Does Geisinger Health Plan Cover Benzphetamine (Didrex)

Explore if Geisinger Health Plan covers Benzphetamine (Didrex), reasons for denial, how to secure coverage, costs without insurance, and FAQs.
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Benzphetamine (Didrex) Coverage

 

  • Geisinger Health Plan may cover Benzphetamine (Didrex) as part of its prescription drug benefits, but coverage depends on specific plan details.
  •  

  • The medication is typically prescribed for weight loss, and coverage might require prior authorization.
  •  

  • Geisinger Health Plan often stipulates that Benzphetamine should be used in combination with a doctor-approved exercise, behavior change, and reduced-calorie diet program.
  •  

  • For coverage, patients may need to meet certain criteria, such as a documented body mass index (BMI) requirement or evidence of obesity-related health conditions.
  •  

  • Plan members should contact Geisinger directly or review their plan documents for the most precise information regarding their specific benefits and coverage criteria.

 

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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.

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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.

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Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

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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 Benzphetamine (Didrex) Coverage with Geisinger Health Plan

 

Confirm Benzphetamine (Didrex) in Your Plan Formulary

 

  • Visit the Geisinger Health Plan website and access their formulary to check if Benzphetamine (Didrex) is covered under your specific plan.
  •  

  • If not listed, contact Geisinger Health Plan customer service to inquire about potential coverage options or alternative medications.

 

Verify Prescription Coverage Requirements

 

  • Consult your plan’s documentation or online member portal to understand any specific requirements for covering Benzphetamine, such as prior authorization or step therapy.
  •  

  • For further clarification, contact the customer service department for detailed guidance on fulfilling these requirements.

 

Consult with Your Healthcare Provider

 

  • Discuss with your doctor the necessity of Benzphetamine for your treatment. Ensure that it fits into your health needs and the criteria outlined by the Geisinger Health Plan.
  •  

  • Request that your healthcare provider be prepared to submit any necessary documentation to support your prescription, such as a prior authorization form.

 

Submit a Prior Authorization Request

 

  • Have your healthcare provider submit a prior authorization request to Geisinger Health Plan, if required. This request typically includes medical necessity documentation for Benzphetamine.
  •  

  • Track the progress of the prior authorization through your healthcare provider or the Geisinger Health Plan member portal to ensure timely processing.

 

Utilize Cost-Saving Options

 

  • Explore generic alternatives or cost-sharing options recommended by Geisinger Health Plan if Benzphetamine is not fully covered. Discuss these alternatives with your healthcare provider.
  •  

  • Check for any available discounts or pharmaceutical assistance programs that may reduce the cost of Benzphetamine.

 

File an Appeal if Necessary

 

  • If your initial request for coverage is denied, file an appeal with Geisinger Health Plan. Gather additional supporting documentation from your healthcare provider for submission.
  •  

  • Follow the appeal process outlined in your plan documents, which may include written requests or phone calls to the appeals department.

 

Review the Benefits Plan Regularly

 

  • Periodically review your benefits plan details and stay updated on any changes impacting medication coverage, including formulary adjustments by Geisinger Health Plan.
  •  

  • Contact customer service with any questions or clarifications regarding ongoing coverage or new prescription needs.

 

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FAQs

Does Geisinger Health Plan Cover Benzphetamine (Didrex)

Explore if Geisinger Health Plan covers Benzphetamine (Didrex), reasons for denial, how to secure coverage, costs without insurance, and FAQs.
Curex allergy drops unboxing

Is Benzphetamine (Didrex) Covered by Geisinger Health Plan

 

Benzphetamine (Didrex) Coverage

 

  • Geisinger Health Plan may cover Benzphetamine (Didrex) as part of its prescription drug benefits, but coverage depends on specific plan details.
  •  

  • The medication is typically prescribed for weight loss, and coverage might require prior authorization.
  •  

  • Geisinger Health Plan often stipulates that Benzphetamine should be used in combination with a doctor-approved exercise, behavior change, and reduced-calorie diet program.
  •  

  • For coverage, patients may need to meet certain criteria, such as a documented body mass index (BMI) requirement or evidence of obesity-related health conditions.
  •  

  • Plan members should contact Geisinger directly or review their plan documents for the most precise information regarding their specific benefits and coverage criteria.

 

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Geisinger Health Plan's Approved Criteria for Benzphetamine (Didrex) Coverage

 

Criteria for Benzphetamine (Didrex) Coverage

 

  • The patient must be diagnosed with obesity, characterized by a body mass index (BMI) of 30 kg/m2 or greater.
  •  

  • If the patient has a BMI of 27 kg/m2 or greater, there must be at least one weight-related comorbidity such as hypertension, type 2 diabetes, or dyslipidemia.
  •  

  • The patient must have failed to achieve weight loss after attempting lifestyle interventions, including diet and exercise programs, as documented within medical records.
  •  

  • Benzphetamine must be prescribed by a healthcare provider who specializes in obesity management or weight-related disorders.
  •  

  • The patient should not have any contraindications, such as a history of cardiovascular disease, uncontrolled hypertension, hyperthyroidism, or glaucoma.
  •  

  • A complete medical history and physical examination must be provided, confirming the appropriateness of benzphetamine as a weight management tool for the patient.
  •  

  • The prescription is for a short-term treatment plan not exceeding 12 weeks.
  •  

  • An initial assessment should be conducted to evaluate potential benefits and risks associated with benzphetamine use, with continuous monitoring for possible side effects throughout the treatment period.
  •  

  • The healthcare provider must provide documentation of the patient's commitment to adhering to a comprehensive weight management program including dietary intervention, physical activity, and behavioral therapy.
  •  

 

Why Geisinger Health Plan Might Deny Benzphetamine (Didrex) Coverage

 

Reasons for Denial of Benzphetamine Coverage

 

  • Lack of Medical Necessity: If Benzphetamine (Didrex) is not deemed medically necessary based on the patient's current health status or condition, the health plan may deny coverage.
  •  

  • Non-Compliance with Plan's Formulary: The drug may not be included in the Geisinger Health Plan's formulary list, leading to a denial of coverage if prescribed.
  •  

  • Absence of Prior Authorization: Benzphetamine might require prior authorization from the insurer, without which the coverage can be denied.
  •  

  • Exceeding Prescribed Dosage: If the prescribed dosage or duration of therapy exceeds the plan's limits, coverage may be refused.
  •  

  • Use for Non-Approved Indications: Coverage can be denied if Benzphetamine is used for purposes not approved by the appropriate health authorities.
  •  

  • Patient Ineligibility: If the patient does not meet the specific eligibility criteria defined by the plan, such as age or diagnosed condition, coverage might not be provided.
  •  

  • Failure to Try Alternatives: The health plan may require that other weight-loss drugs or therapies be tried first; failure to do so can lead to denied coverage.
  •  

 

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How Much Does Benzphetamine (Didrex) Cost without Insurance?

 

Understanding Benzphetamine (Didrex) Cost

 

  • Benzphetamine, commonly known by the brand name Didrex, is a prescription medication used as a short-term adjunct in weight reduction therapy.
  •  

  • The cost of Benzphetamine without insurance can vary significantly depending on the pharmacy and the dosage prescribed.
  •  

  • On average, the cost for a 30-day supply of Benzphetamine (50 mg tablets) can range from $40 to $70.
  •  

  • Prices may be higher or lower, depending on location, pharmacy pricing policies, and available discounts or coupons.
  •  

  • Pharmacy discount programs and generic versions of the drug may offer cost savings.

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 Benzphetamine (Didrex) Coverage with Geisinger Health Plan

 

Confirm Benzphetamine (Didrex) in Your Plan Formulary

 

  • Visit the Geisinger Health Plan website and access their formulary to check if Benzphetamine (Didrex) is covered under your specific plan.
  •  

  • If not listed, contact Geisinger Health Plan customer service to inquire about potential coverage options or alternative medications.

 

Verify Prescription Coverage Requirements

 

  • Consult your plan’s documentation or online member portal to understand any specific requirements for covering Benzphetamine, such as prior authorization or step therapy.
  •  

  • For further clarification, contact the customer service department for detailed guidance on fulfilling these requirements.

 

Consult with Your Healthcare Provider

 

  • Discuss with your doctor the necessity of Benzphetamine for your treatment. Ensure that it fits into your health needs and the criteria outlined by the Geisinger Health Plan.
  •  

  • Request that your healthcare provider be prepared to submit any necessary documentation to support your prescription, such as a prior authorization form.

 

Submit a Prior Authorization Request

 

  • Have your healthcare provider submit a prior authorization request to Geisinger Health Plan, if required. This request typically includes medical necessity documentation for Benzphetamine.
  •  

  • Track the progress of the prior authorization through your healthcare provider or the Geisinger Health Plan member portal to ensure timely processing.

 

Utilize Cost-Saving Options

 

  • Explore generic alternatives or cost-sharing options recommended by Geisinger Health Plan if Benzphetamine is not fully covered. Discuss these alternatives with your healthcare provider.
  •  

  • Check for any available discounts or pharmaceutical assistance programs that may reduce the cost of Benzphetamine.

 

File an Appeal if Necessary

 

  • If your initial request for coverage is denied, file an appeal with Geisinger Health Plan. Gather additional supporting documentation from your healthcare provider for submission.
  •  

  • Follow the appeal process outlined in your plan documents, which may include written requests or phone calls to the appeals department.

 

Review the Benefits Plan Regularly

 

  • Periodically review your benefits plan details and stay updated on any changes impacting medication coverage, including formulary adjustments by Geisinger Health Plan.
  •  

  • Contact customer service with any questions or clarifications regarding ongoing coverage or new prescription needs.

 

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Benzphetamine (Didrex) FAQ

What are the side effects of Benzphetamine (Didrex)?

 

Common Side Effects

 

  • Insomnia
  • Nervousness
  • Dizziness
  • Dry Mouth
  • Headache
  • Constipation

 

Severe Side Effects

 

  • Increased Blood Pressure
  • Heart Palpitations
  • Seizures
  • Severe Mood Changes
  • Chest Pain
  • Breathing Difficulties

 

Important Considerations

 

  • If you experience severe side effects, seek medical attention immediately.
  • Use cautiously if you have a history of cardiovascular conditions.
  • Avoid usage in individuals with a history of drug abuse.
  • Always follow the prescribed dosage to minimize risks.
  • Inform your doctor of any existing health conditions or medications.

 

How does Benzphetamine help with weight loss?

 

Mechanism of Action

 

  • Benzphetamine is an appetite suppressant. It stimulates the central nervous system, which increases heart rate and blood pressure.
  •  
  • This leads to a reduced appetite and a feeling of fullness, helping individuals to control their caloric intake.

 

Usage Guidelines

 

  • It should be used as part of a comprehensive weight loss plan, including diet, exercise, and behavioral modification.
  •  
  • Typically prescribed for short-term use to jump-start weight loss efforts.

 

Precautions

 

  • Not suitable for individuals with a history of cardiovascular diseases, hyperthyroidism, or glaucoma.
  •  
  • It may cause side effects such as insomnia, dizziness, and dry mouth.

Is Benzphetamine similar to Phentermine?

 

Similarity between Benzphetamine and Phentermine

 

  • Benzphetamine (Didrex) and Phentermine are both stimulant medications primarily used to treat obesity.
  •  

  • They function as appetite suppressants by affecting the central nervous system.
  •  

  • Both are chemically related to amphetamines but are not classified as amphetamines themselves.

 

Differences

 

  • Benzphetamine is a prodrug and metabolizes into amphetamine and methamphetamine, while Phentermine does not convert into amphetamine derivatives.
  •  

  • Phentermine is generally preferred due to a more established safety profile and fewer side effects compared to Benzphetamine.
  •  

  • Phentermine is typically dosed once daily, whereas Benzphetamine might require multiple doses.

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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.

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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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