Does Regence Cover Dulera

Explore Regence coverage for Dulera. Learn why it may be denied, tips to get coverage, cost without insurance, and answers to common questions.
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Coverage Basics

 

  • Regence generally provides coverage for Dulera, a prescription asthma medication, under its pharmacy benefits. Coverage specifics can depend on your particular plan type, so reviewing your policy is crucial.
  •  

  • Dulera may be found on the formulary list, but tier placement can vary, affecting co-pays or co-insurance requirements. Higher-tier medications might have additional out-of-pocket costs.

 

Coverage Criteria

 

  • Usually, prescriptions must be prescribed by a healthcare provider within the plan's network. Non-network providers might result in higher costs or no coverage.
  •  

  • Prior authorization might be required to ensure treatment necessity and cost-effectiveness, especially if it's a higher-tier drug.

 

Steps to Ensure Coverage

 

  • Verify Dulera's status on Regence's prescription drug coverage list for your specific plan.
  •  

  • Consult with your healthcare provider to complete any necessary pre-authorization procedures.
  •  

  • Contact Regence customer service for any policy clarifications or to verify coverage details for Dulera under your current plan.

 

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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 Regence

 

Verify Your Coverage Eligibility

 

  • Start by checking your current health insurance plan documents to see if Dulera is listed under covered medications. This information is usually available in the formulary section of your policy handbook or online via your Regence member portal.
  •  

  • If you’re unable to find this information in your plan documents, contact Regence customer service directly to inquire about Dulera coverage. Make sure to have your member ID ready for quicker assistance.

 

Consult with Your Health Care Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Dulera. Your provider can help determine if Dulera is medically necessary for your condition, which can be important for insurance coverage justification.
  •  

  • Ask your healthcare provider to provide documentation, such as a Letter of Medical Necessity, that you can submit to Regence if necessary.

 

Understand Your Plan's Tier System

 

  • Regence, like many insurance providers, uses a tiered system for medications. Typically, drugs are classified into different levels or tiers based on their cost and effectiveness.
  •  

  • Find out what tier Dulera falls under in your specific plan, as this can affect your co-payment or co-insurance amounts. This information can be found on your Regence member portal or by contacting their customer service.

 

File a Prescription Claim

 

  • Once you have a prescription from your healthcare provider, submit your claim to Regence. This can often be done electronically through your pharmacy or manually if required.
  •  

  • If you are using a pharmacy within your insurance network, the pharmacy will typically handle the submission process. Ensure that you provide your current insurance information to avoid delays.

 

Request Prior Authorization or an Exception

 

  • If you find that Dulera is not covered or falls into a high-cost tier, you may need to request prior authorization. Contact Regence to understand the exact procedure for requesting prior authorization for Dulera.
  •  

  • In cases where Dulera is not typically covered, your doctor may need to help you apply for a formulary exception by providing evidence of why Dulera is necessary for your treatment.

 

Monitor Your Benefits and Payments

 

  • Keep an eye on your insurance benefits statement to ensure that any claims for Dulera are processed correctly according to your coverage plan.
  •  

  • Make sure your out-of-pocket costs, such as co-pays or co-insurance, align with the information in your insurance documents and have not been improperly charged.

 

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FAQs

Does Regence Cover Dulera

Explore Regence coverage for Dulera. Learn why it may be denied, tips to get coverage, cost without insurance, and answers to common questions.
Curex allergy drops unboxing

Is Dulera Covered by Regence

 

Coverage Basics

 

  • Regence generally provides coverage for Dulera, a prescription asthma medication, under its pharmacy benefits. Coverage specifics can depend on your particular plan type, so reviewing your policy is crucial.
  •  

  • Dulera may be found on the formulary list, but tier placement can vary, affecting co-pays or co-insurance requirements. Higher-tier medications might have additional out-of-pocket costs.

 

Coverage Criteria

 

  • Usually, prescriptions must be prescribed by a healthcare provider within the plan's network. Non-network providers might result in higher costs or no coverage.
  •  

  • Prior authorization might be required to ensure treatment necessity and cost-effectiveness, especially if it's a higher-tier drug.

 

Steps to Ensure Coverage

 

  • Verify Dulera's status on Regence's prescription drug coverage list for your specific plan.
  •  

  • Consult with your healthcare provider to complete any necessary pre-authorization procedures.
  •  

  • Contact Regence customer service for any policy clarifications or to verify coverage details for Dulera under your current plan.

 

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Regence's Approved Criteria for Dulera Coverage

 

Criteria for Dulera Coverage

 

  • Dulera is covered for the treatment of asthma as a maintenance therapy in individuals who are 12 years of age and older.
  •  

  • Patients must have a documented diagnosis of asthma that requires chronic daily therapy with an inhaled corticosteroid.
  •  

  • The patient should have demonstrated a need for a combination therapy to manage their asthma effectively, usually indicated by experiencing frequent asthma symptoms or exacerbations despite adherence to an optimal inhaled corticosteroid regimen alone.
  •  

  • Coverage is contingent on prior documented unsuccessful use or intolerance of alternative asthma control measures, which must include an acceptable trial with other single or combination inhalation treatments such as a separate inhaled corticosteroid and long-acting beta-agonist, unless contraindicated.
  •  

  • A healthcare provider must submit a request indicating the patient has had a full clinical evaluation and continues to exhibit uncontrolled moderate to severe persistent asthma symptoms.
  •  

  • Therapy must be consistent with current asthma management guidelines as recommended by the treating healthcare provider.
  •  

  • The prescriber should provide evidence that Dulera will replace one or more previously prescribed asthma maintenance medications to improve adherence, symptom control, or reduce adverse effects.

 

Why Regence Might Deny Dulera Coverage

 

Situations Where Regence Might Deny Dulera Coverage

 

  • The prescription is not deemed medically necessary. Regence may require documentation that other treatments were ineffective or not suitable.
  •  

  • The member's health plan specifically excludes coverage for Dulera or certain medications in its formulary.
  •  

  • The member has not tried first-line therapies that are usually recommended before Dulera.
  •  

  • Dulera is prescribed for a condition not listed in Regence's approved uses or guidelines.
  •  

  • The prescription does not meet age or dosage guidelines established by Regence's coverage criteria.
  •  

  • Prescriptions from non-network healthcare providers may lead to coverage denial unless prior authorization is obtained.
  •  

  • Refill limitations are exceeded without demonstrating a medical necessity or a change in treatment plan.
  •  

 

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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 Regence

 

Verify Your Coverage Eligibility

 

  • Start by checking your current health insurance plan documents to see if Dulera is listed under covered medications. This information is usually available in the formulary section of your policy handbook or online via your Regence member portal.
  •  

  • If you’re unable to find this information in your plan documents, contact Regence customer service directly to inquire about Dulera coverage. Make sure to have your member ID ready for quicker assistance.

 

Consult with Your Health Care Provider

 

  • Schedule an appointment with your healthcare provider to discuss your need for Dulera. Your provider can help determine if Dulera is medically necessary for your condition, which can be important for insurance coverage justification.
  •  

  • Ask your healthcare provider to provide documentation, such as a Letter of Medical Necessity, that you can submit to Regence if necessary.

 

Understand Your Plan's Tier System

 

  • Regence, like many insurance providers, uses a tiered system for medications. Typically, drugs are classified into different levels or tiers based on their cost and effectiveness.
  •  

  • Find out what tier Dulera falls under in your specific plan, as this can affect your co-payment or co-insurance amounts. This information can be found on your Regence member portal or by contacting their customer service.

 

File a Prescription Claim

 

  • Once you have a prescription from your healthcare provider, submit your claim to Regence. This can often be done electronically through your pharmacy or manually if required.
  •  

  • If you are using a pharmacy within your insurance network, the pharmacy will typically handle the submission process. Ensure that you provide your current insurance information to avoid delays.

 

Request Prior Authorization or an Exception

 

  • If you find that Dulera is not covered or falls into a high-cost tier, you may need to request prior authorization. Contact Regence to understand the exact procedure for requesting prior authorization for Dulera.
  •  

  • In cases where Dulera is not typically covered, your doctor may need to help you apply for a formulary exception by providing evidence of why Dulera is necessary for your treatment.

 

Monitor Your Benefits and Payments

 

  • Keep an eye on your insurance benefits statement to ensure that any claims for Dulera are processed correctly according to your coverage plan.
  •  

  • Make sure your out-of-pocket costs, such as co-pays or co-insurance, align with the information in your insurance documents and have not been improperly charged.

 

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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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