Does Security Health Plan Cover Symbicort

Explore if Security Health Plan covers Symbicort, reasons for denial, coverage steps, Symbicort costs without insurance, and FAQs.
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Does Security Health Plan Cover Symbicort?

 

  • Coverage for Symbicort under Security Health Plan may depend on specific plan benefits, including formulary status and medical necessity.
  •  

  • Typically covers Symbicort for asthma or COPD management, provided there is a documented need and it is part of the formulary list.
  •  

  • A prior authorization process might be necessary, requiring proof of diagnosis and previous prescription treatments.
  •  

  • Members are encouraged to consult the plan’s formulary or contact customer service for confirmation of coverage specifics and any possible out-of-pocket costs.
  •  

  • It’s essential to verify specific policy terms, as coverage and criteria may vary by location and individual plan type.

 

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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 Symbicort Coverage with Security Health Plan

 

Understand Security Health Plan Coverage

 

  • Review the benefits offered by Security Health Plan, focusing on the prescription drug coverage section to understand what is included under your current plan.
  •  

  • Check the formulary provided by Security Health Plan to make sure Symbicort is listed. The formulary is a list of medications that are covered by your insurance.

 

Consult with Your Healthcare Provider

 

  • Discuss Symbicort as a treatment option with your healthcare provider and ensure it is medically necessary for your condition.
  •  

  • Request your healthcare provider to submit any required documentation or medical necessity forms to Security Health Plan to support the need for Symbicort.

 

Contact Security Health Plan

 

  • Reach out to Security Health Plan’s customer service for detailed information on obtaining coverage for Symbicort, their process, and any specific requirements they may have.
  •  

  • Inquire about any co-pays or out-of-pocket costs associated with Symbicort under your plan. Verify if a prior authorization is needed before filling the prescription.

 

Complete Prior Authorization

 

  • If prior authorization is required, work with your healthcare provider to complete and submit the necessary forms. This step is crucial for getting coverage approved.
  •  

  • Follow up with both your provider and Security Health Plan to ensure the authorization is processed in a timely manner.

 

Fill Your Prescription

 

  • Once you have prior authorization, take your prescription to a pharmacy that is in-network with Security Health Plan to fill your order.
  •  

  • Verify with the pharmacist that your insurance coverage for Symbicort is applied correctly, and confirm any remaining cost you need to pay.

 

Appeal if Necessary

 

  • If your request for Symbicort coverage is denied, review the denial letter carefully to understand the reasons provided by Security Health Plan.
  •  

  • Use Security Health Plan’s appeal process to submit a reconsideration request, providing any additional documentation or justification necessary to support your case.

 

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FAQs

Does Security Health Plan Cover Symbicort

Explore if Security Health Plan covers Symbicort, reasons for denial, coverage steps, Symbicort costs without insurance, and FAQs.
Curex allergy drops unboxing

Is Symbicort Covered by Security Health Plan

 

Does Security Health Plan Cover Symbicort?

 

  • Coverage for Symbicort under Security Health Plan may depend on specific plan benefits, including formulary status and medical necessity.
  •  

  • Typically covers Symbicort for asthma or COPD management, provided there is a documented need and it is part of the formulary list.
  •  

  • A prior authorization process might be necessary, requiring proof of diagnosis and previous prescription treatments.
  •  

  • Members are encouraged to consult the plan’s formulary or contact customer service for confirmation of coverage specifics and any possible out-of-pocket costs.
  •  

  • It’s essential to verify specific policy terms, as coverage and criteria may vary by location and individual plan type.

 

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Security Health Plan's Approved Criteria for Symbicort Coverage

 

Eligibility for Symbicort Coverage

 

  • Patient must have a documented diagnosis of asthma or chronic obstructive pulmonary disease (COPD).
  •  

  • Documentation of failed previous management with at least one preferred inhaled corticosteroid in combination with a long-acting beta-agonist (LABA) or confirmation that such therapies are not appropriate for the patient.
  •  

  • Symbicort is prescribed as part of a comprehensive asthma or COPD maintenance treatment plan.
  •  

 

Age Requirements

 

  • Symbicort coverage is typically approved for patients aged 12 years and older for asthma management.
  •  

  • Patients with COPD must be 18 years or older to qualify for coverage.
  •  

 

Quantity Limits

 

  • Monthly quantity limits for Symbicort are enforced to ensure appropriate use of the medication as prescribed by healthcare professionals.
  •  

  • Requests for additional quantities beyond the standard monthly allotment will require prior authorization and substantial clinical justification.
  •  

 

Prior Authorization Requirements

 

  • A detailed medical history and documentation supporting the need for Symbicort must be provided by a healthcare provider for prior authorization approval.
  •  

  • Prior authorization ensures that Symbicort is used as part of a step-wise treatment approach for controlling asthma or COPD symptoms.
  •  

 

Special Provisions for Specific Conditions

 

  • Patients with severe asthma or COPD who are considered high-risk may qualify for exceptions to standard coverage criteria, pending clinical review and documentation by their healthcare provider.
  •  

  • Exceptions may include patients who have frequent exacerbations or hospitalizations related to their respiratory condition.
  •  

 

Why Security Health Plan Might Deny Symbicort Coverage

 

Reasons Symbicort Coverage Might Be Denied by Security Health Plan

 

  • **Non-Formulary Drug**: If Symbicort is not included in the formulary list of medications covered by Security Health Plan, it may not be eligible for coverage.
  •  

  • **Frequent Prescription Changes**: Coverage might be denied if there is a history of frequent prescription changes without clear medical justification.
  •  

  • **Off-Label Use**: The plan may reject coverage if Symbicort is prescribed for a condition not approved by the FDA or not documented in the plan's coverage guidelines.
  •  

  • **Failure to Try Preferred Alternatives**: If preferred alternative treatments listed by the plan have not been tried and documented, Symbicort coverage is likely to be denied.
  •  

  • **Non-Compliance with Step Therapy**: Coverage may be denied if the required step therapy protocols—starting with cheaper drugs before moving to Symbicort—are not followed.
  •  

  • **Lack of Prior Authorization**: If prior authorization procedures are not completed or approved, Security Health Plan may deny coverage for Symbicort.
  •  

  • **Exceeded Quantity Limits**: The coverage might be denied if the prescribed quantity of Symbicort exceeds the plan’s set limits and no exception has been granted.
  •  

  • **Absence of Medical Necessity**: If the prescribed use of Symbicort does not meet the plan’s criteria for medical necessity, coverage may be denied.

 

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How Much Does Symbicort Cost without Insurance?

 

Cost of Symbicort without Insurance

 

  • Symbicort is a prescription medication commonly used to treat asthma and chronic obstructive pulmonary disease (COPD). Without insurance, its cost can be quite high, varying largely due to factors such as dosage, pharmacy, and location. On average, the out-of-pocket cost for a 30-day supply of Symbicort (160/4.5 mcg) inhaler is around $250 to $350.
  •  

  • Prices can vary significantly from one pharmacy to another. Some big-box or discount pharmacies might offer slightly lower prices, while smaller local pharmacies may have higher rates without insurance discounts.
  •  

  • Patients can also explore manufacturer coupons or patient assistance programs, which might help reduce the overall cost. Additionally, online resources and discount cards may offer ways to slightly lower the cash price at participating pharmacies.
  •  

  • It's advisable for patients to check various pharmacies to ensure they are getting the best possible price. Comparing online pharmacy prices and visiting discount retailers could help mitigate high costs when paying out-of-pocket.

 

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 Symbicort Coverage with Security Health Plan

 

Understand Security Health Plan Coverage

 

  • Review the benefits offered by Security Health Plan, focusing on the prescription drug coverage section to understand what is included under your current plan.
  •  

  • Check the formulary provided by Security Health Plan to make sure Symbicort is listed. The formulary is a list of medications that are covered by your insurance.

 

Consult with Your Healthcare Provider

 

  • Discuss Symbicort as a treatment option with your healthcare provider and ensure it is medically necessary for your condition.
  •  

  • Request your healthcare provider to submit any required documentation or medical necessity forms to Security Health Plan to support the need for Symbicort.

 

Contact Security Health Plan

 

  • Reach out to Security Health Plan’s customer service for detailed information on obtaining coverage for Symbicort, their process, and any specific requirements they may have.
  •  

  • Inquire about any co-pays or out-of-pocket costs associated with Symbicort under your plan. Verify if a prior authorization is needed before filling the prescription.

 

Complete Prior Authorization

 

  • If prior authorization is required, work with your healthcare provider to complete and submit the necessary forms. This step is crucial for getting coverage approved.
  •  

  • Follow up with both your provider and Security Health Plan to ensure the authorization is processed in a timely manner.

 

Fill Your Prescription

 

  • Once you have prior authorization, take your prescription to a pharmacy that is in-network with Security Health Plan to fill your order.
  •  

  • Verify with the pharmacist that your insurance coverage for Symbicort is applied correctly, and confirm any remaining cost you need to pay.

 

Appeal if Necessary

 

  • If your request for Symbicort coverage is denied, review the denial letter carefully to understand the reasons provided by Security Health Plan.
  •  

  • Use Security Health Plan’s appeal process to submit a reconsideration request, providing any additional documentation or justification necessary to support your case.

 

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Symbicort FAQ

1. What are the side effects of Symbicort?

 

Common Side Effects of Symbicort

 

  • Headache: Frequently reported and usually mild.
  • Throat irritation: Can occur due to inhalation route.
  • Hoarseness: Temporary voice changes may be noticed.
  • Cough: Occasional, linked to inhaler use.

 

Less Common Side Effects

 

  • Nausea: A less frequent side effect.
  • Increased blood pressure: Monitor regularly.
  • Palpitations: Uncommon but notable.
  • Muscle cramps: May occur in some patients.

 

Rare but Serious Side Effects

 

  • Allergic reactions: Rash, itching, or difficulty breathing.
  • Worsening of asthma: Requires immediate attention.
  • Pneumonia: Particularly in COPD patients.
  • Cardiac arrhythmias: Monitor heart rhythm.

 

2. How does Symbicort work for asthma?

 

How Symbicort Works

 

  • Combination Therapy: Symbicort contains budesonide, a corticosteroid, and formoterol, a long-acting beta-agonist. Together, they manage asthma by reducing inflammation and opening airways.
  •  

  • Inflammation Control: Budesonide targets the inflammatory process in the lungs, decreasing swelling and irritation to prevent asthma symptoms.
  •  

  • Bronchodilation: Formoterol relaxes muscles around the airways, quickly improving breathing and reducing wheezing.
  •  

  • Maintenance and Relief: While primarily for maintenance, Symbicort provides relief from symptoms and reduces the frequency of asthma attacks.

 

3. Is Symbicort a steroid inhaler?

 

Is Symbicort a Steroid Inhaler?

 

  • Yes, Symbicort is a combination inhaler that contains a steroid. It combines budesonide, a corticosteroid, and formoterol, a long-acting beta agonist (LABA).
  •  

  • Corticosteroids like budesonide help to reduce inflammation in the airways, which is crucial for managing asthma and chronic obstructive pulmonary disease (COPD).
  •  

  • Formoterol helps in relaxing the muscles around the airways to make breathing easier.
  •  

  • Symbicort is prescribed for long-term management and not for immediate relief of acute symptoms.
  •  

  • Regular use is essential to decrease the chance of flare-ups and improve overall lung function.

 

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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.

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