Does Network Health Cover Dulera

Explore if Network Health covers Dulera, reasons for denial, how to secure coverage, costs without insurance, and answers to common questions.
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Network Health Coverage for Dulera

 

  • Dulera, a prescription asthma medication, may be covered by Network Health depending on your specific plan and medical necessity.
  •  

  • Coverage is likely to be provided for Dulera if it is deemed medically necessary by a primary care physician or specialist for the management of asthma in patients over 12 years old.
  •  

  • The medication must be included in the formulary of covered drugs, and you may need to provide documentation of previous treatments and medical necessity.
  •  

  • Prior authorization might be required, where your healthcare provider submits a request to approve the prescription as part of your treatment plan.
  •  

  • Check the details of your specific Network Health plan to see if Dulera is covered, and be aware of any co-payments or deductibles that could apply.
  •  

  • Consult with a Network Health customer service representative or your healthcare provider for guidance specific to your circumstances and healthcare plan.

 

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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.

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.

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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 Network Health

 

Evaluate Your Current Coverage

 

  • Check your current insurance policy with Network Health to see if Dulera is already covered under your plan.
  •  

  • If unsure, contact Network Health customer support for clarification on your plan's specific coverage for medications.

 

Visit the Network Health Website

 

  • Go to the official Network Health website to browse potential plans if you need to enroll or change your plan.
  •  

  • Look for details about pharmaceutical coverage or a drug formulary to identify which medications are included.

 

Consult the Network Health Drug Formulary

 

  • Access the drug formulary document on the Network Health website. This lists all medications covered and their respective coverage tiers.
  •  

  • Search for Dulera in the formulary to understand its coverage details, such as preferred, non-preferred, or any specific requirements.

 

Contact a Customer Service Representative

 

  • Reach out to Network Health customer service to verify Dulera's coverage and ask any specific questions about the process.
  •  

  • Inquire about any necessary steps you must take or forms to fill out for Dulera coverage.

 

Consult Your Healthcare Provider

 

  • Speak with your healthcare provider about prescribing Dulera and discuss any coverage necessity through Network Health.
  •  

  • Ensure your provider is in-network with Network Health, which may affect the approval and coverage process.

 

Complete Required Documentation

 

  • Submit any prescriptions or documentation required by Network Health for Dulera coverage.
  •  

  • Your healthcare provider might need to complete a prior authorization request if Dulera requires approval before coverage.

 

Follow Up Regularly

 

  • Stay in touch with Network Health to check the status of your Dulera coverage request.
  •  

  • Keep records of all communications and any submitted documents in case they are needed for future reference.

 

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FAQs

Does Network Health Cover Dulera

Explore if Network Health covers Dulera, reasons for denial, how to secure coverage, costs without insurance, and answers to common questions.
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Is Dulera Covered by Network Health

 

Network Health Coverage for Dulera

 

  • Dulera, a prescription asthma medication, may be covered by Network Health depending on your specific plan and medical necessity.
  •  

  • Coverage is likely to be provided for Dulera if it is deemed medically necessary by a primary care physician or specialist for the management of asthma in patients over 12 years old.
  •  

  • The medication must be included in the formulary of covered drugs, and you may need to provide documentation of previous treatments and medical necessity.
  •  

  • Prior authorization might be required, where your healthcare provider submits a request to approve the prescription as part of your treatment plan.
  •  

  • Check the details of your specific Network Health plan to see if Dulera is covered, and be aware of any co-payments or deductibles that could apply.
  •  

  • Consult with a Network Health customer service representative or your healthcare provider for guidance specific to your circumstances and healthcare plan.

 

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Network Health's Approved Criteria for Dulera Coverage

 

Eligibility Criteria for Dulera Coverage

 

  • Network Health provides coverage for Dulera based on a diagnosis of asthma that is inadequately controlled by other forms of medication and where an additional long-term treatment is necessary.
  •  

  • Patients must be 12 years of age or older to be eligible for Dulera coverage under Network Health policy.

 

Required Documentation for Dulera Coverage

 

  • A comprehensive medical history of the patient, detailing previous and current asthma treatments that have been tried and failed or provided insufficient control.
  •  

  • An asthma action plan developed in consultation with a healthcare provider, including Dulera as a prescribed medication.

 

Prior Authorization for Dulera

 

  • Network Health requires a prior authorization form to be completed by the prescribing healthcare provider, outlining the medical necessity for using Dulera.
  •  

  • The prior authorization must include documentation supporting the diagnosis and previous treatments as described in the eligibility criteria.

 

Continuation of Therapy

 

  • Coverage for continuation of Dulera therapy requires evidence of clinical benefit, which may involve periodic medical reviews.
  •  

  • Documentation of improvement in asthma control parameters as defined in the asthma action plan can support continued coverage.

 

Prescription Requirements

 

  • Dulera must be prescribed by a specialist in pulmonary medicine, allergy/immunology, or another healthcare provider experienced in treating asthma.
  •  

  • The prescription must adhere to standard labeling indications and recommended dosages unless specifically justified in the medical records.

 

Why Network Health Might Deny Dulera Coverage

 

Situations Where Network Health Might Deny Dulera Coverage

 

  • Prescriptions that do not meet medically necessary criteria according to Network Health's guidelines. The medication may be deemed unnecessary based on a patient's specific condition or diagnosis.
  •  

  • Requests for higher dosages of Dulera that are not in line with the FDA-approved labeling or recognized medical standards may be denied.
  •  

  • Off-label use of Dulera for conditions not specified within Network Health's approved coverage policies could be a reason for denial.
  •  

  • Treatment plans that do not align with step therapy protocols, where less expensive or alternative medications have not been tried first, may lead to denial of coverage.
  •  

  • Lack of prior authorization in situations where it is required for Dulera; not obtaining or failing to submit necessary documentation can result in denial.
  •  

  • Duplicate therapy, where Dulera is prescribed along with similar medications, might not be covered due to potential safety and cost-effectiveness concerns.
  •  

  • Claims associated with an out-of-network provider or pharmacy in instances where the plan requires in-network services might not be covered.

 

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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.

 

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 Network Health

 

Evaluate Your Current Coverage

 

  • Check your current insurance policy with Network Health to see if Dulera is already covered under your plan.
  •  

  • If unsure, contact Network Health customer support for clarification on your plan's specific coverage for medications.

 

Visit the Network Health Website

 

  • Go to the official Network Health website to browse potential plans if you need to enroll or change your plan.
  •  

  • Look for details about pharmaceutical coverage or a drug formulary to identify which medications are included.

 

Consult the Network Health Drug Formulary

 

  • Access the drug formulary document on the Network Health website. This lists all medications covered and their respective coverage tiers.
  •  

  • Search for Dulera in the formulary to understand its coverage details, such as preferred, non-preferred, or any specific requirements.

 

Contact a Customer Service Representative

 

  • Reach out to Network Health customer service to verify Dulera's coverage and ask any specific questions about the process.
  •  

  • Inquire about any necessary steps you must take or forms to fill out for Dulera coverage.

 

Consult Your Healthcare Provider

 

  • Speak with your healthcare provider about prescribing Dulera and discuss any coverage necessity through Network Health.
  •  

  • Ensure your provider is in-network with Network Health, which may affect the approval and coverage process.

 

Complete Required Documentation

 

  • Submit any prescriptions or documentation required by Network Health for Dulera coverage.
  •  

  • Your healthcare provider might need to complete a prior authorization request if Dulera requires approval before coverage.

 

Follow Up Regularly

 

  • Stay in touch with Network Health to check the status of your Dulera coverage request.
  •  

  • Keep records of all communications and any submitted documents in case they are needed for future reference.

 

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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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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.

 

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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.

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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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