$49$0.99

Does Group Health Cooperative (GHC) Cover Dupixent

Explore GHC coverage for Dupixent, reasons for denial, costs without insurance, and FAQs. Learn how to navigate coverage challenges effectively.

Treat your allergies with Curex

as seen on

“Curex is changing the landscape of allergies in 2024”

GHC's Coverage of Dupixent

GHC covers Dupixent primarily for conditions like moderate to severe atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyposis.

Authorization is typically required before prescription. This means your healthcare provider must demonstrate the medical necessity based on GHC's guidelines.

Coverage often depends on the severity of the condition, previous treatments tried and failed, and specialist recommendations.

Patients may need to show documented evidence of inadequate response or intolerance to other medications.

Approval for Dupixent might involve step therapy, where other treatment options are trialed first before moving to Dupixent.

Check the specific policy document or contact GHC directly as coverage details may vary and change over time.

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 Dupixent Coverage with Group Health Cooperative (GHC)

Understanding Your Coverage

Review your Group Health Cooperative (GHC) plan documents to understand the specifics of your coverage, particularly focusing on prescription drug benefits.

Check if Dupixent is listed on GHC's formulary, which is a list of medications covered by the health plan. You can usually find this information on GHC’s website or by contacting their customer service.

Determine if there are any specific criteria or steps you must meet for Dupixent to be covered, such as prior authorization or step therapy.

Consult with Your Healthcare Provider

Schedule an appointment with your healthcare provider to discuss your need for Dupixent and to confirm that it is a suitable treatment option for your condition.

Ask your provider to prepare a detailed prescription and possibly a letter of medical necessity, which outlines why Dupixent is essential for your treatment.

Prior Authorization Process

Contact GHC to determine if a prior authorization is required for Dupixent. This process involves your healthcare provider and potentially you filling out specific forms and providing relevant medical documentation.

Ensure your healthcare provider submits all required information to GHC to facilitate the approval process. This may include your diagnosis, previous treatments, and the necessity of Dupixent.

Appealing a Denial

If your request for Dupixent coverage is initially denied, obtain the denial reason from GHC. It is essential to understand why the denial was issued to effectively address and potentially overturn the decision.

Work with your healthcare provider to gather additional supporting documentation or to clarify the initial submission. They may need to provide a more detailed letter of medical necessity or additional rationale for choosing Dupixent.

Submit an appeal to GHC with the new information. Follow their procedures closely, including any deadlines to ensure timely reconsideration of your request.

Exploring Financial Assistance Programs

If coverage challenges persist, investigate financial assistance programs offered by the manufacturers of Dupixent or third-party organizations. These programs may offer financial help for patients with significant financial constraints or those dealing with insurance denials.

Contact the Dupixent MyWay® program, a patient support service that can help navigate insurance coverage, reimbursements, and potential financial assistance options.

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 Group Health Cooperative (GHC) Cover Dupixent

Explore GHC coverage for Dupixent, reasons for denial, costs without insurance, and FAQs. Learn how to navigate coverage challenges effectively.

Achieve Your Goals Faster with Curex

Is Dupixent Covered by Group Health Cooperative (GHC)

GHC's Coverage of Dupixent

GHC covers Dupixent primarily for conditions like moderate to severe atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyposis.

Authorization is typically required before prescription. This means your healthcare provider must demonstrate the medical necessity based on GHC's guidelines.

Coverage often depends on the severity of the condition, previous treatments tried and failed, and specialist recommendations.

Patients may need to show documented evidence of inadequate response or intolerance to other medications.

Approval for Dupixent might involve step therapy, where other treatment options are trialed first before moving to Dupixent.

Check the specific policy document or contact GHC directly as coverage details may vary and change over time.

A weight management program tailored to you

Start with Curex

Group Health Cooperative (GHC)'s Approved Criteria for Dupixent Coverage

Criteria for Dupixent Coverage

Dupixent is covered for the treatment of moderate-to-severe atopic dermatitis in adults and adolescents (aged 12 years or older) whose condition is not adequately controlled with topical prescription therapies or when those therapies are not advisable.

Dupixent coverage is available for patients with moderate-to-severe asthma whose condition is not adequately controlled with inhaled corticosteroids and other forms of maintenance therapy. Dupixent is indicated as an add-on maintenance treatment.

For patients with chronic rhinosinusitis with nasal polyposis (CRSwNP), Dupixent is covered for those 18 years and older who have inadequately controlled disease despite established guidelines-based treatment approaches.

Dupixent is approved for patients with eosinophilic esophagitis (EoE) who are at least 12 years old and weigh at least 40 kilograms, necessitating treatment beyond dietary restrictions and recommended medications that do not sufficiently manage the condition.

Authorization Requirements

Initial authorization is typically granted for a period of 12 months, based on medical necessity and documentation of clinical stability or improvement on this therapy.

For reauthorization, documentation must be provided showing continued clinical stability or improvement, adherence to therapy, and the absence of unacceptable toxicity or adverse events.

Complete patient medical history and records indicating previous unsuccessful treatments or contraindications for alternative therapies are required for the approval of Dupixent.

Why Group Health Cooperative (GHC) Might Deny Dupixent Coverage

Exclusion Criteria for Dupixent Coverage by Group Health Cooperative (GHC)

Prescriptions for Dupixent that do not meet the specific diagnosis requirements outlined in the GHC policy guidelines. This includes conditions not explicitly approved by the FDA.

Requests for Dupixent that exceed the recommended dosage or duration as established by health authorities and the GHC formulary.

Use of Dupixent for experimental or investigational purposes, as these uses are not typically covered by GHC under their insurance plans.

Treatment with Dupixent for off-label conditions unless specific authorization is provided following rigorous medical necessity criteria.

Applications for Dupixent that are not supported by adequate clinical documentation or evidence of prior treatment failure with standard therapies.

Situations where Dupixent coverage is requested without adherence to the required step therapy protocols as part of GHC’s utilization management strategies.

Continuity of coverage issues, such as changes in coverage plan or lapses in insurance, impacting the eligibility for Dupixent under the current plan terms.

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

Join Curex

How Much Does Dupixent Cost without Insurance?

Approximate Cost of Dupixent Without Insurance

The cost of Dupixent without insurance can be quite high, usually ranging between $3,200 to $3,500 per month. This cost is for the standard dose, which consists of two pre-filled syringes or injection pens, each containing 300 mg of medication.

Prices can vary depending on the pharmacy, location, and any potential deals or discounts offered by specific pharmacies or third-party services.

Patients are encouraged to explore manufacturer copay cards, patient assistance programs, or discount cards which might be available to help reduce out-of-pocket expenses.

For those requiring treatment for conditions like eczema, asthma, or other approved uses, Dupixent is often administered bi-weekly after an initial loading dose, which should be taken into consideration when calculating monthly or annual expenses.

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 Dupixent Coverage with Group Health Cooperative (GHC)

Understanding Your Coverage

Review your Group Health Cooperative (GHC) plan documents to understand the specifics of your coverage, particularly focusing on prescription drug benefits.

Check if Dupixent is listed on GHC's formulary, which is a list of medications covered by the health plan. You can usually find this information on GHC’s website or by contacting their customer service.

Determine if there are any specific criteria or steps you must meet for Dupixent to be covered, such as prior authorization or step therapy.

Consult with Your Healthcare Provider

Schedule an appointment with your healthcare provider to discuss your need for Dupixent and to confirm that it is a suitable treatment option for your condition.

Ask your provider to prepare a detailed prescription and possibly a letter of medical necessity, which outlines why Dupixent is essential for your treatment.

Prior Authorization Process

Contact GHC to determine if a prior authorization is required for Dupixent. This process involves your healthcare provider and potentially you filling out specific forms and providing relevant medical documentation.

Ensure your healthcare provider submits all required information to GHC to facilitate the approval process. This may include your diagnosis, previous treatments, and the necessity of Dupixent.

Appealing a Denial

If your request for Dupixent coverage is initially denied, obtain the denial reason from GHC. It is essential to understand why the denial was issued to effectively address and potentially overturn the decision.

Work with your healthcare provider to gather additional supporting documentation or to clarify the initial submission. They may need to provide a more detailed letter of medical necessity or additional rationale for choosing Dupixent.

Submit an appeal to GHC with the new information. Follow their procedures closely, including any deadlines to ensure timely reconsideration of your request.

Exploring Financial Assistance Programs

If coverage challenges persist, investigate financial assistance programs offered by the manufacturers of Dupixent or third-party organizations. These programs may offer financial help for patients with significant financial constraints or those dealing with insurance denials.

Contact the Dupixent MyWay® program, a patient support service that can help navigate insurance coverage, reimbursements, and potential financial assistance options.

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.

Dupixent FAQ

1. What are the common side effects of Dupixent?

Common Side Effects of Dupixent

Injection site reactions: redness, swelling, and pain at the injection site are frequently reported. These reactions usually subside shortly after injection.

Conjunctivitis: Some patients experience symptoms like red, itchy, or watery eyes.

Blepharitis: Inflammation of the eyelids, leading to symptoms such as redness, swelling, and itching, may occur.

Oral herpes: A mild increase in probabilities of cold sores has been noted in some cases.

Sore throat: Some individuals may develop pharyngitis, which manifests as throat discomfort or pain.

2. How does Dupixent work for eczema?

How Dupixent Works for Eczema

Dupixent is a monoclonal antibody that targets interleukin-4 receptor alpha (IL-4Rα).

By blocking IL-4Rα, it inhibits the signaling pathways of IL-4 and IL-13, key cytokines involved in the inflammatory response in eczema.

This leads to a reduction in the overactive immune response, which is characterized by inflammation and itchiness in atopic dermatitis.

As a result, Dupixent helps alleviate symptoms like redness, itch, and skin thickening by modulating the immune response.

3. Is Dupixent used for asthma treatment?

Dupixent for Asthma

Dupixent (dupilumab) is approved for use in the treatment of moderate-to-severe asthma in adults and adolescents (12 years and older).

It is particularly beneficial for patients with eosinophilic asthma or those dependent on oral corticosteroids.

Dupixent acts by targeting and inhibiting the signaling of interleukins IL-4 and IL-13, which play central roles in the inflammatory response involved in asthma.

The medication is administered via subcutaneous injection, typically every two weeks after an initial loading dose.

Clinical trials have shown Dupixent to reduce asthma exacerbations and improve lung function, thereby potentially reducing the need for oral corticosteroids.

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 Group Health Cooperative (GHC) Cover Dupixent

Explore GHC coverage for Dupixent, reasons for denial, costs without insurance, and FAQs. Learn how to navigate coverage challenges effectively.

Achieve Your Goals Faster with Curex