$49$0.99

Does Priority Health Cover Dupixent

Explore Dupixent coverage challenges with Priority Health, tips for approval, costs without insurance, and answers to common questions in this comprehensive guide.

Treat your allergies with Curex

as seen on

“Curex is changing the landscape of allergies in 2024”

Coverage Overview for Dupixent

Priority Health may cover Dupixent for conditions like atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyposis, depending on the specific plan.

Basic Coverage Criteria

Your condition must generally be moderate to severe and not well managed by other treatments. Documentation from a healthcare provider is typically required.
Dupixent should be prescribed by a specialist, such as a dermatologist or allergist, depending on the condition.

Authorization Process

Coverage usually requires pre-authorization. The healthcare provider might need to submit clinical notes and other supporting documents to justify the need.
Verify coverage and out-of-pocket costs directly with Priority Health to understand your specific plan details.

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 Priority Health

Initiate the Process

Contact Priority Health's customer service to confirm specific coverage details for Dupixent under your plan. This initial contact will help you understand any prerequisites or prerequisites.

Sign in to your Priority Health member account online to access plan information and coverage options. This platform may offer additional resources or guides specific to medication coverage.

Consult Your Healthcare Provider

Schedule an appointment with your healthcare provider to discuss the medical necessity of Dupixent for your condition. Ensure that your provider includes documented proof of medical necessity in your file.

Ask your provider to prepare a detailed letter of medical necessity. This documentation should clearly explain the need for Dupixent based on your medical history and current health status, referring to any failed treatments if applicable.

Prepare Necessary Documentation

Gather all relevant medical records, including previous treatment attempts and results, to support your case for coverage. Have these records ready to submit to Priority Health if needed.

Ensure that your provider’s office will handle the submission of the required paperwork to Priority Health. Confirm that they use the correct forms and processes as outlined by Priority Health.

Submit a Coverage Request

Work with your healthcare provider to submit a prior authorization request through Priority Health. This step is crucial for specialty medications like Dupixent, as it often requires approval before coverage is granted.

Ensure all forms are filled out accurately and submitted as early as possible to avoid delays. Double-check that all supporting documents, such as the letter of medical necessity, are included.

Follow Up and Appeal if Necessary

After submission, actively follow up with Priority Health on the status of your request. Consistent communication can expedite the process and ensure that no information is missing or needs further clarification.

If the initial request is denied, review the denial letter carefully and file an appeal. Gather any additional support from your healthcare provider to strengthen the appeal, and follow Priority Health’s appeal process promptly.

Explore Additional Financial Assistance

If coverage through Priority Health is delayed or denied, explore financial assistance programs offered by the drug manufacturer or non-profit organizations dedicated to patient assistance. These programs can provide interim support for purchasing the medication.

Discuss alternative payment options or medication access programs with your healthcare provider, as they may have resources or experience in securing medication while insurance approvals are pending.

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 Priority Health Cover Dupixent

Explore Dupixent coverage challenges with Priority Health, tips for approval, costs without insurance, and answers to common questions in this comprehensive guide.

Achieve Your Goals Faster with Curex

Is Dupixent Covered by Priority Health

Coverage Overview for Dupixent

Priority Health may cover Dupixent for conditions like atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyposis, depending on the specific plan.

Basic Coverage Criteria

Your condition must generally be moderate to severe and not well managed by other treatments. Documentation from a healthcare provider is typically required.
Dupixent should be prescribed by a specialist, such as a dermatologist or allergist, depending on the condition.

Authorization Process

Coverage usually requires pre-authorization. The healthcare provider might need to submit clinical notes and other supporting documents to justify the need.
Verify coverage and out-of-pocket costs directly with Priority Health to understand your specific plan details.

A weight management program tailored to you

Start with Curex

Priority Health's Approved Criteria for Dupixent Coverage

Eligibility for Dupixent Coverage

Patients must have a documented diagnosis of a condition approved for Dupixent treatment, such as atopic dermatitis, asthma, or chronic rhinosinusitis with nasal polyposis.
There must be documented evidence that the patient has tried and failed or has contraindications to standard therapies appropriate for the condition.
A treatment plan from a healthcare provider specializing in the condition being treated is required, demonstrating that Dupixent is medically necessary for the patient.

Dosage and Administration Criteria

The prescribed dosing must align with the FDA-approved dosing guidelines for the specific condition being treated.
Initial and maintenance doses should be clearly specified, accounting for the patient’s age, weight, and medical history.
Healthcare providers must provide documentation on any dosage adjustments and their medical necessity.

Continuation of Therapy Criteria

For ongoing coverage, there must be evidence of clinical benefit from Dupixent, documented in follow-up visits with the healthcare provider.
Documentation should demonstrate compliance with prescribed therapy and a positive response to treatment, such as disease control and symptom reduction.
Regular assessment reports, including treatment efficacy and any side effects, must be maintained in the patient’s medical records.

Special Considerations

Special consideration will be given for pediatric patients, ensuring that the requirements align with pediatric-specific guidelines and evidence.
Patients with co-morbid conditions may require adjusted criteria, with supporting documentation from the healthcare provider.
Providers should submit any additional information that may support the necessity and exceptional requirement for Dupixent coverage in unique cases.

Why Priority Health Might Deny Dupixent Coverage

Non-Medically Necessary Treatment

Priority Health may deny coverage for Dupixent if it is deemed not medically necessary for the patient's condition according to their guidelines.

Lack of Prior Authorization

Coverage could be denied if prior authorization was not obtained before the prescription of Dupixent.

Off-Label Use

Dupixent may not be covered if prescribed for conditions not approved by regulatory agencies or outside Priority Health's coverage policies.

Non-Compliance with Medical Criteria

Instances where the patient does not meet specific clinical criteria established by Priority Health, which are necessary for coverage.

Out-of-Network Providers

Prescriptions from healthcare providers that are not within the Priority Health network may lead to a denial of coverage for Dupixent.

Prescription without Appropriate Documentation

Denial may occur if there is insufficient documentation supporting the necessity of Dupixent for the patient’s treatment.

Exceeding Quantity Limits

Dupixent coverage may be denied if the prescribed quantity exceeds the limits set by Priority Health policy guidelines.

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 Priority Health

Initiate the Process

Contact Priority Health's customer service to confirm specific coverage details for Dupixent under your plan. This initial contact will help you understand any prerequisites or prerequisites.

Sign in to your Priority Health member account online to access plan information and coverage options. This platform may offer additional resources or guides specific to medication coverage.

Consult Your Healthcare Provider

Schedule an appointment with your healthcare provider to discuss the medical necessity of Dupixent for your condition. Ensure that your provider includes documented proof of medical necessity in your file.

Ask your provider to prepare a detailed letter of medical necessity. This documentation should clearly explain the need for Dupixent based on your medical history and current health status, referring to any failed treatments if applicable.

Prepare Necessary Documentation

Gather all relevant medical records, including previous treatment attempts and results, to support your case for coverage. Have these records ready to submit to Priority Health if needed.

Ensure that your provider’s office will handle the submission of the required paperwork to Priority Health. Confirm that they use the correct forms and processes as outlined by Priority Health.

Submit a Coverage Request

Work with your healthcare provider to submit a prior authorization request through Priority Health. This step is crucial for specialty medications like Dupixent, as it often requires approval before coverage is granted.

Ensure all forms are filled out accurately and submitted as early as possible to avoid delays. Double-check that all supporting documents, such as the letter of medical necessity, are included.

Follow Up and Appeal if Necessary

After submission, actively follow up with Priority Health on the status of your request. Consistent communication can expedite the process and ensure that no information is missing or needs further clarification.

If the initial request is denied, review the denial letter carefully and file an appeal. Gather any additional support from your healthcare provider to strengthen the appeal, and follow Priority Health’s appeal process promptly.

Explore Additional Financial Assistance

If coverage through Priority Health is delayed or denied, explore financial assistance programs offered by the drug manufacturer or non-profit organizations dedicated to patient assistance. These programs can provide interim support for purchasing the medication.

Discuss alternative payment options or medication access programs with your healthcare provider, as they may have resources or experience in securing medication while insurance approvals are pending.

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 Priority Health Cover Dupixent

Explore Dupixent coverage challenges with Priority Health, tips for approval, costs without insurance, and answers to common questions in this comprehensive guide.

Achieve Your Goals Faster with Curex