Does CareFirst BlueCross BlueShield Cover Symbicort

Find out if CareFirst BlueCross BlueShield covers Symbicort, why it might deny coverage, how to secure it, and costs without insurance. Symbicort FAQ included.
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CareFirst BlueCross BlueShield Coverage for Symbicort

 

  • Coverage depends on the specific health plan and prescription drug benefits. Symbicort is generally covered under many plans but may require prior authorization.
  •  

  • To confirm coverage, patients must check their specific policy details via their member portal or contact customer service for precise information.
  •  

    Criteria for Coverage

     

    • The prescription must be deemed medically necessary, usually for conditions like asthma or COPD, as determined by a healthcare provider.
    •  

    • Prior authorization may be required, involving documentation of previous treatments tried and the necessity for Symbicort specifically.

     

    Additional Considerations

     

    • Formulary lists might influence the coverage, including preferred drug status or generic options that may affect approval.
    •  

    • Patients might encounter copayments or coinsurance fees, which vary based on the plan type and tier placement of Symbicort.

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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 Symbicort Coverage with CareFirst BlueCross BlueShield

 

Check Your Health Plan

 

  • Visit the CareFirst website or log into your member account to understand the specifics of your health plan coverage.
  •  
  • Look for details in the prescription drug section to see if Symbicort is covered under your policy.
  •  
  • If you have the plan documents, review the formulary list for any specific tiers or requirements related to Symbicort coverage.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Symbicort.
  •  
  • Ask your healthcare provider to prescribe Symbicort and specify the medical necessity if required.
  •  
  • Ensure that you understand any alternative medications and why Symbicort is specifically recommended for you.

 

Verify Coverage with CareFirst

 

  • Contact CareFirst BlueCross BlueShield directly using the member services number found on your insurance card.
  •  
  • Ask a representative to confirm the coverage of Symbicort under your specific plan, including any co-pays or pre-authorization requirements.
  •  
  • If necessary, ask about any process for appealing or seeking exceptions for non-covered medications.

 

Submit Necessary Documentation

 

  • Gather any required forms or documentation from your healthcare provider, including a prescription for Symbicort.
  •  
  • Fill out any pre-authorization forms or appeals required by CareFirst for medical necessity.
  •  
  • Ensure all forms are accurately completed and include relevant information such as your member ID and provider details.

 

Pharmaceutical Assistance Programs

 

  • Research if AstraZeneca, the manufacturer of Symbicort, offers any patient assistance programs or rebates.
  •  
  • Consider enrolling in these programs if eligible, to receive discounts or assistance in obtaining Symbicort.
  •  
  • You can usually find information about these programs on the manufacturer's website or by asking your healthcare provider.

 

Follow Up With Pharmacy

 

  • Once your coverage is clear, take your prescription to a participating pharmacy or use CareFirst’s mail-order pharmacy service if available.
  •  
  • Verify with the pharmacist that your insurance has been applied and understand your out-of-pocket costs.
  •  
  • If there are any issues with coverage at the pharmacy, contact CareFirst or your healthcare provider for assistance.

 

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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

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Studies that have been reviewed by certified physicians show that sublingual immunotherapy is a safe treatment option
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FAQs

Does CareFirst BlueCross BlueShield Cover Symbicort

Find out if CareFirst BlueCross BlueShield covers Symbicort, why it might deny coverage, how to secure it, and costs without insurance. Symbicort FAQ included.
Curex allergy drops unboxing

Is Symbicort Covered by CareFirst BlueCross BlueShield

 

CareFirst BlueCross BlueShield Coverage for Symbicort

 

  • Coverage depends on the specific health plan and prescription drug benefits. Symbicort is generally covered under many plans but may require prior authorization.
  •  

  • To confirm coverage, patients must check their specific policy details via their member portal or contact customer service for precise information.
  •  

    Criteria for Coverage

     

    • The prescription must be deemed medically necessary, usually for conditions like asthma or COPD, as determined by a healthcare provider.
    •  

    • Prior authorization may be required, involving documentation of previous treatments tried and the necessity for Symbicort specifically.

     

    Additional Considerations

     

    • Formulary lists might influence the coverage, including preferred drug status or generic options that may affect approval.
    •  

    • Patients might encounter copayments or coinsurance fees, which vary based on the plan type and tier placement of Symbicort.

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CareFirst BlueCross BlueShield's Approved Criteria for Symbicort Coverage

 

Criteria for Symbicort Coverage

 

  • **Diagnosis Requirement**: The patient must have a documented diagnosis of asthma or chronic obstructive pulmonary disease (COPD) for consideration of coverage.
  •  

  • **Age Requirement**: The patient should be at least 12 years old for asthma treatment and 18 years old for COPD treatment.
  •  

  • **Medical History**: There should be a documented history of asthma or COPD symptoms not adequately controlled by a long-acting beta-agonist (LABA) or inhaled corticosteroid alone.
  •  

  • **Prior Medication Trials**: Documentation must show that the patient has tried and not achieved desired results with other standard combination inhaled therapy, such as corticosteroid/LABA combinations.
  •  

  • **Physician Prescription**: Symbicort must be prescribed by a licensed healthcare provider who specializes in managing asthma or COPD, such as a pulmonologist or an allergist.
  •  

  • **Regular Follow-Up**: The patient must agree to regular follow-up appointments to monitor the effectiveness and safety of the medication.
  •  

  • **Adherence to Treatment Plan**: Patient's commitment to adhering to the prescribed treatment regimen, including proper inhaler technique and consistent medication usage, must be evident.
  •  

  • **Smoking Cessation**: For COPD patients, documentation should reflect that the patient is either non-smoking or actively involved in a smoking cessation program.
  •  

  • **Allergy Certification**: Documented absence of hypersensitivity to any component of Symbicort, such as budesonide or formoterol, is required.

 

Additional Considerations

 

  • **Special Situations**: Pregnancy, breastfeeding, or concurrent significant health conditions must be carefully considered and documented as part of the coverage approval.
  •  

  • **Pharmacy Benefit Management**: Only approved network pharmacies may dispense Symbicort as per the insurance guidelines.
  •  

  • **Prior Authorization**: A prior authorization form may need to be completed and approved before Symbicort is covered under the insurance plan.

 

Why CareFirst BlueCross BlueShield Might Deny Symbicort Coverage

 

Reasons for Denial of Symbicort Coverage by CareFirst BlueCross BlueShield

 

  • Symbicort may not be covered if it is not listed on the formulary plan provided by CareFirst BlueCross BlueShield. Each plan may have a different formulary, and Symbicort may be excluded.
  •  

  • The prescribed use of Symbicort is outside of FDA-approved indications or not supported by clinical guidelines, leading to coverage denial.
  •  

  • Lack of prior authorization or failure to meet step therapy requirements may result in non-coverage. CareFirst BlueCross BlueShield may require trying a generic alternative or other preferred medications first.
  •  

  • In cases where an off-label use is attempted without sufficient documentation or clinical evidence to support its necessity and efficacy, Symbicort coverage may be denied.
  •  

  • Failure to provide documentation proving medical necessity, especially if there is a lack of information regarding the patient’s diagnosis or response to other therapies, can result in denial.
  •  

  • The prescribed dosage or quantity exceeds the recommended limit or is considered experimental, which might not be covered by the insurance plan.
  •  

  • Coverage might be denied if Symbicort is dispensed or prescribed by a non-participating pharmacy or healthcare provider not within the CareFirst BlueCross BlueShield network.

 

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

How Much Does Symbicort Cost without Insurance?

 

Cost of Symbicort without Insurance

 

  • Symbicort is a prescription medication commonly used to treat asthma and chronic obstructive pulmonary disease (COPD). Without insurance, its cost can be quite high, varying largely due to factors such as dosage, pharmacy, and location. On average, the out-of-pocket cost for a 30-day supply of Symbicort (160/4.5 mcg) inhaler is around $250 to $350.
  •  

  • Prices can vary significantly from one pharmacy to another. Some big-box or discount pharmacies might offer slightly lower prices, while smaller local pharmacies may have higher rates without insurance discounts.
  •  

  • Patients can also explore manufacturer coupons or patient assistance programs, which might help reduce the overall cost. Additionally, online resources and discount cards may offer ways to slightly lower the cash price at participating pharmacies.
  •  

  • It's advisable for patients to check various pharmacies to ensure they are getting the best possible price. Comparing online pharmacy prices and visiting discount retailers could help mitigate high costs when paying out-of-pocket.

 

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 Symbicort Coverage with CareFirst BlueCross BlueShield

 

Check Your Health Plan

 

  • Visit the CareFirst website or log into your member account to understand the specifics of your health plan coverage.
  •  
  • Look for details in the prescription drug section to see if Symbicort is covered under your policy.
  •  
  • If you have the plan documents, review the formulary list for any specific tiers or requirements related to Symbicort coverage.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Symbicort.
  •  
  • Ask your healthcare provider to prescribe Symbicort and specify the medical necessity if required.
  •  
  • Ensure that you understand any alternative medications and why Symbicort is specifically recommended for you.

 

Verify Coverage with CareFirst

 

  • Contact CareFirst BlueCross BlueShield directly using the member services number found on your insurance card.
  •  
  • Ask a representative to confirm the coverage of Symbicort under your specific plan, including any co-pays or pre-authorization requirements.
  •  
  • If necessary, ask about any process for appealing or seeking exceptions for non-covered medications.

 

Submit Necessary Documentation

 

  • Gather any required forms or documentation from your healthcare provider, including a prescription for Symbicort.
  •  
  • Fill out any pre-authorization forms or appeals required by CareFirst for medical necessity.
  •  
  • Ensure all forms are accurately completed and include relevant information such as your member ID and provider details.

 

Pharmaceutical Assistance Programs

 

  • Research if AstraZeneca, the manufacturer of Symbicort, offers any patient assistance programs or rebates.
  •  
  • Consider enrolling in these programs if eligible, to receive discounts or assistance in obtaining Symbicort.
  •  
  • You can usually find information about these programs on the manufacturer's website or by asking your healthcare provider.

 

Follow Up With Pharmacy

 

  • Once your coverage is clear, take your prescription to a participating pharmacy or use CareFirst’s mail-order pharmacy service if available.
  •  
  • Verify with the pharmacist that your insurance has been applied and understand your out-of-pocket costs.
  •  
  • If there are any issues with coverage at the pharmacy, contact CareFirst or your healthcare provider for assistance.

 

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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.

Symbicort FAQ

1. What are the side effects of Symbicort?

 

Common Side Effects of Symbicort

 

  • Headache: Frequently reported and usually mild.
  • Throat irritation: Can occur due to inhalation route.
  • Hoarseness: Temporary voice changes may be noticed.
  • Cough: Occasional, linked to inhaler use.

 

Less Common Side Effects

 

  • Nausea: A less frequent side effect.
  • Increased blood pressure: Monitor regularly.
  • Palpitations: Uncommon but notable.
  • Muscle cramps: May occur in some patients.

 

Rare but Serious Side Effects

 

  • Allergic reactions: Rash, itching, or difficulty breathing.
  • Worsening of asthma: Requires immediate attention.
  • Pneumonia: Particularly in COPD patients.
  • Cardiac arrhythmias: Monitor heart rhythm.

 

2. How does Symbicort work for asthma?

 

How Symbicort Works

 

  • Combination Therapy: Symbicort contains budesonide, a corticosteroid, and formoterol, a long-acting beta-agonist. Together, they manage asthma by reducing inflammation and opening airways.
  •  

  • Inflammation Control: Budesonide targets the inflammatory process in the lungs, decreasing swelling and irritation to prevent asthma symptoms.
  •  

  • Bronchodilation: Formoterol relaxes muscles around the airways, quickly improving breathing and reducing wheezing.
  •  

  • Maintenance and Relief: While primarily for maintenance, Symbicort provides relief from symptoms and reduces the frequency of asthma attacks.

 

3. Is Symbicort a steroid inhaler?

 

Is Symbicort a Steroid Inhaler?

 

  • Yes, Symbicort is a combination inhaler that contains a steroid. It combines budesonide, a corticosteroid, and formoterol, a long-acting beta agonist (LABA).
  •  

  • Corticosteroids like budesonide help to reduce inflammation in the airways, which is crucial for managing asthma and chronic obstructive pulmonary disease (COPD).
  •  

  • Formoterol helps in relaxing the muscles around the airways to make breathing easier.
  •  

  • Symbicort is prescribed for long-term management and not for immediate relief of acute symptoms.
  •  

  • Regular use is essential to decrease the chance of flare-ups and improve overall lung function.

 

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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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