idaho customer support for specific plan guidelines and requirements.

 

A weight management program tailored to you

Start with Curex

Blue Cross of Idaho's Approved Criteria for Phentermine (Adipex-P, Lomaira) Coverage

 

Criteria for Coverage of Phentermine (Adipex-P, Lomaira) by Blue Cross of Idaho

 

  • Individuals must have a Body Mass Index (BMI) of 30 kg/m² or greater. BMI can be lower if there are serious comorbid conditions such as hypertension, type 2 diabetes, or sleep apnea.
  •  

  • The patient must be over the age of 16.
  •  

  • There must be a documented history of unsuccessful weight loss attempts through diet and exercise alone.
  •  

  • A physician must oversee the comprehensive weight management program, which includes nutritional, physical activity, and behavioral interventions appropriate for the individual's needs.
  •  

  • Regular follow-up visits must be scheduled with the prescribing physician to monitor weight loss progress and manage any potential side effects.
  •  

  • The prescribing physician should evaluate and document that phentermine is prescribed for short-term management as part of a broader weight-loss strategy.
  •  

  • Phentermine may be covered as part of a treatment plan only if the physician assesses and verifies the potential benefit outweighs the risk for the particular patient.
  •  

 

Why Blue Cross of Idaho Might Deny Phentermine (Adipex-P, Lomaira) Coverage

 

Situations When Blue Cross of Idaho Denies Phentermine Coverage

 

  • Phentermine is requested without prior authorization, as it typically requires a doctor’s prescription and approval of necessity.
  •  

  • The patient does not meet the specific body mass index (BMI) criteria defined by Blue Cross of Idaho for weight loss medication coverage.
  •  

  • The intended use is for a purpose other than what is approved by the FDA or defined by the health plan's guidelines.
  •  

  • There is a lack of documented trials of other weight loss methods, such as diet and exercise, showing an unsuccessful attempt at significant weight reduction or maintenance.
  •  

  • Phentermine prescriptions are for long-term use beyond the durations approved by the plan, as it is typically covered only for short-term management.
  •  

  • The patient has a history of cardiovascular diseases or other contraindications as Phentermine may pose health risks for these individuals.
  •  

  • The prescription is for combination with other weight loss drugs not approved by Blue Cross of Idaho, due to potential for increased side effects or lack of evidence of efficacy.
  •  

  • Prescriptions are filled at non-participating pharmacies that do not align with Blue Cross of Idaho's network agreements or policies.

 

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

How Much Does Phentermine (Adipex-P, Lomaira) Cost without Insurance?

 

Cost of Phentermine (Adipex-P, Lomaira) Without Insurance

 

  • The price of Phentermine can vary based on the pharmacy location and dosage strength. Typically, the cost for Adipex-P (the tablet form) without insurance is approximately $30 to $100 for a 30-day supply, at the standard dose of 37.5 mg per tablet.
  •  

  • Lomaira, which is a lower-dosage version of Phentermine, might be priced differently. The average cost without insurance for Lomaira is around $50 to $90 for a 30-day supply, depending on the pharmacy and location.
  •  

  • It's worth noting that these costs reflect retail prices, and there might be cheaper generic options available. Additionally, some pharmacies offer discount programs or coupons which can significantly lower the price.
  •  

  • Shopping around at different pharmacies or using online resources may help in obtaining the best available price without insurance.

 

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 Phentermine (Adipex-P, Lomaira) Coverage with Blue Cross of Idaho

 

Understand Your Coverage

 

  • Review your current Blue Cross of Idaho health plan details to understand the coverage provisions related to prescription medications.
  •  

  • Check if weight loss medications, specifically Phentermine (Adipex-P, Lomaira), are included under the terms of your policy.

 

Consult with Your Healthcare Provider

 

  • Discuss your weight loss concerns and need for Phentermine with your doctor to get their professional assessment.
  •  

  • Ensure that your healthcare provider is aware of any health conditions or medications you're currently using that might affect the prescribing decision.
  •  

  • Request a prescription for Phentermine if your doctor deems it necessary for your health.

 

Contact Blue Cross of Idaho

 

  • Call the customer service number located on your insurance card for detailed inquiries about medication coverage.
  •  

  • Ask if Phentermine (Adipex-P, Lomaira) is covered under your plan and what criteria need to be met for coverage.
  •  

  • Inquire about any necessary prior authorizations or documentation required by Blue Cross of Idaho for approval.

 

Submit a Prior Authorization Request

 

  • If required, work with your healthcare provider to complete and submit any necessary prior authorization forms to Blue Cross of Idaho.
  •  

  • Ensure that the prior authorization includes any supportive documentation or justification from your doctor regarding the necessity of Phentermine.
  •  

  • Track the status of your prior authorization request via the Blue Cross of Idaho portal or customer service line.

 

Follow Up and Appeal if Necessary

 

  • If your prior authorization is denied, review the reason for denial provided by Blue Cross of Idaho.
  •  

  • Work with your healthcare provider to gather additional documentation or evidence to support the necessity of the medication.
  •  

  • File an appeal with Blue Cross of Idaho if you believe Phentermine is medically necessary and should be covered.
  •  

  • Continue to communicate with both your doctor and Blue Cross of Idaho representatives throughout the appeal process.

 

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.

Phentermine (Adipex-P, Lomaira) FAQ

What are the side effects of phentermine?

 

Common Side Effects

 

  • Increased heart rate
  • Insomnia
  • Anxiety
  • Dry mouth

 

Less Common Side Effects

 

  • Dizziness
  • Constipation
  • Chest discomfort

 

Severe Side Effects

 

  • Shortness of breath
  • Severe headache
  • Heart palpitations

 

Recommendations

 

  • Avoid combining with other stimulants.
  • Limit alcohol consumption.
  • Consult a physician if side effects are severe or persist.

 

Important Note

 

  • Use only as prescribed by your doctor.
  • Avoid taking it late in the day to prevent insomnia.

 

How does phentermine help with weight loss?

 

How Phentermine Aids Weight Loss

 

  • Phentermine suppresses appetite by releasing neurotransmitters like norepinephrine in the brain, which helps reduce hunger.
  •  

  • It is similar to an amphetamine and works by stimulating the central nervous system, increasing heart rate and blood pressure, which can decrease appetite.
  •  

  • The medication should be combined with a reduced-calorie diet, increased physical activity, and behavior therapy for optimal results.
  •  

  • Often used for short-term management of obesity, typically up to 12 weeks, as part of a broader weight-loss program.

 

Is phentermine safe to use long-term?

 

Phentermine Safety

 

  • Phentermine is mainly prescribed for short-term use, generally up to 12 weeks, due to the lack of long-term efficacy and safety studies.
  •  

  • While it can be effective for weight loss over a short period, the potential for dependency and cardiovascular issues makes prolonged use risky.
  •  

  • Long-term use may lead to side effects like elevated blood pressure, palpitations, insomnia, and mood changes.
  •  

  • Consult your healthcare provider regularly to evaluate its ongoing necessity and monitor any adverse effects.
  •  

  • Alternative weight management strategies, such as lifestyle changes, should be prioritized for sustainable results.

 

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