{"id":630168,"date":"2024-10-22T13:42:54","date_gmt":"2024-10-22T17:42:54","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=630168"},"modified":"2026-04-10T15:09:02","modified_gmt":"2026-04-10T19:09:02","slug":"does-blue-cross-cover-nurtec","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-blue-cross-cover-nurtec\/","title":{"rendered":"Does Blue Cross cover Nurtec?"},"content":{"rendered":"

Nurtec ODT is a prescription drug with the active ingredient rimegepant that is approved by the Food and Drug Administration (FDA) to prevent and <\/span>treat migraine<\/span><\/a>. But it can be expensive for some people <\/span>without insurance coverage<\/span><\/a>, averaging $1,410 for 8 tablets. If you have Blue Cross and Blue Shield insurance, Nurtec may be covered, but it depends on the plan and its requirements.<\/span><\/p>\n

Does Blue Cross Blue Shield cover Nurtec?<\/span><\/h2>\n

Blue Cross Blue Shield (BCBS) may cover Nurtec, but coverage depends on so many factors, like where you live, what type of coverage you have, and whether or not you have tried other migraine medications and gotten relief. It also depends on your plan\u2019s drug formulary, which is a list of prescription drugs it covers. If it is on a higher tier, you\u2019ll pay more for the drug than if it is on a lower tier. It may also depend on whether the plan considers it a preferred drug or a nonpreferred drug.<\/span><\/p>\n

\u201cIf you are using Nurtec for migraine prevention, your insurance company usually wants you to try two or three other migraine prevention medications first before it will cover Nurtec,\u201d says <\/span>Marcella Mwaisela<\/span><\/a>, MD, a neurologist at the Center for Neurology at Greater Baltimore Medical Center in Towson, Maryland. \u201cAnd if you want to use Nurtec for migraine pain, your insurance company may want you to try at least two other prescription medicines first.\u201d<\/span><\/p>\n

For example, <\/span>Anthem Blue Cross and Blue Shield<\/span><\/a> places Nurtec prescriptions on tier 2 of its national drug list, but it typically requires <\/span>prior authorization<\/span><\/a> (PA) and has quantity limits. When a prescription requires a PA, your healthcare provider\u2019s office will need to submit additional clinical information before the plan decides whether to cover the drug. <\/span>Blue Cross Blue Shield of Massachusetts<\/span><\/a> has the same requirements for its basic plans. For its Medicare prescription drug plans, Nurtec is often placed on tier 3 while also imposing quantity limits and requiring prior authorization, although specific plans may vary.<\/span><\/p>\n

RELATED: <\/b>Nurtec assistance for Medicare patients<\/b><\/a><\/p>\n

How much does Nurtec cost?<\/span><\/h2>\n

If you don\u2019t have insurance, the <\/span>cost of Nurtec<\/span><\/a> depends on the quantity prescribed and the location of your pharmacy, among other factors. The average retail price for Nurtec without insurance is generally $1,410 for a box of 8 disintegrating tablets.<\/span><\/p>\n

Why is Nurtec so expensive?<\/span><\/h2>\n

Nurtec is expensive because it is a newer medication with <\/span>no generic alternatives<\/span><\/a>. Developing a new drug is an <\/span>expensive process<\/span><\/a>, and Nurtec is the only oral medication that can be used to prevent and treat migraine.<\/span><\/p>\n

\u201cFor the millions of Americans living with migraine, Nurtec may be used not only at the onset of a migraine attack but also to prevent migraine attacks from occurring,\u201d says <\/span>Lauren R. Natbony<\/span><\/a>, MD, FAHS, medical director at <\/span>Integrative Headache Medicine of New York<\/span><\/a> and an assistant clinical professor of neurology at the Icahn School of Medicine at Mount Sinai Medical Center. \u201cThe versatility makes Nurtec a great option for people needing both rescue and preventive treatment for migraine,\u201d Dr. Natbony says.<\/span><\/p>\n

How to check whether your Blue Cross Blue Shield plan covers Nurtec<\/h2>\n

There are a few ways you can find out if your Blue Cross Blue Shield plan covers Nurtec.<\/span><\/p>\n