Does SelectHealth Cover Benzphetamine (Didrex)

Explore coverage for Benzphetamine (Didrex) by SelectHealth, understand cost factors, and learn how to secure coverage if initially denied.
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Coverage for Benzphetamine (Didrex)

 

  • SelectHealth may cover Benzphetamine (Didrex) under certain circumstances. Coverage usually applies when the prescription is deemed medically necessary for treating obesity, particularly in cases where it is part of a comprehensive weight loss plan.
  •  

  • Before Benzphetamine is covered, patients typically need to demonstrate that they have unsuccessfully tried other weight management measures, such as diet and exercise, or other medications. Documentation of these efforts may be required.
  •  

  • Coverage is typically contingent upon a prior authorization process. This process usually requires healthcare providers to submit detailed medical records and justification for using Benzphetamine, including the anticipated benefit for the patient and any pertinent health conditions that necessitate this treatment.

 

Basic Rules and Criteria

 

  • Patients must be enrolled in a SelectHealth plan that includes prescription drug coverage. The relevant plan documentation should specify whether Benzphetamine is included in the formulary list.
  •  

  • Physicians may need to prescribe Benzphetamine for short-term use, as part of a broader treatment plan reviewed periodically for effectiveness and safety.
  •  

  • Patients may have to meet specific criteria such as BMI thresholds or comorbid conditions for coverage approval. These criteria can vary based on plan-specific guidelines.

 

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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.

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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.

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Immunotherapy made simple.  We enable patients to receive personalized allergy care on their own time. No more waiting rooms.

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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 Benzphetamine (Didrex) Coverage with SelectHealth

 

Contact SelectHealth Customer Service

 

  • Reach out to SelectHealth by calling the number on the back of your insurance card.
  •  

  • Ask for information specifically about coverage for Benzphetamine (Didrex).
  •  

  • Request clarification on any requirements or procedures necessary for coverage.

 

Review SelectHealth Formulary

 

  • Visit the SelectHealth website and access their formulary, which is a list of covered medications.
  •  

  • Search for Benzphetamine (Didrex) within the formulary to confirm its coverage status.
  •  

  • If Benzphetamine is not listed, inquire with SelectHealth about possible alternatives or necessary steps for a prior authorization.

 

Consult with Your Healthcare Provider

 

  • Speak with your doctor about your need for Benzphetamine (Didrex) and discuss your insurance coverage situation.
  •  

  • Request that your healthcare provider submits a prior-authorization request to SelectHealth if necessary.
  •  

  • Ensure your doctor provides all required documentation to support the medical necessity of the prescription.

 

Submit a Formal Prior Authorization Request

 

  • If required, work with your healthcare provider to submit a prior authorization request directly to SelectHealth.
  •  

  • Ensure that all relevant medical information and justification for Benzphetamine (Didrex) are included.
  •  

  • Follow up with your healthcare provider to confirm submission and approval status.

 

Appeal Denied Prior Authorization

 

  • If your initial prior authorization request is denied, file an appeal with SelectHealth.
  •  

  • Gather additional supporting documents or statements from your healthcare provider.
  •  

  • Submit the appeal promptly following SelectHealth’s outlined process and time frame.
  •  

  • Stay in contact with SelectHealth to track the status of your appeal.

 

Enroll in Patient Assistance Programs

 

  • Explore patient assistance programs offered by pharmaceutical companies for Benzphetamine (Didrex), if coverage cannot be obtained.
  •  

  • Contact the manufacturer of Benzphetamine for information on available programs and application processes.
  •  

  • Work with your healthcare provider to gather necessary documentation for program applications.

 

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FAQs

Does SelectHealth Cover Benzphetamine (Didrex)

Explore coverage for Benzphetamine (Didrex) by SelectHealth, understand cost factors, and learn how to secure coverage if initially denied.
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Is Benzphetamine (Didrex) Covered by SelectHealth

 

Coverage for Benzphetamine (Didrex)

 

  • SelectHealth may cover Benzphetamine (Didrex) under certain circumstances. Coverage usually applies when the prescription is deemed medically necessary for treating obesity, particularly in cases where it is part of a comprehensive weight loss plan.
  •  

  • Before Benzphetamine is covered, patients typically need to demonstrate that they have unsuccessfully tried other weight management measures, such as diet and exercise, or other medications. Documentation of these efforts may be required.
  •  

  • Coverage is typically contingent upon a prior authorization process. This process usually requires healthcare providers to submit detailed medical records and justification for using Benzphetamine, including the anticipated benefit for the patient and any pertinent health conditions that necessitate this treatment.

 

Basic Rules and Criteria

 

  • Patients must be enrolled in a SelectHealth plan that includes prescription drug coverage. The relevant plan documentation should specify whether Benzphetamine is included in the formulary list.
  •  

  • Physicians may need to prescribe Benzphetamine for short-term use, as part of a broader treatment plan reviewed periodically for effectiveness and safety.
  •  

  • Patients may have to meet specific criteria such as BMI thresholds or comorbid conditions for coverage approval. These criteria can vary based on plan-specific guidelines.

 

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SelectHealth's Approved Criteria for Benzphetamine (Didrex) Coverage

 

Approved Criteria for Benzphetamine (Didrex) Coverage

 

  • **Patient Diagnosis:** The patient must have a documented diagnosis of exogenous obesity as determined by a healthcare provider.
  •  

  • **Body Mass Index (BMI):** The patient should have a BMI of 30 kg/m² or greater, or 27 kg/m² or greater with at least one related comorbidity such as diabetes, hypertension, or dyslipidemia.
  •  

  • **Age Requirement:** Coverage is applicable for patients who are 12 years of age or older, aligning with the FDA approved age for use.
  •  

  • **Treatment Plan Integration:** Benzphetamine must be part of a comprehensive weight management program that includes dietary changes, increased physical activity, and behavior modification.
  •  

  • **Previous Weight Loss Efforts:** Documentation of previous weight loss attempts through diet, exercise, or previous pharmacotherapy must be presented, showing limited progress or weight regains.
  •  

  • **Monitoring and Evaluation:** Continuous monitoring of the patient’s progress by a healthcare provider is required. Regular assessments should be documented to evaluate effectiveness and any potential side effects.
  •  

  • **Duration of Use:** The initial coverage is typically for a period of 12 weeks. Continuation beyond this period requires documentation of significant weight reduction and no adverse effects.

 

Why SelectHealth Might Deny Benzphetamine (Didrex) Coverage

 

Exclusions for Benzphetamine (Didrex) Coverage

 

  • SelectHealth may exclude coverage for Benzphetamine (Didrex) if it is deemed not medically necessary. This could include situations where the medication is prescribed outside of accepted medical practices or guidelines.
  •  

  • The drug may not be covered if used for off-label purposes that have not been approved or recognized by appropriate medical authorities or guidelines.
  •  

  • If a patient has a history of drug or alcohol abuse, SelectHealth might deny the coverage, presuming a higher risk of misuse or addiction associated with the use of Benzphetamine.
  •  

  • Benzphetamine (Didrex) may not be covered if it is a part of a combination therapy where a similar therapeutic option covered by the plan can achieve the same outcome.
  •  

  • In instances where Benzphetamine (Didrex) is not the first-line treatment, SelectHealth might require prior authorization, and lack of compliance with this requirement could result in denial of coverage.
  •  

  • The medication may be excluded from coverage if it is not included in the SelectHealth formulary or tiered drug list.
  •  

  • If Benzphetamine (Didrex) is prescribed for cosmetic weight loss rather than treatment of obesity as diagnosed by standardized medical criteria, coverage may be denied.
  •  

  • Situations in which the prescriber or pharmacy fails to provide sufficient or required documentation supporting the necessity of Benzphetamine (Didrex) could lead to denial.

 

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How Much Does Benzphetamine (Didrex) Cost without Insurance?

 

Understanding Benzphetamine (Didrex) Cost

 

  • Benzphetamine, commonly known by the brand name Didrex, is a prescription medication used as a short-term adjunct in weight reduction therapy.
  •  

  • The cost of Benzphetamine without insurance can vary significantly depending on the pharmacy and the dosage prescribed.
  •  

  • On average, the cost for a 30-day supply of Benzphetamine (50 mg tablets) can range from $40 to $70.
  •  

  • Prices may be higher or lower, depending on location, pharmacy pricing policies, and available discounts or coupons.
  •  

  • Pharmacy discount programs and generic versions of the drug may offer cost savings.

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 Benzphetamine (Didrex) Coverage with SelectHealth

 

Contact SelectHealth Customer Service

 

  • Reach out to SelectHealth by calling the number on the back of your insurance card.
  •  

  • Ask for information specifically about coverage for Benzphetamine (Didrex).
  •  

  • Request clarification on any requirements or procedures necessary for coverage.

 

Review SelectHealth Formulary

 

  • Visit the SelectHealth website and access their formulary, which is a list of covered medications.
  •  

  • Search for Benzphetamine (Didrex) within the formulary to confirm its coverage status.
  •  

  • If Benzphetamine is not listed, inquire with SelectHealth about possible alternatives or necessary steps for a prior authorization.

 

Consult with Your Healthcare Provider

 

  • Speak with your doctor about your need for Benzphetamine (Didrex) and discuss your insurance coverage situation.
  •  

  • Request that your healthcare provider submits a prior-authorization request to SelectHealth if necessary.
  •  

  • Ensure your doctor provides all required documentation to support the medical necessity of the prescription.

 

Submit a Formal Prior Authorization Request

 

  • If required, work with your healthcare provider to submit a prior authorization request directly to SelectHealth.
  •  

  • Ensure that all relevant medical information and justification for Benzphetamine (Didrex) are included.
  •  

  • Follow up with your healthcare provider to confirm submission and approval status.

 

Appeal Denied Prior Authorization

 

  • If your initial prior authorization request is denied, file an appeal with SelectHealth.
  •  

  • Gather additional supporting documents or statements from your healthcare provider.
  •  

  • Submit the appeal promptly following SelectHealth’s outlined process and time frame.
  •  

  • Stay in contact with SelectHealth to track the status of your appeal.

 

Enroll in Patient Assistance Programs

 

  • Explore patient assistance programs offered by pharmaceutical companies for Benzphetamine (Didrex), if coverage cannot be obtained.
  •  

  • Contact the manufacturer of Benzphetamine for information on available programs and application processes.
  •  

  • Work with your healthcare provider to gather necessary documentation for program applications.

 

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Benzphetamine (Didrex) FAQ

What are the side effects of Benzphetamine (Didrex)?

 

Common Side Effects

 

  • Insomnia
  • Nervousness
  • Dizziness
  • Dry Mouth
  • Headache
  • Constipation

 

Severe Side Effects

 

  • Increased Blood Pressure
  • Heart Palpitations
  • Seizures
  • Severe Mood Changes
  • Chest Pain
  • Breathing Difficulties

 

Important Considerations

 

  • If you experience severe side effects, seek medical attention immediately.
  • Use cautiously if you have a history of cardiovascular conditions.
  • Avoid usage in individuals with a history of drug abuse.
  • Always follow the prescribed dosage to minimize risks.
  • Inform your doctor of any existing health conditions or medications.

 

How does Benzphetamine help with weight loss?

 

Mechanism of Action

 

  • Benzphetamine is an appetite suppressant. It stimulates the central nervous system, which increases heart rate and blood pressure.
  •  
  • This leads to a reduced appetite and a feeling of fullness, helping individuals to control their caloric intake.

 

Usage Guidelines

 

  • It should be used as part of a comprehensive weight loss plan, including diet, exercise, and behavioral modification.
  •  
  • Typically prescribed for short-term use to jump-start weight loss efforts.

 

Precautions

 

  • Not suitable for individuals with a history of cardiovascular diseases, hyperthyroidism, or glaucoma.
  •  
  • It may cause side effects such as insomnia, dizziness, and dry mouth.

Is Benzphetamine similar to Phentermine?

 

Similarity between Benzphetamine and Phentermine

 

  • Benzphetamine (Didrex) and Phentermine are both stimulant medications primarily used to treat obesity.
  •  

  • They function as appetite suppressants by affecting the central nervous system.
  •  

  • Both are chemically related to amphetamines but are not classified as amphetamines themselves.

 

Differences

 

  • Benzphetamine is a prodrug and metabolizes into amphetamine and methamphetamine, while Phentermine does not convert into amphetamine derivatives.
  •  

  • Phentermine is generally preferred due to a more established safety profile and fewer side effects compared to Benzphetamine.
  •  

  • Phentermine is typically dosed once daily, whereas Benzphetamine might require multiple doses.

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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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