Does Security Health Plan Cover Humira

Explore why Security Health Plan might deny Humira, ways to secure coverage, the cost without insurance, and FAQs about Humira.
Curex allergy drops unboxing
“Curex is changing the landscape of allergies in 2024”
man opening Curex packaging
man opening Curex packaging

 

Does Security Health Plan Cover Humira?

 

  • Security Health Plan may cover Humira, subject to specific conditions and prior authorization requirements. Coverage typically includes treatment for autoimmune diseases like rheumatoid arthritis, Crohn's disease, and ulcerative colitis.
  •  

  • Patients must have a confirmed diagnosis that qualifies under Security Health Plan policies. Additionally, the prescribing healthcare provider needs to demonstrate that other treatments have been tried and found ineffective before opting for Humira.
  •  

  • Members might be required to obtain prior authorization, ensuring that Humira is medically necessary based on clinical criteria established by Security Health Plan. This step ensures that all formulary and step therapy protocols are followed.
  •  

  • Copayment or cost-sharing details depend on the specific plan, and members should check their plan documents or consult customer service for precise coverage information regarding Humira.

 

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.

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 Humira Coverage with Security Health Plan

 

Verify Your Coverage Plan

 

  • Contact Security Health Plan's customer service to confirm if Humira is covered under your current plan.
  •  

  • Review your insurance policy documents or the Security Health Plan website for detailed prescription drug coverage.

 

Consult with Your Physician

 

  • Discuss your need for Humira with your healthcare provider to ensure it's medically necessary for your condition.
  •  

  • Request a prior authorization if your plan requires it for Humira prescriptions to secure insurance coverage.

 

Coordinate with the Pharmacy

 

  • Choose a pharmacy within the Security Health Plan network to avoid additional out-of-pocket costs.
  •  

  • Ensure the pharmacy can handle the prior authorization paperwork if needed and verify Humira availability.

 

Gather Necessary Documentation

 

  • Collect any required medical records or previous treatment documentation that supports the necessity for Humira.
  •  

  • Ensure your physician submits necessary paperwork required by Security Health Plan for claims processing.

 

Submit Claims Correctly

 

  • Work with your healthcare provider and pharmacy to file claims with the correct procedural codes to avoid denials.
  •  

  • Monitor the claims process through the Security Health Plan member portal to ensure timely processing and approval.

 

Review Financial Assistance Options

 

  • If you encounter coverage limitations, inquire about any available patient assistance programs for Humira that Security Health Plan might offer.
  •  

  • Consult with Security Health Plan about any copay assistance or discount programs available for medications like Humira.

 

Appeal a Denied Claim

 

  • If the claim for Humira is denied, request detailed information regarding the reason and prepare to file an appeal.
  •  

  • Ensure all additional information or documentation requested by Security Health Plan is included in the appeal submission.

 

Curex allergy drops unboxing

We love helping people!

Allie, Nevada

five stars

"I have two cats I can finally cuddle!"

Cat and dog allergies

Zachary, Texas

five stars

“I can breathe through my nose for the first time in like 20 years!"

dust allergy
mold allergy

Dust and mold allergies

Erika, New York

five stars

“I've noticed less sneezing and shortness of breath.”

tree allergy
grass allergy

Tree and grass allergies

Richard, Texas

five stars


I love the convenience!

tree allergy

Tree and cat allergies

We Treat Food, Indoor & Outdoor Allergies

tree allergy
Tree Pollens
maple leaf icon
Weed Pollens
Cat Allergies
Dog Allergies
insect icon
Dust Mites
mold allergy
Molds
Food Allergies
 curex user showing allergy treatment kita patient showing allergy treatment boxa male patient showing allergy drops vial
50,000+ users have overcome their allergies
Am I eligible?

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
male medical practitioner smiling

Treatment prescribed
by clinician

1
right line icon
Curex packaging

Clinicaly made allergen extracts are customized for your allergies

2
right line icon
insect icon
grass icon
man opening Curex packaging

Your immune system gets desensitized to allergens, giving you long-term relief.

3

FAQs

Does Security Health Plan Cover Humira

Explore why Security Health Plan might deny Humira, ways to secure coverage, the cost without insurance, and FAQs about Humira.
Curex allergy drops unboxing

Is Humira Covered by Security Health Plan

 

Does Security Health Plan Cover Humira?

 

  • Security Health Plan may cover Humira, subject to specific conditions and prior authorization requirements. Coverage typically includes treatment for autoimmune diseases like rheumatoid arthritis, Crohn's disease, and ulcerative colitis.
  •  

  • Patients must have a confirmed diagnosis that qualifies under Security Health Plan policies. Additionally, the prescribing healthcare provider needs to demonstrate that other treatments have been tried and found ineffective before opting for Humira.
  •  

  • Members might be required to obtain prior authorization, ensuring that Humira is medically necessary based on clinical criteria established by Security Health Plan. This step ensures that all formulary and step therapy protocols are followed.
  •  

  • Copayment or cost-sharing details depend on the specific plan, and members should check their plan documents or consult customer service for precise coverage information regarding Humira.

 

A weight management program tailored to you

Start with Curex

Security Health Plan's Approved Criteria for Humira Coverage

 

General Requirements for Humira Coverage

 

  • Patient must have a diagnosis from a healthcare provider that Humira is likely to improve their condition, and documentation supporting this must be provided.
  •  

  • The use of Humira must be approved by the Food and Drug Administration for the prescribed condition, and both the dose and frequency of administration should be recommended by the healthcare provider.
  •  

  • Patient's previous treatment history must show that other conventional therapies have been ineffective or are contraindicated.

 

Specific Conditions for Humira Coverage

 

  • Rheumatoid Arthritis: Documented diagnosis of moderate to severe rheumatoid arthritis, with evidence of failure of at least one disease-modifying antirheumatic drug (DMARD), such as methotrexate.
  •  

  • Plaque Psoriasis: Diagnosis of chronic plaque psoriasis with moderate to severe symptoms that have not responded to other systemic therapies or phototherapy.
  •  

  • Crohn's Disease and Ulcerative Colitis: Diagnosis of moderate to severe Crohn's disease or ulcerative colitis with inadequate response to corticosteroids or immunosuppressants.
  •  

  • Psoriatic Arthritis: Documented moderate to severe psoriatic arthritis with an inadequate response to previous non-biologic DMARDs.
  •  

  • Ankylosing Spondylitis: Diagnosis of active ankylosing spondylitis with documented symptoms uncontrolled by conventional therapies such as NSAIDs.

 

Additional Notes

 

  • Patient eligibility criteria may be subject to periodic updates. It is recommended to consult the latest policy documents or contact Security Health Plan directly for updated information.
  •  

  • Independent medical review and approval may be required to assess the necessity of Humira based on individual patient circumstances.
  •  

  • Ongoing coverage may require regular assessment and documentation confirming the effectiveness and safety of Humira in continuing treatment.

 

Why Security Health Plan Might Deny Humira Coverage

 

Reasons for Denial of Humira Coverage by Security Health Plan

 

  • **Non-Approved Diagnosis**: Security Health Plan may deny coverage if the medication is prescribed for a condition that is not approved by the plan's formulary or guidelines.
  •  

  • **Lack of Prior Authorization**: If Humira is dispensed without obtaining prior authorization when required by the plan, coverage might be denied.
  •  

  • **Incomplete or Incorrect Documentation**: Failure to provide complete clinical documentation or submission of incorrect information can result in denial of coverage.
  •  

  • **Use of Non-Preferred Alternatives**: Use of Humira when alternative treatments (preferred by the plan) have not been attempted or documented may lead to denial.
  •  

  • **Failure to Meet Step Therapy Requirements**: If step therapy protocols are not followed and documented, coverage for Humira might be rejected.
  •  

  • **Non-Compliance with Renewal Criteria**: Denial can occur if renewal criteria such as re-assessment or proof of continued effectiveness are not met as per Security Health Plan's requirements.
  •  

  • **Out-of-Network Prescriptions**: If Humira is filled by an out-of-network provider without prior approval, coverage might not be provided.
  •  

  • **Expired Prior Authorization**: Usage of Humira under an expired authorization may lead to denial if reauthorization is not done in time.

 

Together with our partners we have changed the lives of over 300,000 patients.

How Much Does Humira Cost without Insurance?

 

Understanding Humira's Cost

 

  • Humira, a medication used to treat various autoimmune conditions, can be quite expensive without insurance coverage.
  •  

  • The cost for a single 40 mg/0.4 ml pen of Humira is typically priced between $5,000 and $6,000, depending on the pharmacy and location.
  •  

  • Patients often require multiple pens per month, so monthly costs can range from $10,000 to $24,000 or more, depending on dosage and frequency of use.
  •  

  • Pharmaceutical companies may offer financial assistance programs or patient support to help lower these costs for eligible patients.
  •  

  • Discount programs and manufacturer coupons could sometimes reduce the cost for patients who qualify.

 

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 Humira Coverage with Security Health Plan

 

Verify Your Coverage Plan

 

  • Contact Security Health Plan's customer service to confirm if Humira is covered under your current plan.
  •  

  • Review your insurance policy documents or the Security Health Plan website for detailed prescription drug coverage.

 

Consult with Your Physician

 

  • Discuss your need for Humira with your healthcare provider to ensure it's medically necessary for your condition.
  •  

  • Request a prior authorization if your plan requires it for Humira prescriptions to secure insurance coverage.

 

Coordinate with the Pharmacy

 

  • Choose a pharmacy within the Security Health Plan network to avoid additional out-of-pocket costs.
  •  

  • Ensure the pharmacy can handle the prior authorization paperwork if needed and verify Humira availability.

 

Gather Necessary Documentation

 

  • Collect any required medical records or previous treatment documentation that supports the necessity for Humira.
  •  

  • Ensure your physician submits necessary paperwork required by Security Health Plan for claims processing.

 

Submit Claims Correctly

 

  • Work with your healthcare provider and pharmacy to file claims with the correct procedural codes to avoid denials.
  •  

  • Monitor the claims process through the Security Health Plan member portal to ensure timely processing and approval.

 

Review Financial Assistance Options

 

  • If you encounter coverage limitations, inquire about any available patient assistance programs for Humira that Security Health Plan might offer.
  •  

  • Consult with Security Health Plan about any copay assistance or discount programs available for medications like Humira.

 

Appeal a Denied Claim

 

  • If the claim for Humira is denied, request detailed information regarding the reason and prepare to file an appeal.
  •  

  • Ensure all additional information or documentation requested by Security Health Plan is included in the appeal submission.

 

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.

Humira FAQ

What are the side effects of Humira?

 

Common Side Effects of Humira

 

  • Injection site reactions: redness, itching, or swelling.
  • Upper respiratory infections: sinus congestion and sore throat.
  • Headaches and nausea.

 

Serious Side Effects

 

  • Severe allergic reactions: difficulty breathing, chest pain, or swelling of the face.
  • Risk of infections: tuberculosis, fungal, or viral infections.
  • Blood disorders: unusual bruising or bleeding, pale skin.
  • Heart problems: shortness of breath, swelling of ankles/feet.

 

Long-term Considerations

 

  • Increased risk of certain cancers, particularly lymphomas.
  • Possible liver issues: jaundice or dark urine.

 

How does Humira work for rheumatoid arthritis?

 

How Humira Works

 

  • Humira is a TNF inhibitor. TNF, or tumor necrosis factor, is a substance in the body that causes inflammation.
  •  

  • By blocking TNF, Humira helps reduce inflammation and slow disease progression in rheumatoid arthritis patients.
  •  

  • It targets the underlying cause of inflammation instead of just managing symptoms, providing longer-term relief from discomfort and joint damage.

 

Administration and Effects

 

  • Administered as a subcutaneous injection, typically every two weeks.
  •  

  • Many patients start experiencing relief within a few weeks, though full benefits may take longer.
  •  

  • Consistent use can lead to improved mobility, reduced pain, and decreased swelling, assisting in daily activities.

How often do you take Humira injections?

 

Frequency of Humira Injections

 

  • **Initial Dose**: Typically, patients start with a loading dose. For example, in rheumatoid arthritis, a patient may begin with 160 mg on day 1, followed by 80 mg on day 15.
  •  

  • **Maintenance Dose**: After the initial period, the standard maintenance dose is usually 40 mg every other week. However, some patients may benefit from a weekly dose, depending on the condition and doctor's advice.
  •  

  • **Adjustments**: Dosage frequency may be adjusted based on response and tolerability, making healthcare provider consultation crucial.

 

Consulting Your Physician

 

  • Due to the varying nature of autoimmune conditions, always consult your healthcare professional to determine the appropriate regimen for your specific situation.

 

Have questions left?

Get a personalized online consultation with a doctor at Curex

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

A weight management program tailored to you

Initial Dosage

Your initial medication and dosage are carefully determined by doctors, taking into account your unique health profile. This ensures a personalized and safe treatment plan tailored to your specific needs.

Titration

We gradually adjust your dosage to reach the optimal therapeutic level, ensuring maximum effectiveness while minimizing potential side effects.

Additional Treatments

Our providers may also recommend medications such as metformin or supplements such as vitamin B12. We recognize the importance of managing side effects, so your care plan may include medication to alleviate them.

Got questions? We have answers.

Do your plans include prescriptions and medications?

Curex plans cover everything from reviewing your medical intake to providing prescription medications, with free shipping included. There are no extra or hidden charges. Prescriptions are issued only after a medical provider reviews your information to confirm that the medication is suitable for you. Our service includes continuous support and regular follow-ups to ensure your treatment stays on track.

Our clinicians may order labs and additional medications for you, which would not be covered by the plan but for which you can use your insurance.

Please note: Compounded medications are tailored to individual needs or used in case of shortages, but they are not FDA-approved for safety or effectiveness. A prescription is required. Results may vary from person to person.

What medications do your providers prescribe?

We prioritize a personalized approach to your health. If your medical provider prescribes medication, options may include GLP-1 treatments such as compounded semaglutide (the active ingredient in Wegovy®* and Ozempic®*). Our providers prescribe only combination treatments not available at your local pharmacy that may include vitamin B12, etc. to help you achieve your goals faster.

Depending on your treatment goals, other medications such as metformin may also be considered. We recognize the importance of managing side effects, so your care plan might include medication to ease symptoms like nausea. Your well-being is always our top priority!

Please note that compounded medications are customized to meet individual patient needs and are not FDA-approved for safety or effectiveness. A prescription is necessary. Results may vary from person to person.

Curex and its pharmacy partners do not have any association with Novo Nordisk.

Will I be prescribed semaglutide if I sign up?

Your health journey is unique, and we tailor our care to match. Any prescriptions, including semaglutide, will be based on the expert assessment of the medical provider matched with you through our platform. You can trust that your treatment plan will be personalized to fit your specific needs. And if semaglutide is not prescribed, we will provide a full refund.

What is compounded medication?

Compounding involves creating customized medications to meet the specific needs of individual patients. For instance, a patient may require a liquid version of a medication that is only available in tablet form. Pharmacies can also compound medications using FDA-approved drugs that are on the FDA’s shortage list.

These compounded medications are made by state-licensed pharmacies that follow both federal and state regulations, including quality standards. However, when compounded in accordance with these laws, these medications are not subject to FDA approval and are not evaluated for safety or effectiveness.

Is compounded medication the same as generic medication?

Compounded medications differ from generic drugs. Generics require FDA approval by demonstrating bio-equivalence to the brand-name drug. In contrast, compounded medications are not FDA-approved. They are made based on a personalized prescription that may not be commercially available elsewhere or when a drug appears on the FDA’s shortage list. Compounding pharmacies must have the proper licensed facilities and comply with state and federal regulations before dispensing these medications.

Is insurance required?

No, Curex doesn’t require insurance. We offer clear and simple pricing, along with affordable medication options, making it easy and accessible to take care of your health.

Can I pay with an FSA or HSA card?

Yes! You can pay with your HSA or FSA card.

How much does treatment cost?

Semaglutide Injections:

Prices for semaglutide start at only $149 per month for weekly doses of 0.25mg and 0.5mg. You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 1mg, 1.7mg and 2.4mg of semaglutide for an additional $50 per month for each plan.

Tirzepatide Injections:

Prices for tirzepatide start at only $249 per month for weekly doses of 2.5mg and 5mg of tirzepatide.You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 7.5mg, 10mg and 12.5mg of tirzepatide for an additional $100 per month for each plan.

Semaglutide Tablets:

Prices for semaglutide tablets start at only $149 per month for daily doses of 2mg. You can cancel anytime. Some people experience weight loss at this dose and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 4mg and 8mg of semaglutide daily for an additional $50 per month for each plan.

Tirzepatide Tablets:

Prices for tirzepatide start at only $199 per month for daily dosees of 3mg of tirzepatide. You can cancel anytime. Some people experience weight loss at these doses and higher doses aren't advisable due to a higher risk of side effects. If you need a higher dose to achieve your weight loss goals, we offer higher-dose plans for 6mg and 12 mg of tirzepatide daily for an additional $100 per month for each plan.

Can you prescribe Ozempic®* or Wegovy®*?

Our providers focus on personalized medications and dosages that aren’t commercially available at your local pharmacy. While we don’t prescribe Ozempic®* or Wegovy®* directly, we may prescribe treatments containing the same active ingredient. These medications are specially compounded for you by a licensed pharmacy to meet your specific needs.

Are video visits with a provider required?

Our providers will review your information 100% online. Depending on where you live and the specifics of your medical history, our providers may require you to have a video visit or asynchronous visit via text message. If prescribed, you’ll get unlimited online access to message your provider as needed for follow-ups, adjustments, and answers to your questions.

What states do you serve?

Currently, we do not serve Arkansas, Connecticut, and New Mexico. However, we are always working to expand our reach, so stay in touch with us at hi@getcurex.com.

Made in Webflow