Does SelectHealth Cover Aimovig

Explore Aimovig coverage with SelectHealth, reasons for denial, cost without insurance, and FAQs to navigate your treatment options effectively.
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“Curex is changing the landscape of allergies in 2024”
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SelectHealth Coverage for Aimovig

 

  • SelectHealth may cover Aimovig for patients diagnosed with migraine who have not responded well to other preventive treatments. Coverage is often subjected to prior authorization, which requires documentation of medical necessity.
  •  

  • Patients typically need to meet criteria such as chronic migraine diagnosis and previous trial of other migraine preventives without adequate relief. Specific requirements can vary, and it's essential to check your individual plan details.
  •  

  • Some plans may require patients to use preferred medications before approving Aimovig coverage. Ensure that all criteria specified in your plan for step therapy or prior authorization are satisfied for potential coverage.
  •  

  • Consult with healthcare providers and the SelectHealth customer service to confirm whether pre-existing conditions or additional documentation might affect the approval process.

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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 Aimovig Coverage with SelectHealth

 

Verify Your Coverage

 

  • Contact SelectHealth customer service to verify if Aimovig is covered under your current plan. This is crucial to understand the specifics of your benefits.
  •  

  • Access your SelectHealth member portal online to check your prescription drug list which will indicate if Aimovig is included in your coverage.

 

Consult with Your Healthcare Provider

 

  • Speak with your doctor about your need for Aimovig. Ensure they are willing to provide necessary documentation to support the medical necessity of this medication.
  •  

  • Request a prior authorization form from your healthcare provider's office if necessary. This form is often required by insurance providers for specialty medications like Aimovig.

 

Submit a Prior Authorization Request

 

  • Complete the prior authorization request form with your healthcare provider’s help. This form will include details of your medical condition and why Aimovig is necessary for your treatment.
  •  

  • Send the completed form and any additional required documentation to SelectHealth for review.

 

Follow Up on the Authorization

 

  • Check the status of your prior authorization request by contacting SelectHealth customer service or through their online portal. This ensures that your request is being processed.
  •  

  • If your request is initially denied, inquire about the reasons for denial and your options for appeal or resubmission.

 

Review Out-of-Pocket Costs

 

  • Determine your co-payments or other out-of-pocket costs once approval is obtained. This information can be found in your SelectHealth member portal or by contacting customer service.
  •  

  • Explore SelectHealth's financial assistance programs if the cost is a concern to see if you qualify for any reductions or support.

 

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Does SelectHealth Cover Aimovig

Explore Aimovig coverage with SelectHealth, reasons for denial, cost without insurance, and FAQs to navigate your treatment options effectively.
Curex allergy drops unboxing

Is Aimovig Covered by SelectHealth

 

SelectHealth Coverage for Aimovig

 

  • SelectHealth may cover Aimovig for patients diagnosed with migraine who have not responded well to other preventive treatments. Coverage is often subjected to prior authorization, which requires documentation of medical necessity.
  •  

  • Patients typically need to meet criteria such as chronic migraine diagnosis and previous trial of other migraine preventives without adequate relief. Specific requirements can vary, and it's essential to check your individual plan details.
  •  

  • Some plans may require patients to use preferred medications before approving Aimovig coverage. Ensure that all criteria specified in your plan for step therapy or prior authorization are satisfied for potential coverage.
  •  

  • Consult with healthcare providers and the SelectHealth customer service to confirm whether pre-existing conditions or additional documentation might affect the approval process.

A weight management program tailored to you

Start with Curex

SelectHealth's Approved Criteria for Aimovig Coverage

 

SelectHealth's Approved Criteria for Aimovig Coverage

 

  • **Diagnosis Verification**: Coverage is provided for members with a confirmed diagnosis of chronic or episodic migraine, consisting of at least 4 migraine days per month.
  •  

  • **Previous Treatment Attempts**: Members must demonstrate inadequate response, intolerance, or contraindication to at least two different classes of preventive migraine medications such as beta blockers, antiepileptics, or antidepressants.
  •  

  • **Member Eligibility**: The member must be 18 years of age or older.
  •  

  • **Prescription by a Specialist**: The prescription must be issued by, or in consultation with, a neurologist or headache specialist.
  •  

  • **Dosage Adherence**: Aimovig must be prescribed within the recommended dosage guidelines of 70 mg or 140 mg once monthly.
  •  

  • **Initial Authorization**: Coverage for an initial 6-month period is authorized to evaluate efficacy.
  •  

  • **Reauthorization**: Continuation of coverage requires documented improvement, evidenced by a decrease in the frequency, severity, or duration of migraine episodes relative to baseline measures.

 

Why SelectHealth Might Deny Aimovig Coverage

 

Reasons for Denial of Aimovig Coverage by SelectHealth

 

  • The prescribed dosage or frequency does not align with SelectHealth's approved guidelines or medical necessity criteria for Aimovig.
  •  

  • Aimovig is being sought for a condition or diagnosis that falls outside of what SelectHealth considers medically necessary for this medication.
  •  

  • Prior authorization requirements have not been met, including failure to provide necessary documentation supporting the use of Aimovig.
  •  

  • Alternative treatment options must be tried or have not been adequately trialed and documented before authorizing Aimovig, according to SelectHealth's step therapy protocols.
  •  

  • The patient does not meet specific criteria based on SelectHealth’s clinical guidelines or criteria for migraine prevention treatment with Aimovig.
  •  

  • Coverage is not available for Aimovig due to limitations in the specific SelectHealth insurance plan or policy held by the patient.
  •  

  • A claim for coverage has been submitted outside SelectHealth’s required time frames or without necessary compliance with plan protocols.

 

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

How Much Does Aimovig Cost without Insurance?

 

Understanding the Cost of Aimovig Without Insurance

 

  • Aimovig, a medication for preventing migraines, can be quite expensive without insurance coverage.
  • The cost of Aimovig typically ranges from $575 to $725 per month for a single dose, depending on the pharmacy and geographic location.
  • This price reflects the retail cost for the 70 mg dosage, which is commonly used in migraine prevention treatment.
  • The 140 mg dosage generally costs about the same per unit; however, as a higher dose, it could be slightly more expensive overall, since some patients might be prescribed two doses of 70 mg.

 

Additional Considerations

 

  • Prices can vary significantly due to factors such as pharmacy pricing policies, location, and availability.
  • Discount programs and pharmaceutical aid may be available for eligible patients, which can help reduce the out-of-pocket cost.
  • It's advisable for patients to shop around, as different pharmacies may offer various pricing or additional discounts.
  • Patients should also consider discussing with their healthcare provider about any available generic alternatives or other cost-effective treatment options.

 

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 Aimovig Coverage with SelectHealth

 

Verify Your Coverage

 

  • Contact SelectHealth customer service to verify if Aimovig is covered under your current plan. This is crucial to understand the specifics of your benefits.
  •  

  • Access your SelectHealth member portal online to check your prescription drug list which will indicate if Aimovig is included in your coverage.

 

Consult with Your Healthcare Provider

 

  • Speak with your doctor about your need for Aimovig. Ensure they are willing to provide necessary documentation to support the medical necessity of this medication.
  •  

  • Request a prior authorization form from your healthcare provider's office if necessary. This form is often required by insurance providers for specialty medications like Aimovig.

 

Submit a Prior Authorization Request

 

  • Complete the prior authorization request form with your healthcare provider’s help. This form will include details of your medical condition and why Aimovig is necessary for your treatment.
  •  

  • Send the completed form and any additional required documentation to SelectHealth for review.

 

Follow Up on the Authorization

 

  • Check the status of your prior authorization request by contacting SelectHealth customer service or through their online portal. This ensures that your request is being processed.
  •  

  • If your request is initially denied, inquire about the reasons for denial and your options for appeal or resubmission.

 

Review Out-of-Pocket Costs

 

  • Determine your co-payments or other out-of-pocket costs once approval is obtained. This information can be found in your SelectHealth member portal or by contacting customer service.
  •  

  • Explore SelectHealth's financial assistance programs if the cost is a concern to see if you qualify for any reductions or support.

 

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.

Aimovig FAQ

1. What are the common side effects of Aimovig?

 

Common Side Effects of Aimovig

 

  • **Injection site reactions**: You may experience pain, redness, or swelling where the injection was administered.
  •  

  • **Constipation**: This is a frequently reported side effect, which may vary in severity.
  •  

  • **Muscle spasms**: Some patients may encounter muscle spasms post-administration.
  •  

  • **Fatigue**: Feeling unusually tired or exhausted can commonly occur.
  •  

  • **Nausea**: A feeling of queasiness may be experienced, often mild but potentially bothersome.

 

Note

 

  • Consult with a healthcare provider if side effects persist or worsen.
  •  

  • Serious side effects are rare but should be addressed immediately with professional advice.

 

2. How does Aimovig work to prevent migraines?

 

What is Aimovig?

 

  • Aimovig is a monoclonal antibody used for preventing migraines by targeting the CGRP pathway.

 

How Aimovig Works

 

  • Aimovig binds to the calcitonin gene-related peptide (CGRP) receptor, inhibiting its activity.
  • By blocking CGRP, Aimovig reduces vasodilation and inflammation, commonly linked to migraines.
  • This prevention mechanism helps decrease the frequency and intensity of migraine attacks.

 

Usage and Administration

 

  • Aimovig is administered through a monthly subcutaneous injection, making it convenient for most patients.
  • It's crucial to follow prescribed dosing and consult healthcare providers if any side effects occur.

 

3. How long does it take for Aimovig to start working?

 

How Aimovig Works

 

  • Aimovig is a monoclonal antibody that targets and inhibits the CGRP receptor, helping to prevent migraine onset.
  •  

  • It is specifically designed to reduce the frequency of migraine days by interfering with a key pathway in migraine pathophysiology.

 

Onset of Effects

 

  • Patients may begin to notice a reduction in migraine frequency as early as one week after the first injection.
  •  

  • Clinical trials indicate that significant reduction in migraine days is typically observed within 3 to 4 weeks of starting Aimovig.
  •  

  • Full therapeutic benefits can develop over subsequent months, and individual response times may vary.

 

Recommendations

 

  • Maintain a migraine diary to monitor changes and discuss them with your healthcare provider.
  •  

  • Continue regular check-ins with your doctor to assess effectiveness and make any necessary adjustments to treatment.

 

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. 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 SelectHealth Cover Aimovig

Explore Aimovig coverage with SelectHealth, reasons for denial, cost without insurance, and FAQs to navigate your treatment options effectively.
Curex allergy drops unboxing

Does SelectHealth Cover Aimovig

 

SelectHealth Coverage for Aimovig

 

  • SelectHealth may cover Aimovig for patients diagnosed with migraine who have not responded well to other preventive treatments. Coverage is often subjected to prior authorization, which requires documentation of medical necessity.
  •  

  • Patients typically need to meet criteria such as chronic migraine diagnosis and previous trial of other migraine preventives without adequate relief. Specific requirements can vary, and it's essential to check your individual plan details.
  •  

  • Some plans may require patients to use preferred medications before approving Aimovig coverage. Ensure that all criteria specified in your plan for step therapy or prior authorization are satisfied for potential coverage.
  •  

  • Consult with healthcare providers and the SelectHealth customer service to confirm whether pre-existing conditions or additional documentation might affect the approval process.

A weight management program tailored to you

Start with Curex

Why SelectHealth Might Deny Aimovig Coverage

 

SelectHealth's Approved Criteria for Aimovig Coverage

 

  • **Diagnosis Verification**: Coverage is provided for members with a confirmed diagnosis of chronic or episodic migraine, consisting of at least 4 migraine days per month.
  •  

  • **Previous Treatment Attempts**: Members must demonstrate inadequate response, intolerance, or contraindication to at least two different classes of preventive migraine medications such as beta blockers, antiepileptics, or antidepressants.
  •  

  • **Member Eligibility**: The member must be 18 years of age or older.
  •  

  • **Prescription by a Specialist**: The prescription must be issued by, or in consultation with, a neurologist or headache specialist.
  •  

  • **Dosage Adherence**: Aimovig must be prescribed within the recommended dosage guidelines of 70 mg or 140 mg once monthly.
  •  

  • **Initial Authorization**: Coverage for an initial 6-month period is authorized to evaluate efficacy.
  •  

  • **Reauthorization**: Continuation of coverage requires documented improvement, evidenced by a decrease in the frequency, severity, or duration of migraine episodes relative to baseline measures.

 

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

Aimovig FAQ

 

Reasons for Denial of Aimovig Coverage by SelectHealth

 

  • The prescribed dosage or frequency does not align with SelectHealth's approved guidelines or medical necessity criteria for Aimovig.
  •  

  • Aimovig is being sought for a condition or diagnosis that falls outside of what SelectHealth considers medically necessary for this medication.
  •  

  • Prior authorization requirements have not been met, including failure to provide necessary documentation supporting the use of Aimovig.
  •  

  • Alternative treatment options must be tried or have not been adequately trialed and documented before authorizing Aimovig, according to SelectHealth's step therapy protocols.
  •  

  • The patient does not meet specific criteria based on SelectHealth’s clinical guidelines or criteria for migraine prevention treatment with Aimovig.
  •  

  • Coverage is not available for Aimovig due to limitations in the specific SelectHealth insurance plan or policy held by the patient.
  •  

  • A claim for coverage has been submitted outside SelectHealth’s required time frames or without necessary compliance with plan protocols.

 

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 Much Does Aimovig Cost without Insurance?

 

Understanding the Cost of Aimovig Without Insurance

 

  • Aimovig, a medication for preventing migraines, can be quite expensive without insurance coverage.
  • The cost of Aimovig typically ranges from $575 to $725 per month for a single dose, depending on the pharmacy and geographic location.
  • This price reflects the retail cost for the 70 mg dosage, which is commonly used in migraine prevention treatment.
  • The 140 mg dosage generally costs about the same per unit; however, as a higher dose, it could be slightly more expensive overall, since some patients might be prescribed two doses of 70 mg.

 

Additional Considerations

 

  • Prices can vary significantly due to factors such as pharmacy pricing policies, location, and availability.
  • Discount programs and pharmaceutical aid may be available for eligible patients, which can help reduce the out-of-pocket cost.
  • It's advisable for patients to shop around, as different pharmacies may offer various pricing or additional discounts.
  • Patients should also consider discussing with their healthcare provider about any available generic alternatives or other cost-effective treatment options.

 

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.

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.