$49$0.99

Does Gateway Health Plan Cover Aimovig

Explore Gateway Health's Aimovig coverage, reasons for denial, steps to obtain coverage, cost without insurance, and FAQs in this comprehensive guide.

Treat your allergies with Curex

as seen on

“Curex is changing the landscape of allergies in 2024”

Coverage for Aimovig with Gateway Health Plan

Check your specific plan details, as coverage may vary based on your plan type (Medicare, Medicaid, or Marketplace).

Aimovig may be covered if it's deemed medically necessary, typically for preventing migraines in patients who meet specific criteria.

Pre-authorization is usually required before you can receive coverage for Aimovig.

You might need documentation from your healthcare provider proving the necessity of Aimovig for your condition.

Your healthcare provider might also need to demonstrate that other treatment options have been tried and found ineffective.

Coverage can also depend on the formulary list of your specific plan, which outlines preferred medications and potential alternatives.

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.

Start Now

Clinical Support

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 Aimovig Coverage with Gateway Health Plan

Verify Coverage with Gateway Health Plan

Contact Gateway Health Plan's customer service to confirm if Aimovig is included in your current plan's formulary.

Review your plan's documentation for specific coverage criteria for Aimovig, including any step therapy requirements or prior authorization needs.

Consult Your Healthcare Provider

Discuss with your healthcare provider about the necessity of Aimovig for your treatment. Your provider can provide medical justification if needed.

Ask your provider to write a prescription for Aimovig that meets the plan's requirements.

Prior Authorization Process

If prior authorization is required, your healthcare provider or their staff will need to submit a request to Gateway Health Plan.

Ensure that all necessary documentation supporting the medical necessity of Aimovig is included with the request.

Appeal Process if Denied

If your prior authorization is denied, review the denial letter for the stated reasons and the appeals process.

Work with your healthcare provider to address the reasons for denial and resubmit with additional supporting information if necessary.

Check for Copay Assistance Programs

Explore any manufacturer copay assistance programs for Aimovig that could help reduce out-of-pocket costs.

Verify with Gateway Health Plan if these programs can be applied in conjunction with your insurance coverage.

Happy Customers

We love helping people!

Allie, Nevada

"I have two cats I can finally cuddle!"
‍

Cat and dog allergies

Zachary, Texas

“I can breathe through my nose for the first time in like 20 years!"

Dust and mold allergies

Erika, New York

“I've noticed less sneezing and shortness of breath.”

Tree and grass allergies

Richard, Texas

I love the convenience!
‍

Tree and cat allergies

We Treat Allergies

Food Allergies

Weed Pollens

Cat Allergies

Dog Allergies

Dust Mites

Molds

Tree Pollens

curex user showing allergy treatment kit

a male patient showing allergy drops vial

50,000+ users have overcome their allergies

Am I eligible?

At-home Immunotherapy

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

Treatment prescribed
by clinician

Clinicaly made allergen extracts are customized for your allergies

Your immune system gets desensitized to allergens, giving you long-term relief.

FAQs

Does Gateway Health Plan Cover Aimovig

Explore Gateway Health's Aimovig coverage, reasons for denial, steps to obtain coverage, cost without insurance, and FAQs in this comprehensive guide.

Achieve Your Goals Faster with Curex

Is Aimovig Covered by Gateway Health Plan

Coverage for Aimovig with Gateway Health Plan

Check your specific plan details, as coverage may vary based on your plan type (Medicare, Medicaid, or Marketplace).

Aimovig may be covered if it's deemed medically necessary, typically for preventing migraines in patients who meet specific criteria.

Pre-authorization is usually required before you can receive coverage for Aimovig.

You might need documentation from your healthcare provider proving the necessity of Aimovig for your condition.

Your healthcare provider might also need to demonstrate that other treatment options have been tried and found ineffective.

Coverage can also depend on the formulary list of your specific plan, which outlines preferred medications and potential alternatives.

A weight management program tailored to you

Start with Curex

Gateway Health Plan's Approved Criteria for Aimovig Coverage

Eligibility Requirements for Aimovig Coverage

The patient must have a confirmed diagnosis of a chronic or episodic migraine. Documentation from a healthcare provider validating the migraine diagnosis is required for coverage consideration.

Patients must have experienced inadequate response, intolerance, or contraindication to at least two forms of preventive migraine therapies prior to being approved for Aimovig under Gateway Health Plan.

The prescribed dosage of Aimovig must align with FDA-approved indications and guidelines. Any deviation from the standard dosing requires special consideration and documentation by the healthcare provider.

Patients are required to be evaluated on a regular basis to determine the effectiveness of Aimovig in reducing the frequency and severity of migraine episodes. Continued coverage is dependent on documented clinical benefit.

Consideration for coverage includes an assessment of the patient's current migraine management plan, with an emphasis on ensuring Aimovig is being used as a part of an integrated treatment approach.

Required Documentation for Coverage

A completed and signed prescription form from a licensed healthcare provider specializing in neurology or with demonstrable experience in treating migraines.

Current medical records illustrating the patient's history of migraine treatment, including past and present medications, therapies, and their respective outcomes.

A comprehensive treatment plan that includes Aimovig as a component of migraine management, with specific goals and expected outcomes of therapy discussed.

Documentation of previous preventive migraine treatment attempts, outlining failures, adverse effects, or contraindications necessitating a change to Aimovig.

Prior Authorization Requirements

Prior authorization is mandatory for all patients seeking coverage for Aimovig. The process involves submitting the required documentation and fulfilling predefined criteria as outlined by Gateway Health Plan.

All requests must be submitted through Gateway Health Plan's designated channels, with fully completed forms to avoid delays or denials of coverage requests.

Regular review and reauthorization are necessary to ensure ongoing coverage, requiring updated clinical reports and assessments to justify the continued use of Aimovig.

Why Gateway Health Plan Might Deny Aimovig Coverage

Reasons Why Gateway Health Plan Might Deny Aimovig Coverage

Non-FDA Approved Uses: Gateway Health Plan does not cover Aimovig for uses that have not been approved by the FDA. If the patient is seeking coverage for a condition or use not described in the approved labeling, coverage may be denied.

Lack of Prior Authorization: Aimovig may not be covered if it is not pre-approved through Gateway Health Plan's prior authorization process. Failure to obtain this authorization before receiving treatment can result in a denial of coverage.

Non-Formulary Medication: Aimovig could be excluded from coverage if it is not included on Gateway Health Plan's approved drug formulary. Drugs that are not listed on the formulary may require a special exception, and without it, coverage may be denied.

Insufficient Medical Necessity: Coverage for Aimovig might be denied if Gateway Health Plan determines that the medication is not medically necessary. This decision can be based on a lack of documented medical necessity or if the patient’s health condition does not meet the plan’s established criteria for use.

Alternative Treatments Not Exhausted: If there is an expectation that lower-cost alternatives or generic options have not been exhausted beforehand, Aimovig coverage could be denied. The plan may require documented evidence of trying alternative therapies.

Policy-Specific Exclusions: Some Gateway Health Plan policies may have specific exclusions that disallow certain medications, including Aimovig. These exclusions are typically stated in the coverage policy documents.

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

Join Curex

How Much Does Aimovig Cost without Insurance?

Understanding the Cost of Aimovig Without Insurance

Aimovig, a medication for preventing migraines, can be quite expensive without insurance coverage.
The cost of Aimovig typically ranges from $575 to $725 per month for a single dose, depending on the pharmacy and geographic location.
This price reflects the retail cost for the 70 mg dosage, which is commonly used in migraine prevention treatment.
The 140 mg dosage generally costs about the same per unit; however, as a higher dose, it could be slightly more expensive overall, since some patients might be prescribed two doses of 70 mg.

Additional Considerations

Prices can vary significantly due to factors such as pharmacy pricing policies, location, and availability.
Discount programs and pharmaceutical aid may be available for eligible patients, which can help reduce the out-of-pocket cost.
It's advisable for patients to shop around, as different pharmacies may offer various pricing or additional discounts.
Patients should also consider discussing with their healthcare provider about any available generic alternatives or other cost-effective treatment options.

Clinical Support

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

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

Kayla Mardaga, NP

How to Get Aimovig Coverage with Gateway Health Plan

Verify Coverage with Gateway Health Plan

Contact Gateway Health Plan's customer service to confirm if Aimovig is included in your current plan's formulary.

Review your plan's documentation for specific coverage criteria for Aimovig, including any step therapy requirements or prior authorization needs.

Consult Your Healthcare Provider

Discuss with your healthcare provider about the necessity of Aimovig for your treatment. Your provider can provide medical justification if needed.

Ask your provider to write a prescription for Aimovig that meets the plan's requirements.

Prior Authorization Process

If prior authorization is required, your healthcare provider or their staff will need to submit a request to Gateway Health Plan.

Ensure that all necessary documentation supporting the medical necessity of Aimovig is included with the request.

Appeal Process if Denied

If your prior authorization is denied, review the denial letter for the stated reasons and the appeals process.

Work with your healthcare provider to address the reasons for denial and resubmit with additional supporting information if necessary.

Check for Copay Assistance Programs

Explore any manufacturer copay assistance programs for Aimovig that could help reduce out-of-pocket costs.

Verify with Gateway Health Plan if these programs can be applied in conjunction with your insurance coverage.

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.

Aimovig FAQ

1. What are the common side effects of Aimovig?

Common Side Effects of Aimovig

**Injection site reactions**: You may experience pain, redness, or swelling where the injection was administered.

**Constipation**: This is a frequently reported side effect, which may vary in severity.

**Muscle spasms**: Some patients may encounter muscle spasms post-administration.

**Fatigue**: Feeling unusually tired or exhausted can commonly occur.

**Nausea**: A feeling of queasiness may be experienced, often mild but potentially bothersome.

Note

Consult with a healthcare provider if side effects persist or worsen.

Serious side effects are rare but should be addressed immediately with professional advice.

2. How does Aimovig work to prevent migraines?

What is Aimovig?

Aimovig is a monoclonal antibody used for preventing migraines by targeting the CGRP pathway.

How Aimovig Works

Aimovig binds to the calcitonin gene-related peptide (CGRP) receptor, inhibiting its activity.
By blocking CGRP, Aimovig reduces vasodilation and inflammation, commonly linked to migraines.
This prevention mechanism helps decrease the frequency and intensity of migraine attacks.

Usage and Administration

Aimovig is administered through a monthly subcutaneous injection, making it convenient for most patients.
It's crucial to follow prescribed dosing and consult healthcare providers if any side effects occur.

3. How long does it take for Aimovig to start working?

How Aimovig Works

Aimovig is a monoclonal antibody that targets and inhibits the CGRP receptor, helping to prevent migraine onset.

It is specifically designed to reduce the frequency of migraine days by interfering with a key pathway in migraine pathophysiology.

Onset of Effects

Patients may begin to notice a reduction in migraine frequency as early as one week after the first injection.

Clinical trials indicate that significant reduction in migraine days is typically observed within 3 to 4 weeks of starting Aimovig.

Full therapeutic benefits can develop over subsequent months, and individual response times may vary.

Recommendations

Maintain a migraine diary to monitor changes and discuss them with your healthcare provider.

Continue regular check-ins with your doctor to assess effectiveness and make any necessary adjustments to treatment.

Have questions left?

‍

Get a personalized online consultation with a doctor at Curex

Learn More

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

Button Text

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. 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?

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.

Can you prescribe Ozempic®* or Wegovy®*?

Our providers focus on personalized medications and dosages that aren’t commercially available at your local pharmacy. We don’t prescribe Ozempic®* or Wegovy®.* We may prescribe treatments containing compounded semaglutide or tirzepatide. 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.

Does Gateway Health Plan Cover Aimovig

Explore Gateway Health's Aimovig coverage, reasons for denial, steps to obtain coverage, cost without insurance, and FAQs in this comprehensive guide.

Achieve Your Goals Faster with Curex