Dr. Ahmed Nurtec ODT (orally disintegrating tablet) is used to treat migraines. Its main ingredient, Rimegepant, dilates blood vessels and reduces inflammation and pain signals, relieving symptoms associated with migraine attacks.
This medication can treat migraine with or without aura or the usual associated visual disturbances that come along with the intense migraine headache.
Nurtec is usually administered every other day to reduce the occurrence of migraine headaches. Although it is very effective in migraine treatment, it is a brand drug that comes with a premium price.
Research indicates that Nurtec can help significantly reduce the frequency and severity of migraines, enabling individuals to regain control over their daily activities.
Patient testimonials further support these findings, with many users reporting high levels of satisfaction due to the quick onset of relief and the sustained effectiveness over time.
What’s more unique about Nurtec is that it is a dissolvable tablet, making it easier to administer even when patients have symptoms.
Without insurance coverage, the nurtec cost per month can become prohibitively expensive, deterring individuals from pursuing this effective treatment option.
Understanding how to get Nurtec on insurance is crucial for patients who might otherwise struggle with the financial burden associated with its out-of-pocket costs.
Here, we will learn how to get Nurtec on insurance or alternative ways to get discounts on Nurtec ODT.
What is the cost of Nurtec ODT without insurance?
Nurtec is an expensive drug, but its cost differs with dosage and your prescription. For instance, the retail price for eight 75mg pills is $1,326. This is not the monthly dose, but typically, eight tablets are enough for episodic migraine relief.
For migraine prevention, the dose ranges from 15 to 16 tablets per month, which costs around $2,652 per month or $31,200 per year.
How to Get Nurtec Approved by Insurance?
Most insurance plans cover Nurtec, but you might need some authorization beforehand. To get Nurtec on insurance, you need to submit your treatment plan and additional information from your doctor to begin the authorization process and get the insurance approved.
It is essential to ascertain whether Nurtec is classified as a preferred or non-preferred drug within your insurance plan.
Preferred drugs typically have lower co-pays and are more likely to be fully covered, whereas non-preferred drugs may come with higher costs and more restrictions.
To properly assess Nurtec’s classification, contact your insurance provider or access your insurance account online.
Many plans also provide a searchable formulary guide, which can help you find out specifics regarding Nurtec’s coverage.
If the doctor has selected Nurtec as a suitable treatment option for you, here are a few steps you can take to get insurance coverage for Nurtec:
- Check with your insurance provider to confirm coverage for Nurtec ODT.
- Check if you need any specific coverage requirements, like prior authorization.
- Get a prescription and ask your doctor to submit a prior authorization request to your insurance company so the process starts as soon as possible.
- Give it 4-5 days and check with your doctor for any confirmations.
Getting a Prior Authorization for Nurtec
When seeking coverage for specialty medications like Nurtec, understanding the prior authorization process is essential.
Prior authorization is a formal approval that many insurance companies require before they will cover a prescription medication.
This process is designed to ensure that the prescribed medication is medically necessary, safe for the patient, and the most cost-effective option available.
To initiate the prior authorization process for Nurtec insurance, the first step involves contacting your healthcare provider.
Your physician will need to fill out a specific form provided by your insurance company that details your medical history and justifies the need for Nurtec.
Typically, the documentation should include the patient’s diagnosis, previous treatments attempted, and why those treatments were not successful. It can also be helpful to include any relevant lab results or notes from specialists.
Once the necessary documents are compiled, your healthcare provider should submit the prior authorization request to the insurance company via fax or an online portal.
It is crucial to keep a record of all communications and confirmations to ensure the request is tracked effectively. Depending on the insurance provider, the approval process can take anywhere from a few hours to several days.
If your prior authorization for Nurtec is denied, do not lose hope. It is possible to appeal the decision. Begin by reviewing the denial letter carefully; it will usually include the reason for the denial.
You may need additional documentation or a more in-depth explanation from your healthcare provider. Keeping open lines of communication with both your doctor and your insurance company is vital during this appeal process to facilitate a successful outcome.
In conclusion, navigating the prior authorization for Nurtec can be a daunting task, but understanding each step can lead to effective insurance coverage for this vital medication.
What is the cost of Nurtec ODT when covered with insurance?
The cost of Nurtec ODT depends on the type of insurance coverage. It differs with different coverage levels, copay and additional deductibles. Moreover, the cost depends on how early your insurance plan is approved, which reduces out-of-pocket costs.
How to use a Copay Card for Nurtec ODT?
Nurtec OneSource offers a personalized patient support for patients with a commercial insurance, which means only patients that have private insurance plans are eligible.
With this, you can get Nurtec ODT for $0 for one prescription fill and up to 16 tablets until your insurance is verified.
You can use the copay card once in 30 days. However, the total cost must not exceed $7000 annually. Moreover, you cannot use this copay card if your insurance covers the total cost of Nurtec ODT.
Additionally, this copay card can be used only when you are not already using any other benefits, and it is valid only for U.S. and Puerto Rico citizens.
Why are brand-name drugs more expensive?
Brand-name drugs are expensive due to the years of research required to make them effective and safe for human use. They can be sold for up to 20 years, after which their generic versions can be sold.
Moreover, as all generic drugs have the same active ingredient, their costs are relatively cheaper than brand-name drugs.
Nurtec ODT is also a new medicine that was approved by FDA in 2020, for migraine use and later in 2021 for episodic migraines. So, it will take years to get any competing drug or any generic alternative for Nurtec.
Ways to reduce Nurtec’s cost?
If you don’t have insurance and you want to reduce your monthly bills for Nurtec ODT, here are some strategies that might be useful:
- Get a 3-month supply.
If you are sure that you’ll be taking Nurtec for long term, you can order a 3-month supply instead of just one month. When medicines are bought in large quantity, the cost per pill is a bit lower, and in this way, you can save some of your budget.
Moreover, buying extra supplies reduces your pharmacy visits and shipping charges, too.
- Consider online pharmacies
Buying from online pharmacies increases your chance of getting any discounts. Furthermore, it saves the time and money required to shop from local pharmacies.
Conclusion
Nurtec ODT is highly effective in treating migraines but it comes with a hefty cost that can go up to $1000 dollar per month. To save yourself from this cost, you can check with your insurance company or try to get patient assistance programs.
But if none of this works for you, it is better to switch to other relatively cheaper medications for migraine treatment.
