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Does Humana Cover Dulera

Discover why Humana might deny Dulera coverage and learn how to obtain it. Find out Dulera costs without insurance and get answers in the FAQ section.
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Does Humana Cover Dulera?

 

  • Humana generally covers Dulera, a prescription medication used to treat asthma. Coverage depends on your specific Humana plan and its formulary tiers.

    •  

  • Eligibility requires a valid prescription from a healthcare provider. It is essential to confirm Dulera is listed in your plan's formulary and understand any related costs.

    •  

  • Certain plans may require prior authorization before filling your prescription, ensuring the medication is medically necessary.

    •  

  • Consider generic alternatives or preferred brands that may be more affordable or have better coverage terms under your plan.

    •  

  • Review your policy for copayments, deductibles, or coinsurance obligations, as these factors impact out-of-pocket expenses.

 

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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 Dulera Coverage with Humana

 

Check Your Plan Benefits

 

  • Log in to your Humana member portal to review your current plan details. Look specifically for prescription drug coverage information.

    •  

  • Ensure that your plan includes coverage for Dulera or check if it covers the category of medications that Dulera belongs to.

 

Consult the Formulary

 

  • Access Humana's online formulary, which is the list of covered drugs. You can usually find this in the "Prescription Drug Information" section on the Humana website.

    •  

  • Search for Dulera to confirm whether it is listed as a covered drug under your plan's formulary.

 

Contact Customer Service

 

  • If Dulera isn't explicitly listed, or if you're unsure of your plan's details, call Humana's customer service number. This phone number can be found on the back of your Humana member ID card.

    •  

  • Ask specifically about Dulera coverage and any steps you need to take to ensure it is covered under your plan.

 

Consult Your Doctor

 

  • Speak to your healthcare provider about your Dulera prescription. They can provide a dosage that may be covered, or suggest alternatives that might be covered by Humana.

    •  

  • Your healthcare provider can also write a letter of medical necessity if prior authorization or an exception is required for Dulera coverage.

 

Request Prior Authorization

 

  • If Dulera requires prior authorization, obtain the necessary forms from Humana's website or customer service.

    •  

  • Your doctor will need to fill out and submit these forms, providing any documentation that supports the medical necessity for Dulera.

 

Check Pharmacy Network

 

  • Ensure that the pharmacy you plan to use is within Humana's network. Using a network pharmacy can affect how much you pay out-of-pocket for medications like Dulera.

    •  

  • You can find a list of in-network pharmacies on the Humana website or by calling customer service for assistance.

 

Follow Up

 

  • Keep track of the submission process if prior authorization or requests are being processed. This may involve following up with your healthcare provider or Humana to check the status.

    •  

  • Once approved, confirm with your pharmacy that Dulera is covered under your plan and ensure your medication is ready for pickup.

 

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FAQs

Does Humana Cover Dulera

Discover why Humana might deny Dulera coverage and learn how to obtain it. Find out Dulera costs without insurance and get answers in the FAQ section.
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Is Dulera Covered by Humana

 

Does Humana Cover Dulera?

 

  • Humana generally covers Dulera, a prescription medication used to treat asthma. Coverage depends on your specific Humana plan and its formulary tiers.

    •  

  • Eligibility requires a valid prescription from a healthcare provider. It is essential to confirm Dulera is listed in your plan's formulary and understand any related costs.

    •  

  • Certain plans may require prior authorization before filling your prescription, ensuring the medication is medically necessary.

    •  

  • Consider generic alternatives or preferred brands that may be more affordable or have better coverage terms under your plan.

    •  

  • Review your policy for copayments, deductibles, or coinsurance obligations, as these factors impact out-of-pocket expenses.

 

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Humana's Approved Criteria for Dulera Coverage

 

Humana's Approved Criteria for Dulera Coverage

 

  • **Diagnosis Confirmation**: Patient has a confirmed diagnosis of asthma requiring maintenance therapy. The diagnosis should be supported by relevant clinical evaluations and testing results done by healthcare professionals.

    •  

  • **Age Requirement**: Dulera coverage is approved for individuals aged 12 years and older. Patients younger than 12 must seek alternative treatment options approved for their age group.

    •  

  • **Previous Medication Trials**: Patient must have tried and had an inadequate response, intolerance, or contraindication to other maintenance asthma therapies, such as inhaled corticosteroids or other combination inhalers like Advair or Symbicort.

    •  

  • **Prescription by Specialist**: Coverage requires that Dulera is prescribed by a pulmonologist, allergist, or a healthcare provider specializing in asthma management.

    •  

  • **Adherence to Treatment Protocols**: Patients are expected to adhere to prescribed doses and treatment protocols, and have documented evaluations to ascertain the effectiveness of the medication.

    •  

  • **Regular Monitoring**: The patient should be under regular monitoring to assess the control of asthma symptoms and any potential side effects. Such monitoring should be documented in the patient's medical records.

    •  

  • **Combination Use Justification**: If Dulera is used in combination with other inhalation therapies, there must be documented medical justification showing its necessity for achieving optimal asthma control.

    •  

  • **Authorization Period**: Approved authorization for Dulera typically covers periods of 6 to 12 months, following which reassessment and reauthorization may be required to continue coverage.

 

Why Humana Might Deny Dulera Coverage

 

Why Humana Might Deny Dulera Coverage

 

  • Humana might deny coverage for Dulera if the medication is prescribed for off-label uses not approved by the FDA or not supported by peer-reviewed medical literature.

    •  

  • If Dulera is not listed as a preferred or formulary drug, Humana may deny coverage unless a formulary exception is granted based on medical necessity.

    •  

  • Humana may deny coverage if the required prior authorization process has not been completed or if the authorization request does not meet specific medical criteria.

    •  

  • In cases where there is lack of documentation proving that Dulera is medically necessary and that alternative treatments have been ineffective, coverage can be denied.

    •  

  • If the patient's current health plan does not include coverage for respiratory medications or if the specific plan excludes treatments like Dulera, Humana might not cover it.

    •  

  • Humana might deny coverage due to incomplete or missing documentation from the healthcare provider about the patient's diagnosis or treatment history.

    •  

  • Drug coverage might be denied if Dulera is being prescribed in conjunction with other medications known to be contraindicated, according to Humana's drug interaction guidelines.

 

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How Much Does Dulera Cost without Insurance?

 

Approximate Cost of Dulera Without Insurance

 

  • The cost of Dulera, which is used to help control symptoms of asthma, can vary depending on the pharmacy and location. However, the typical price for a one-month supply (inhaler) of Dulera without insurance is approximately $250 to $350.

    •  

  • This price may differ based on dosage strength, and whether you're purchasing a brand name or a generic version if available.

    •  

  • Prices can fluctuate, and it is advisable to check with different pharmacies or consider using discount cards or coupons that might be available to reduce the cost.

    •  

  • Additionally, some pharmaceutical companies offer patient assistance programs for those who qualify, which can significantly lower the cost of Dulera.

 

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 Dulera Coverage with Humana

 

Check Your Plan Benefits

 

  • Log in to your Humana member portal to review your current plan details. Look specifically for prescription drug coverage information.

    •  

  • Ensure that your plan includes coverage for Dulera or check if it covers the category of medications that Dulera belongs to.

 

Consult the Formulary

 

  • Access Humana's online formulary, which is the list of covered drugs. You can usually find this in the "Prescription Drug Information" section on the Humana website.

    •  

  • Search for Dulera to confirm whether it is listed as a covered drug under your plan's formulary.

 

Contact Customer Service

 

  • If Dulera isn't explicitly listed, or if you're unsure of your plan's details, call Humana's customer service number. This phone number can be found on the back of your Humana member ID card.

    •  

  • Ask specifically about Dulera coverage and any steps you need to take to ensure it is covered under your plan.

 

Consult Your Doctor

 

  • Speak to your healthcare provider about your Dulera prescription. They can provide a dosage that may be covered, or suggest alternatives that might be covered by Humana.

    •  

  • Your healthcare provider can also write a letter of medical necessity if prior authorization or an exception is required for Dulera coverage.

 

Request Prior Authorization

 

  • If Dulera requires prior authorization, obtain the necessary forms from Humana's website or customer service.

    •  

  • Your doctor will need to fill out and submit these forms, providing any documentation that supports the medical necessity for Dulera.

 

Check Pharmacy Network

 

  • Ensure that the pharmacy you plan to use is within Humana's network. Using a network pharmacy can affect how much you pay out-of-pocket for medications like Dulera.

    •  

  • You can find a list of in-network pharmacies on the Humana website or by calling customer service for assistance.

 

Follow Up

 

  • Keep track of the submission process if prior authorization or requests are being processed. This may involve following up with your healthcare provider or Humana to check the status.

    •  

  • Once approved, confirm with your pharmacy that Dulera is covered under your plan and ensure your medication is ready for pickup.

 

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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.

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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.

Dulera FAQ

What are the side effects of Dulera?

 

Common Side Effects of Dulera

 

  • Headache
  • Sore throat
  • Sinus pain
  • Nosebleed
  • Oral thrush (fungal infection)

 

Serious Side Effects

 

  • Wheezing or breathing problems
  • Severe allergic reactions (rash, itching/swelling)
  • Vision problems
  • Reduced bone density with long-term use

 

Monitoring and Precautions

 

  • Regularly check bone health and eye exams
  • Rinse mouth after inhalation to prevent oral infections
  • Consult your doctor if side effects worsen or persist

 

How does Dulera work for asthma?

 

Mechanism of Action

 

  • Dulera is a combination inhaler containing mometasone (a corticosteroid) and formoterol (a long-acting beta-agonist).

    •  

  • Mometasone reduces inflammation in the airways, minimizing swelling and irritation.

    •  

  • Formoterol relaxes bronchial muscles, improving airflow and easing breathing.

 

Benefits for Asthma

 

  • Helps prevent asthma attacks by maintaining open airways over long periods.

    •  

  • Decreases the usage frequency of rescue inhalers due to improved control of symptoms.

 

Usage Guidance

 

  • Use regularly as prescribed, even without current symptoms, for effective management.

    •  

  • Rinse mouth after inhalation to reduce risks of oral thrush from corticosteroid use.

 

Consultation Necessity

 

  • Discuss with healthcare provider if side effects occur or asthma symptoms do not improve.

 

Is Dulera a steroid inhaler?

 

Is Dulera a Steroid Inhaler?

 

  • Dulera is a combination inhaler used for asthma management, containing both formoterol, a long-acting beta-agonist (LABA), and mometasone furoate, which is a corticosteroid.

    •  

  • Corticosteroids in Dulera are used to reduce inflammation in the airways, helping to prevent and control asthma symptoms.

    •  

  • Formoterol helps in relaxing muscles around the airways, making breathing easier by widening the air passages.

    •  

  • It's essential to use Dulera regularly for it to be effective; it is not intended for relief of acute asthma attacks.

    •  

  • Patients should be aware of potential side effects like throat irritation or thrush due to the steroid component, and rinsing the mouth after use may help minimize these risks.

 

Have questions left?

‍

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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 (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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Curex provides allergy care plans for allergies, asthma, eczema and pet allergies.

Curex providers may prescribe sublingual allergy drops that contain the same ingredients as allergy shots but are more convenient & affordable.
‍
Curex-affiliated medical practices are independently owned and operated by licensed physicians who provide services using the Curex telehealth platform.

Compounded medications have not been approved by the FDA and the FDA has not evaluated their safety or efficacy.

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