Does WellCare Cover Nexium

Explore Nexium coverage by WellCare. Learn why it might be denied, how to secure it, costs without insurance, and get answers to FAQs.
Curex allergy drops unboxing
“Curex is changing the landscape of allergies in 2024”
man opening Curex packaging
man opening Curex packaging

 

Coverage of Nexium by WellCare

 

  • WellCare may cover prescription Nexium (esomeprazole) in certain situations based on plan specifics.
  •  

  • Coverage often applies to treating conditions like GERD, Zollinger-Ellison syndrome, and prevention of gastric ulcers.
  •  

  • Nexium coverage is generally subject to prior authorization, meaning a doctor must demonstrate medical necessity.

 

Basic Rules and Criteria for Coverage

 

  • A prescription from a healthcare provider is mandatory.
  •  

  • Typically, generic or alternative medications may be recommended before Nexium is covered.
  •  

  • Check the formulary of your specific WellCare plan to confirm Nexium’s inclusion and any restrictions.
  •  

  • Patients may be required to try and fail on other therapies before approval for Nexium.

 

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 Nexium Coverage with WellCare

 

Gather Necessary Information

 

  • Check your WellCare insurance plan details to see if prescription drug coverage is included. You can find this information in your plan documents or by contacting WellCare customer service.
  •  

  • Make a list of your current medications, including Nexium, and note any additional medical requirements or conditions that might impact your coverage needs.

 

Verify Nexium Coverage

 

  • Access WellCare’s formulary list, which is typically available on their official website. This list will indicate whether Nexium is covered under your specific plan.
  •  

  • If you cannot find Nexium on the formulary list, contact WellCare customer support for confirmation and inquire if there are any alternatives or specific criteria needed for coverage.

 

Consult Your Healthcare Provider

 

  • Discuss with your healthcare provider the necessity of using Nexium. They might provide you with documentation or a prescription that supports your need for this medication, which can be useful if you need to apply for pre-authorization or appeal a coverage denial.
  •  

  • Your doctor may also suggest alternative medications that have the same effect as Nexium and are covered by WellCare, which could simplify the process.

 

Pre-Authorization Process

 

  • If Nexium requires pre-authorization, gather all necessary documents, including your prescription, any letters of necessity, and your insurance details.
  •  

  • Submit the pre-authorization request through WellCare, either by using their online portal or through your healthcare provider’s office. Make sure to follow up for confirmation that the request was received and processed.

 

Consideration of Medicare Part D

 

  • If you are on Medicare, review your WellCare Medicare Part D plan to ensure it includes Nexium or inquire about the options available for adding coverage.
  •  

  • Consider switching to a different plan during the open enrollment period if necessary, where Nexium is covered at a better rate or with better terms.

 

Appealing a Denied Claim

 

  • If coverage for Nexium is denied, gather supporting documents such as medical records and a detailed explanation from your healthcare provider.
  •  

  • File an appeal with WellCare, clearly explaining why Nexium is necessary for your health and how alternatives may not be suitable. Keep track of all correspondence and deadlines for submission of additional documents.

 

Regularly Review Plan Updates

 

  • Stay informed about any changes to your WellCare coverage and the formulary list by regularly checking their communications and website.
  •  

  • Adjust your strategy as needed based on any modifications to the coverage details, ensuring Nexium (or its alternatives) remains part of your health plan.

 

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 WellCare Cover Nexium

Explore Nexium coverage by WellCare. Learn why it might be denied, how to secure it, costs without insurance, and get answers to FAQs.
Curex allergy drops unboxing

Is Nexium Covered by WellCare

 

Coverage of Nexium by WellCare

 

  • WellCare may cover prescription Nexium (esomeprazole) in certain situations based on plan specifics.
  •  

  • Coverage often applies to treating conditions like GERD, Zollinger-Ellison syndrome, and prevention of gastric ulcers.
  •  

  • Nexium coverage is generally subject to prior authorization, meaning a doctor must demonstrate medical necessity.

 

Basic Rules and Criteria for Coverage

 

  • A prescription from a healthcare provider is mandatory.
  •  

  • Typically, generic or alternative medications may be recommended before Nexium is covered.
  •  

  • Check the formulary of your specific WellCare plan to confirm Nexium’s inclusion and any restrictions.
  •  

  • Patients may be required to try and fail on other therapies before approval for Nexium.

 

A weight management program tailored to you

Start with Curex

WellCare's Approved Criteria for Nexium Coverage

 

Criteria for Nexium Coverage by WellCare

 

  • **Gastroesophageal Reflux Disease (GERD)**: Coverage is available for individuals diagnosed with GERD, requiring confirmation from diagnostic tests like endoscopy or pH testing.
  •  

  • **Erosive Esophagitis**: Patients with documented erosive esophagitis as a result of acid-mediated damage are eligible for Nexium coverage following appropriate diagnostic confirmation.
  •  

  • **Zollinger-Ellison Syndrome**: Those diagnosed with Zollinger-Ellison Syndrome, which demands potent acid suppression treatment, are covered for Nexium under WellCare policies.
  •  

  • **H. pylori Eradication**: Coverage is granted for individuals undergoing treatment to eradicate H. pylori infection, often in combination with antibiotics, to reduce ulcer risk.
  •  

  • **NSAID-Induced Gastric Ulcer Prevention**: Patients at risk of developing gastric ulcers due to prolonged NSAID therapy can receive coverage for Nexium as a preventive measure.
  •  

  • **Chronic Proton Pump Inhibitor (PPI) Therapy**: Long-term PPI therapy is covered for individuals with conditions requiring continuous acid suppression therapy, providing there is documented necessity reviewed by healthcare practitioners.
  •  

  • **Age Consideration and Appropriateness**: Coverage can be extended to pediatric and adult patients, ensuring age-related dosing and necessity have been appropriately determined by a healthcare professional.

 

Why WellCare Might Deny Nexium Coverage

 

Situations Where WellCare Might Deny Nexium Coverage

 

  • **Off-Label Use**: Coverage may be denied if Nexium is prescribed for a use not approved by the FDA or not listed in WellCare's formulary guidelines.
  •  

  • **Non-Medically Necessary**: If the prescription does not meet WellCare's criteria for medical necessity, it could be denied. This could include lack of evidence for the necessity of Nexium over other treatments.
  •  

  • **Step Therapy Requirement**: WellCare often requires patients to try and fail less expensive medications before approving Nexium. If this step is bypassed, coverage might be denied.
  •  

  • **Quantity Limits Exceeded**: Prescriptions exceeding WellCare’s allowable quantity limits without appropriate justification or documentation may be denied.
  •  

  • **Non-Preferred Drug**: If Nexium is classified as a non-preferred medication and there are other generic or preferred equivalents that are advised, coverage might be denied.
  •  

  • **Lack of Prior Authorization**: If Nexium requires prior authorization and it is not obtained, WellCare may reject the claim for coverage.
  •  

 

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

How Much Does Nexium Cost without Insurance?

 

Cost of Nexium Without Insurance

 

  • The retail price of Nexium (esomeprazole) can vary depending on the pharmacy and location.
  •  

  • For a 30-pill supply of 20 mg Nexium, the cost can range from approximately $200 to $250.
  •  

  • For a similar supply of 40 mg Nexium, prices may be slightly higher, ranging from about $250 to $300.
  •  

  • Retail prices often vary, so it may be beneficial to check with different pharmacies or consider generic versions, like esomeprazole, which are usually more affordable.
  •  

  • Discount programs or pharmacy coupons may be available to lower the cost significantly, so it's advisable to explore such 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 Nexium Coverage with WellCare

 

Gather Necessary Information

 

  • Check your WellCare insurance plan details to see if prescription drug coverage is included. You can find this information in your plan documents or by contacting WellCare customer service.
  •  

  • Make a list of your current medications, including Nexium, and note any additional medical requirements or conditions that might impact your coverage needs.

 

Verify Nexium Coverage

 

  • Access WellCare’s formulary list, which is typically available on their official website. This list will indicate whether Nexium is covered under your specific plan.
  •  

  • If you cannot find Nexium on the formulary list, contact WellCare customer support for confirmation and inquire if there are any alternatives or specific criteria needed for coverage.

 

Consult Your Healthcare Provider

 

  • Discuss with your healthcare provider the necessity of using Nexium. They might provide you with documentation or a prescription that supports your need for this medication, which can be useful if you need to apply for pre-authorization or appeal a coverage denial.
  •  

  • Your doctor may also suggest alternative medications that have the same effect as Nexium and are covered by WellCare, which could simplify the process.

 

Pre-Authorization Process

 

  • If Nexium requires pre-authorization, gather all necessary documents, including your prescription, any letters of necessity, and your insurance details.
  •  

  • Submit the pre-authorization request through WellCare, either by using their online portal or through your healthcare provider’s office. Make sure to follow up for confirmation that the request was received and processed.

 

Consideration of Medicare Part D

 

  • If you are on Medicare, review your WellCare Medicare Part D plan to ensure it includes Nexium or inquire about the options available for adding coverage.
  •  

  • Consider switching to a different plan during the open enrollment period if necessary, where Nexium is covered at a better rate or with better terms.

 

Appealing a Denied Claim

 

  • If coverage for Nexium is denied, gather supporting documents such as medical records and a detailed explanation from your healthcare provider.
  •  

  • File an appeal with WellCare, clearly explaining why Nexium is necessary for your health and how alternatives may not be suitable. Keep track of all correspondence and deadlines for submission of additional documents.

 

Regularly Review Plan Updates

 

  • Stay informed about any changes to your WellCare coverage and the formulary list by regularly checking their communications and website.
  •  

  • Adjust your strategy as needed based on any modifications to the coverage details, ensuring Nexium (or its alternatives) remains part of your health plan.

 

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.

Nexium FAQ

What are the side effects of Nexium?

 

Common Side Effects

 

  • Headache: A mild, frequently reported side effect.
  • Diarrhea: Can result from changes in stomach acid levels.
  • Nausea: Often subsides after continued use.
  • Flatulence: A possible gastrointestinal reaction.

 

Less Common Side Effects

 

  • Constipation: May occur, though not frequently.
  • Dizziness: Reported by some users.
  • Dry Mouth: An uncommon, but noted effect.

 

Serious Side Effects

 

  • Severe allergic reactions: Seek immediate medical help.
  • Bone Fractures: Long-term use may increase this risk.
  • Kidney Issues: Signs include changes in urine frequency.

 

How long does it take for Nexium to work?

 

Nexium Onset Time

 

  • Nexium (esomeprazole) typically begins relief within 1 hour, but full benefits for conditions like GERD may take up to 4 days.
  •  

  • For some individuals, noticeable improvement in symptoms might occur after several days of consistent use.

 

Factors Affecting Efficacy

 

  • Severity of symptoms and underlying condition can influence how quickly Nexium provides relief.
  •  

  • Dietary habits and adherence to recommended dosage also affect its performance.

 

Usage Tips

 

  • Take Nexium at least 1 hour before meals for optimal absorption.
  •  

  • Consistency in daily intake timing can enhance effectiveness.

 

Consult Healthcare Provider

 

  • If relief is not achieved within the expected timeframe, consult your healthcare provider for further evaluation and guidance.

 

Can I take Nexium with other medications?

 

Taking Nexium with Other Medications

 

  • Nexium (esomeprazole) may interact with other medications, altering their effectiveness. It's crucial to consult your healthcare provider before combining it with others.
  •  

  • Nexium can affect drugs metabolized by CYP2C19, like clopidogrel. It might reduce clopidogrel's effectiveness. Your doctor may adjust your treatment accordingly.
  •  

  • Other drug interactions may include certain antifungals, anticoagulants, and HIV medications. Always check with your pharmacist for potential interactions.
  •  

  • Inform your doctor about all medications you're taking, including prescriptions, over-the-counter drugs, and supplements, to ensure safe use of Nexium.

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