Does Centene Corporation Cover Symbicort

Explore Centene's coverage for Symbicort, reasons for denial, ways to secure coverage, costs without insurance, and FAQs in our detailed guide.
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Centene Corporation Coverage for Symbicort

 

  • Centene Corporation offers coverage for Symbicort, a medication used to treat asthma and COPD. Coverage can vary based on specific health plans and state requirements.
  •  

  • Typically, coverage includes medically necessary prescriptions for managing chronic respiratory conditions, provided they meet the plan's guidelines.
  •  

  • To get Symbicort covered, a doctor’s prescription must validate its necessity, aligning with Centene's formulary and clinical policies.
  •  

  • Prior authorization may be required to ensure the medication is suitable for the patient's condition, and alternative therapies have been considered.
  •  

  • Patients should confirm with their specific Centene plan regarding co-pays, tiers, and the presence of any restrictions or step therapy protocols.
  •  

 

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Dr. Neeta Ogden, MD

Curex is poised to revolutionize the way allergies are treated in America, expanding access to clinical care and treatments that can meaningfully improve patients quality of life.

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 Centene Corporation

 

Contact Centene Corporation

 

  • Reach out to Centene Corporation's customer service via phone or their website to inquire about prescription coverage for Symbicort.
  •  

  • Request information on the specific healthcare plans that include Symbicort as a covered medication.

 

Review Current Insurance Benefits

 

  • Examine your current insurance policy details to check if Symbicort is already covered or qualifies for any special programs.
  •  

  • Get in touch with your insurance representative to confirm coverage specifics and any potential out-of-pocket costs.

 

Explore Centene Corporation Plans

 

  • Investigate Centene's different healthcare plans online, focusing on those that offer prescription drug coverage, including Symbicort.
  •  

  • Look for plans that match your healthcare needs and budget while providing the necessary medication coverage.

 

Switch to a Centene Plan

 

  • If your current plan does not cover Symbicort, consider enrolling in a Centene plan during the open enrollment period that does include the medication.
  •  

  • Consult with Centene's customer service to understand the enrollment process and any required documentation.

 

Obtain Necessary Authorizations

 

  • Consult your healthcare provider to obtain any prior authorization or documentation required for Symbicort.
  •  

  • Ensure your prescriptions are up-to-date and that you have a clear understanding of any refill requirements under the new plan.

 

Verify Coverage Upon Activation

 

  • Once enrolled in a Centene plan that covers Symbicort, verify that your medication is listed under your coverage benefits.
  •  

  • Check your insurance card or online member portal to confirm the inclusion of Symbicort and any related co-pay amounts.

 

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FAQs

Does Centene Corporation Cover Symbicort

Explore Centene's coverage for Symbicort, reasons for denial, ways to secure coverage, costs without insurance, and FAQs in our detailed guide.
Curex allergy drops unboxing

Is Symbicort Covered by Centene Corporation

 

Centene Corporation Coverage for Symbicort

 

  • Centene Corporation offers coverage for Symbicort, a medication used to treat asthma and COPD. Coverage can vary based on specific health plans and state requirements.
  •  

  • Typically, coverage includes medically necessary prescriptions for managing chronic respiratory conditions, provided they meet the plan's guidelines.
  •  

  • To get Symbicort covered, a doctor’s prescription must validate its necessity, aligning with Centene's formulary and clinical policies.
  •  

  • Prior authorization may be required to ensure the medication is suitable for the patient's condition, and alternative therapies have been considered.
  •  

  • Patients should confirm with their specific Centene plan regarding co-pays, tiers, and the presence of any restrictions or step therapy protocols.
  •  

 

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Centene Corporation's Approved Criteria for Symbicort Coverage

 

Eligibility for Symbicort Coverage

 

  • Symbicort coverage is available for individuals diagnosed with asthma or Chronic Obstructive Pulmonary Disease (COPD) when deemed medically necessary by a healthcare provider.
  • The patient must have a documented history of asthma or COPD and show clinical signs that necessitate the use of combination inhalation therapy.
  • Prior treatment with inhaled corticosteroids, long-acting beta-agonists, or other respiratory medications must have been inadequate, as documented by a healthcare professional.
  • Medical records should reflect a detailed history of symptoms, treatment regimens, and response to previous therapies.

 

Documentation Requirements

 

  • A written prescription from a licensed healthcare provider outlining the necessity for Symbicort is required.
  • Medical documentation that validates a prior inadequate response to other medications or therapies for asthma or COPD management.
  • Evidence of a comprehensive asthma or COPD management plan must be provided, demonstrating the necessity of Symbicort as part of this plan.
  • Periodic reevaluation documentation by a healthcare provider to justify the continuation of Symbicort therapy.

 

Additional Supportive Conditions

 

  • Coverage may also be considered for individuals who have specific contraindications, allergies, or intolerances to alternative therapies.
  • Patients with special healthcare needs, where Symbicort is indicated as part of a broader, individualized treatment strategy recommended by healthcare professionals, may qualify.
  • Special circumstances, such as a need for therapy adjustment due to changes in clinical condition or treatment guidelines, may be supported with appropriate justification from healthcare providers.

 

Renewal of Symbicort Coverage

 

  • To renew coverage, patients must continue to meet the initial eligibility criteria and provide updated documentation as required.
  • Patients should submit evidence of ongoing need and effectiveness of the treatment as part of their reevaluation process.
  • Healthcare providers must document ongoing symptom management, therapeutic outcomes, and any incidences prompting therapy continuation or adjustment.

 

Why Centene Corporation Might Deny Symbicort Coverage

 

Reasons Centene Corporation Might Deny Symbicort Coverage

 

  • Symbicort is prescribed for an off-label use that is not FDA-approved. Off-label uses often do not receive coverage as they lack regulatory endorsement.
  •  

  • The patient does not meet the specific criteria outlined by Centene's policy, including age restrictions, pre-existing conditions, or other medical criteria that need to be satisfied for medication approval.
  •  

  • An appropriate generic alternative is available, and the patient has not tried it before. Centene may require the use of a generic equivalent as a first-line treatment.
  •  

  • The patient’s prescription does not align with Centene's step therapy protocols, which require trying less expensive options before approving more costly treatments like Symbicort.
  •  

  • There are issues with the documentation submitted by the healthcare provider, such as incomplete or missing prior authorization forms, which are necessary for obtaining coverage approval.
  •  

  • The patient’s coverage plan specifically excludes inhalers or maintenance medications, a stipulation found in certain insurance policy agreements.
  •  

  • The patient has exceeded the allowable quantity limits for Symbicort, which are set forth by the insurer to manage dosing and usage patterns.

 

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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 Centene Corporation

 

Contact Centene Corporation

 

  • Reach out to Centene Corporation's customer service via phone or their website to inquire about prescription coverage for Symbicort.
  •  

  • Request information on the specific healthcare plans that include Symbicort as a covered medication.

 

Review Current Insurance Benefits

 

  • Examine your current insurance policy details to check if Symbicort is already covered or qualifies for any special programs.
  •  

  • Get in touch with your insurance representative to confirm coverage specifics and any potential out-of-pocket costs.

 

Explore Centene Corporation Plans

 

  • Investigate Centene's different healthcare plans online, focusing on those that offer prescription drug coverage, including Symbicort.
  •  

  • Look for plans that match your healthcare needs and budget while providing the necessary medication coverage.

 

Switch to a Centene Plan

 

  • If your current plan does not cover Symbicort, consider enrolling in a Centene plan during the open enrollment period that does include the medication.
  •  

  • Consult with Centene's customer service to understand the enrollment process and any required documentation.

 

Obtain Necessary Authorizations

 

  • Consult your healthcare provider to obtain any prior authorization or documentation required for Symbicort.
  •  

  • Ensure your prescriptions are up-to-date and that you have a clear understanding of any refill requirements under the new plan.

 

Verify Coverage Upon Activation

 

  • Once enrolled in a Centene plan that covers Symbicort, verify that your medication is listed under your coverage benefits.
  •  

  • Check your insurance card or online member portal to confirm the inclusion of Symbicort and any related co-pay amounts.

 

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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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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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