Does MDwise Cover Benzphetamine (Didrex)

Explore Benzphetamine coverage by MDwise, reasons for denial, securing coverage, costs without insurance, and get answers to common questions.
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MDwise Coverage for Benzphetamine (Didrex)

 

  • MDwise may cover Benzphetamine (Didrex), a weight-loss medication, under specific circumstances.
  •  

  • Certain conditions often need to be met: typically it must be prescribed for obesity treatment when other strategies haven't worked.
  •  

  • Commonly, health insurance plans require a prescription from a healthcare provider who approves using Benzphetamine for weight management.
  •  

  • The approval often asks for evidence of previous weight management efforts, such as diet and exercise plans, to justify the prescription use.
  •  

  • Please confirm through MDwise customer support or their official website, as this information can vary based on your specific plan or location.

 

Rules & Criteria

 

  • Approval usually involves prior authorization; the prescribing doctor may need to submit necessary documentation to MDwise.
  •  

  • MDwise might check patients’ medical history to confirm the necessity of Benzphetamine.
  •  

  • It's advisable to check for preferred network pharmacies to minimize costs under your MDwise plan.

 

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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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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 MDwise

 

Research Coverage Policies

 

  • Visit the MDwise website to understand their prescription drug coverage policies. Look for the formulary or drug list that details covered medications and any restrictions or requirements.
  •  

  • Look up Benzphetamine (Didrex) in the formulary to see if it's listed. Pay attention to any notes regarding prior authorization or step therapy requirements.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Benzphetamine (Didrex). Your doctor can provide medical justification and support your case if a prior authorization is needed.
  •  

  • Ensure your provider is aware of MDwise’s policies and any documentation required for coverage.

 

Gather Necessary Documentation

 

  • Collect any medical records, prescriptions, and provider notes that support the need for Benzphetamine (Didrex).
  •  

  • Prepare this documentation to submit to MDwise for review if required.

 

Contact MDwise Member Services

 

  • Call MDwise Member Services using the contact information provided on their website or your insurance card. Inquire about the process for securing coverage for Benzphetamine.
  •  

  • Request a detailed explanation of their requirements, including any necessary forms or prior authorizations you need to complete.

 

Submit Prior Authorization (if necessary)

 

  • If Benzphetamine (Didrex) requires prior authorization, work with your healthcare provider to complete the required forms. Your provider may need to submit this directly to MDwise on your behalf.
  •  

  • Ensure all necessary documentation is attached and the submission is complete to avoid delays.

 

Follow Up

 

  • After submission, follow up with MDwise to confirm receipt of the prior authorization request and obtain an estimated processing time.
  •  

  • Contact them periodically to check the status of your request if you haven't received a decision in a timely manner.

 

Appeal if Denied

 

  • If coverage is denied, request information on the appeals process. You may need to provide additional documentation or a more detailed explanation from your healthcare provider.
  •  

  • File an appeal as directed by MDwise, adhering to any deadlines and ensuring all required information is included.

 

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FAQs

Does MDwise Cover Benzphetamine (Didrex)

Explore Benzphetamine coverage by MDwise, reasons for denial, securing coverage, costs without insurance, and get answers to common questions.
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Is Benzphetamine (Didrex) Covered by MDwise

 

MDwise Coverage for Benzphetamine (Didrex)

 

  • MDwise may cover Benzphetamine (Didrex), a weight-loss medication, under specific circumstances.
  •  

  • Certain conditions often need to be met: typically it must be prescribed for obesity treatment when other strategies haven't worked.
  •  

  • Commonly, health insurance plans require a prescription from a healthcare provider who approves using Benzphetamine for weight management.
  •  

  • The approval often asks for evidence of previous weight management efforts, such as diet and exercise plans, to justify the prescription use.
  •  

  • Please confirm through MDwise customer support or their official website, as this information can vary based on your specific plan or location.

 

Rules & Criteria

 

  • Approval usually involves prior authorization; the prescribing doctor may need to submit necessary documentation to MDwise.
  •  

  • MDwise might check patients’ medical history to confirm the necessity of Benzphetamine.
  •  

  • It's advisable to check for preferred network pharmacies to minimize costs under your MDwise plan.

 

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MDwise's Approved Criteria for Benzphetamine (Didrex) Coverage

 

MDwise Criteria for Benzphetamine (Didrex) Coverage

 

  • The patient must have a documented body mass index (BMI) of 30 or greater, qualifying as obese, or a BMI of 27 or greater with concurrent weight-related comorbid conditions such as hypertension, type 2 diabetes, or dyslipidemia.
  •  

  • Documentation must be provided showing the patient's unsuccessful attempt to lose weight through a comprehensive lifestyle intervention, focusing on diet and exercise, over a period of at least 6 months.
  •  

  • Prescribing must be done by or in consultation with a healthcare provider specializing in obesity management, such as an endocrinologist.
  •  

  • The patient should be between the ages of 17 and 65, as this medication is generally approved for adults within this age range.
  •  

  • The patient must not be currently pregnant or breastfeeding, due to potential risks associated with the use of Benzphetamine during pregnancy or lactation.
  •  

  • An evaluation for medication interactions must be performed, ensuring that the patient is not taking other medications that benzphetamine might adversely interact with.
  •  

  • There should be an absence of contraindications such as advanced arteriosclerosis, severe hypertension, or other significant cardiovascular diseases.
  •  

  • Continued coverage may require documentation of weight loss progress and ongoing adherence to a weight management plan, typically reviewed every 3 months.
  •  

  • Approval will take into consideration a patient's complete health profile, including psychological health assessments to rule out any potential for drug misuse or abuse.

 

Why MDwise Might Deny Benzphetamine (Didrex) Coverage

 

Reasons for Denial of Benzphetamine (Didrex) Coverage

 

  • MDwise may deny coverage if Benzphetamine is not approved by FDA for the requested use or condition.
  •  

  • The prescription is requested for off-label use that lacks sufficient medical evidence or guidelines supporting it.
  •  

  • Insurance coverage might be denied if Benzphetamine is considered not medically necessary for the individual's condition.
  •  

  • Failure to provide necessary documentation reflecting the criteria met for approval, such as proof of previous medication failure or intolerance, may lead to denial.
  •  

  • Coverage might not be provided if the request does not comply with MDwise's step therapy protocols and the necessary medications haven’t been tried first.
  •  

  • MDwise could deny if the prescribed dosage does not fall within the plan's approved limit or exceeds specified safety guidelines.
  •  

  • Prescriptions may be denied if prescribed for a patient who falls outside of the recommended age or demographic that MDwise covers for Benzphetamine.
  •  

  • Insurance might not cover Benzphetamine if the prescribing healthcare provider is not in the MDwise network, depending on the plan's stipulations.
  •  

  • Failure to adhere to formulary or prior authorization processes as defined by MDwise can result in denial of Benzphetamine 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 MDwise

 

Research Coverage Policies

 

  • Visit the MDwise website to understand their prescription drug coverage policies. Look for the formulary or drug list that details covered medications and any restrictions or requirements.
  •  

  • Look up Benzphetamine (Didrex) in the formulary to see if it's listed. Pay attention to any notes regarding prior authorization or step therapy requirements.

 

Consult with Your Healthcare Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Benzphetamine (Didrex). Your doctor can provide medical justification and support your case if a prior authorization is needed.
  •  

  • Ensure your provider is aware of MDwise’s policies and any documentation required for coverage.

 

Gather Necessary Documentation

 

  • Collect any medical records, prescriptions, and provider notes that support the need for Benzphetamine (Didrex).
  •  

  • Prepare this documentation to submit to MDwise for review if required.

 

Contact MDwise Member Services

 

  • Call MDwise Member Services using the contact information provided on their website or your insurance card. Inquire about the process for securing coverage for Benzphetamine.
  •  

  • Request a detailed explanation of their requirements, including any necessary forms or prior authorizations you need to complete.

 

Submit Prior Authorization (if necessary)

 

  • If Benzphetamine (Didrex) requires prior authorization, work with your healthcare provider to complete the required forms. Your provider may need to submit this directly to MDwise on your behalf.
  •  

  • Ensure all necessary documentation is attached and the submission is complete to avoid delays.

 

Follow Up

 

  • After submission, follow up with MDwise to confirm receipt of the prior authorization request and obtain an estimated processing time.
  •  

  • Contact them periodically to check the status of your request if you haven't received a decision in a timely manner.

 

Appeal if Denied

 

  • If coverage is denied, request information on the appeals process. You may need to provide additional documentation or a more detailed explanation from your healthcare provider.
  •  

  • File an appeal as directed by MDwise, adhering to any deadlines and ensuring all required information is included.

 

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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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