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Drug Info

Does Blue Cross cover Nurtec?

Nurtec insurance coverage can help people looking for a medication that prevents migraine and treats acute migraine
Rosemary Black
By | Oct. 22, 2024 Medically reviewed by Gerardo Sison, Pharm.D.
A health insurance card and pills: Does Blue Cross cover Nurtec?

Key takeaways

  • While Blue Cross Blue Shield may cover Nurtec, coverage depends on your specific plan and its prescription drug list.

  • To learn whether your plan covers Nurtec, visit the Blue Cross Blue Shield website for your state and then locate your plan’s formulary.

  • You may be able to save money on Nurtec with a SingleCare prescription discount card or a Nurtec copay card.     

In this article:

Nurtec ODT is a prescription drug with the active ingredient rimegepant that is approved by the Food and Drug Administration (FDA) to treat migraine. “For 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,” says Lauren R. Natbony, MD, FAHS, medical director at Integrative Headache Medicine of New York and an assistant clinical professor of neurology at the Icahn School of Medicine at Mount Sinai Medical Center. “The versatility makes Nurtec a great option for people needing both rescue and preventive treatment for migraine,” Dr. Natbony says. But it can be expensive for some people without insurance coverage, averaging $1,326 for 8 tablets.

Does Blue Cross Blue Shield cover Nurtec?

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’s drug formulary, which is a list of prescription drugs it covers. If it is on a higher tier, you’ll 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.

“If 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,” says Marcella Mwaisela, MD, a neurologist at the Center for Neurology at Greater Baltimore Medical Center in Towson, Maryland. “And if you want to use Nurtec for migraine pain, your insurance company may want you to try at least two other prescription medicines first.”

For example, Anthem Blue Cross and Blue Shield places Nurtec prescriptions on tier 2 of its national drug list, but it typically requires prior authorization and has quantity limits. Blue Cross Blue Shield of Massachusetts has the same requirements for its basic plans. But for its Medicare prescription drug plans, it puts Nurtec on tier 3 while also imposing quantity limits and requiring prior authorization.

Nurtec prescription drug alternatives

If your insurance doesn’t cover Nurtec, there are alternatives available for the acute treatment and prevention of migraine. “But Nurtec may offer some advantages over other migraine medications, especially for people who are not getting enough relief from other medications or who can’t tolerate other migraine medications due to side effects,” says Alyssa M. Wozniak, Pharm.D., BCPS, assistant dean for Clinical Affairs, Outreach, and Special Projects in the School of Pharmacy at D’Youville University. 

People who live with migraine have elevated levels of a protein called calcitonin gene-related peptide (CGRP) both during and between migraine attacks. “During a migraine attack, CGRP is released, and it attaches to and activates receptors in the brain,” Dr. Natbony says. Nurtec belongs to a class of drugs known as CGRP receptor antagonists. These medications work by blocking the CGRP receptor sites in the brain, thus interfering with the series of events that lead to migraine. 

Nurtec alternatives for acute migraine treatment

For acute migraine treatment, Dr. Natbony recommends Ubrelvy (ubrogepant) and Zavzpret (zavegepant), which are CGRP receptor antagonists, similar to Nurtec. 

Another treatment option for migraine is a class of drugs called triptans, which act on serotonin receptors to help narrow the brain’s blood vessels and decrease pain signals. Examples of triptans are Imitrex (sumatriptan succinate) and Maxalt (rizatriptan benzoate). “Your insurance company may require you to try one of these before agreeing to pay for Nurtec,” Dr. Mwaisela says. This process is called step therapy.

“Triptans have generic options that may make them more affordable,” Wozniak says. So they’re often more widely covered by insurance plans as well. But you shouldn’t use triptans if you have had a stroke or a heart attack, according to Marcella Mwaisela, MD, a neurologist at the Center for Neurology at Greater Baltimore Medical Center in Towson, Maryland. “Nurtec, however, would be considered safer for these individuals.” 

Nurtec alternatives for migraine prevention

For migraine prevention, Dr. Natbony would recommend Qulipta (atogepant). Medications like Aimovig (erenumab-aooe) and Emgality (galcanezumab-gnlm) also target CGRP. “But these are injectable and often very expensive as well,” Dr. Wozniak says. “Your doctor and pharmacist can help you find the right treatment based on your needs and insurance coverage as this, among other factors, needs to be considered to ensure a similar medicine is appropriate for you.”

How much does Nurtec cost?

If you don’t have insurance, the cost of Nurtec depends on the dosage prescribed and the location of your pharmacy, among other factors. The average retail price for Nurtec without insurance is generally $1,326 for a box of 8 disintegrating tablets. 

How much does Nurtec cost with Blue Cross Blue Shield?

The cost of Nurtec with Blue Cross Blue Shield depends on many factors. Consult your insurance provider or pharmacy to get specific information about your coverage and your copay.

Your healthcare provider may need to submit additional information to your insurance plan so that Nurtec will be covered. Once you and your healthcare provider decide that Nurtec may help you, ask whether a Nurtec prescription requires prior authorization. If so, your healthcare provider can start the process. 

How to save on Nurtec

You may save money with a Nurtec coupon from SingleCare, which could bring the price down to $836 for 8 disintegrating tablets. You can access Nurtec coupons with a SingleCare prescription discount card, which you can use at over 35,000 participating pharmacies across the United States.

If you have health insurance, you may be able to get Nurtec for as little as $0 with a Nurtec ODT copay card. This copay card is only available to people with commercial or private health insurance, though. Anyone enrolled in a state or federally funded insurance program, such as Medicare or Medicaid, is ineligible.