Understanding Nurx's Insurance Billing Process: A Step-By-Step Guide

If you have health insurance, Nurx will bill your insurance plan directly. However, it's not a problem if you don't have insurance or would prefer to pay yourself. The cost of your prescription will be covered by your insurance in most cases, but insurance companies set the copay for prescriptions. Depending on your plan and the prescription, there will usually be no added copay. If you do have a copay, Nurx will charge a $30 amount at checkout. If your copay is over $30, you will receive a notification to accept or decline the higher copay.

Whether Nurx submits claims to insurance for medical consultation fees

When it comes to billing insurance, Nurx does not currently submit claims to insurance for medical consultation fees. This means that if you are seeking reimbursement for a medical consultation, you will need to contact your insurance company directly. However, it's important to note that Nurx does accept health insurance for medication.

For birth control prescriptions, Nurx charges a $30 consultation fee, which includes unlimited messaging with their medical team for one year. This fee is not covered by insurance. If you have health insurance accepted by Nurx, your prescription cost will likely be covered by your insurance, and you will only be charged a $30 copay at checkout if you have one. If your copay is over $30, you will receive a notification to accept or decline the higher copay.

For emergency contraception, the consultation fee is $15 and is also not covered by insurance. If you choose to pay out of pocket or don't have insurance, Nurx offers birth control brands starting at $15 per month.

For PrEP evaluations, the consultation fee is $30 and is not covered by insurance. Nurx will bill your insurance if you choose to use it and help you apply for payment assistance programs.

For STI Home Test Kits, there is also a $30 consultation fee that is not submitted to insurance. With health insurance, each test kit costs $29.50 plus applicable copays or deductibles. If Nurx's partner lab, Molecular Testing Labs, is out-of-network with your insurance, you will be billed a negotiated rate of $99 for lab testing.

For HPV tests, there is a consultation fee that is not covered by insurance. With health insurance, you will be charged an initial $49, and any additional costs will depend on your insurance plan.

For herpes treatment, there is a medical consultation fee that is not submitted to insurance. If you pay with insurance, Nurx will bill your insurance directly, and the price will depend on your plan.

For acne, melasma, rosacea, anti-aging, hair loss and scalp, mental health, UTI, yeast infection, and bacterial vaginosis treatments, there are consultation fees that are not covered by insurance. Nurx will bill your insurance for any medications required, and the cost will depend on your specific plan.

How to pay out-of-pocket

If you choose to pay out-of-pocket or if you don’t have insurance, Nurx offers birth control brands that start at $15 per month. If you’d like a price estimate for a specific brand or type of birth control, please connect with our team at [email protected]

If you choose to pay out-of-pocket or if you don’t have insurance: $164 for comprehensive testing, which includes all of the necessary tests to get on PrEP + extra testing for additional sexually transmitted infections (STIs); OR $94 for basic testing which includes all of the testing necessary to get on and stay on PrEP, and free shipping both ways.

If you pay with insurance, we will bill your insurance directly for your medication and the price you pay will depend on the specifics of your plan. Because valacyclovir is a generic medication your copay (if you have one) should be quite affordable.

If you do not pay with insurance and pay directly for the medication it costs $45 for a 3-month supply of outbreak treatment (meaning you only take the medication when you experience an outbreak or feel one coming on). It costs $75 for a 3-month supply of preventive therapy (meaning that you take a pill every day to prevent outbreaks). If you have both oral and genital herpes and need outbreak treatment the price will be $60 for a 3-month supply. Prescriptions are delivered with free shipping.

We will bill insurance (if you have it) for your medications, and the copay (if any) will depend on your particular plan. If you do not have insurance we offer transparent out-of-pocket pricing, which starts at $20/month for prescription topical medication and $15/month for prescription oral treatments.

We will bill insurance (if you have it) for your medications, and the copay (if any) will depend on your particular plan. If you do not have insurance we offer transparent out-of-pocket pricing, which starts at $30/month for prescription topical medication and $20-40/month for prescription oral treatments.

Medication prices range from $50-$90 for a three-month supply, and are not covered by insurance. Prescriptions are delivered with free shipping.

Once you share your health history and pay $20 for your medical consultation, a Nurx healthcare provider will evaluate your skin and determine if prescription eyelash growth serum is right for you. Then we’ll send a 3-month supply of bimatoprost (generic Latisse®) for $159 to your door. That’s about $2 per day for thicker, fuller eyelashes. Depending on your treatment plan, we’ll continue to send refills every 3 months with free shipping. The cost of your medical consultation includes ongoing care and unlimited messaging with our medical team for one year, as needed. Patients will need to complete a new annual medical consultation in order to renew a prescription.

For those with health insurance accepted by Nurx, the total cost for your prescription will likely be covered by your health insurance. Insurance companies set the copay for prescriptions and depending on your plan and the prescription, this will usually be $0-$10. Please connect with your insurance company if you would like to learn more about your copay.

If you do not have or wish to use insurance, we offer transparent out-of-pocket pricing, which is $25/month for most medications.

How to pay with insurance

If you have health insurance, you can enter your insurance information when placing your order. Nurx will bill your insurance plan directly. If you have health insurance accepted by Nurx, the cost of your prescription will be covered by your insurance in most cases. Insurance companies set the copay for prescriptions, and depending on your plan and the prescription, there will usually be no added copay.

If you do have a copay, Nurx will charge a $30 amount at checkout and it will only be charged if you have a copay. If your copay is over $30, you will receive a notification to accept or decline the higher copay.

If you are paying with insurance for a home HPV test, you will be charged an initial $49 for the HPV test kit. Once your tests have been processed by the lab, they will bill your insurance and you will be responsible for any out-of-pocket costs (beyond the $49) including copays and deductibles associated with your plan.

If you are paying with insurance for STI Home Test Kits, each test kit costs $29.50 and applicable copays or deductibles. If you pay with insurance, your out-of-pocket expense will depend on whether the partner lab, Molecular Testing Labs, is in-network with your insurance and on your specific plan's coverage. Once you've submitted your samples, Molecular Testing Labs will then bill your insurance for the lab services, and you will only be responsible for any out-of-pocket costs.

If you are paying with insurance for herpes treatment, Nurx will bill your insurance directly for your medication, and the price you pay will depend on the specifics of your plan.

If you are paying with insurance for acne, rosacea, or anti-aging treatment, Nurx will bill insurance (if you have it) for your medications, and the copay (if any) will depend on your particular plan.

If you are paying with insurance for mental health treatment, the total cost for your prescription will likely be covered by your health insurance. Insurance companies set the copay for prescriptions, and depending on your plan and the prescription, this will usually be $0-$10.

If you are paying with insurance for UTI, bacterial vaginosis, or yeast infection treatment, Nurx submits claims to insurance for the medical consultation. You will pay for the medication at the pharmacy, and the price will depend on the pharmacy and whether you pay with insurance or out-of-pocket.

What to do if your medication is a non-covered item on your insurance plan

If your medication is a non-covered item on your insurance plan, there are several steps you can take to resolve the issue. Here are some detailed instructions on what to do in this situation:

• Contact your insurance provider: It is recommended to call your insurance company to understand what medications are covered under your plan. This information will be useful when discussing alternative treatment options with your doctor.
• Discuss alternatives with your doctor: Talk to your doctor about alternative medications that may be covered by your insurance plan. There might be generic versions or similar medications with different active ingredients that can be used instead. Your doctor can help determine if these alternatives will work for your specific needs.
• Request an exception: If no suitable alternatives are available, you can ask your insurance company for an exception to cover your prescribed medication. This process usually requires a supporting statement from your doctor, explaining the medical necessity of the medication and why alternatives would have an adverse effect.
• File an appeal: If your request for an exception is denied, you have the right to file an appeal with your insurance company. The process may vary depending on your insurer, but it typically involves submitting a letter of appeal or application with supporting documentation. If the appeal is denied, you can request an independent review through your state's insurance regulator.
• Look into patient assistance programs: Many drug manufacturers offer patient assistance programs to help cover the cost of medications. These programs are often need-based and may provide discounts or coupons to reduce out-of-pocket expenses. You can check the manufacturer's website or search for your medication online to find available programs.
• Re-evaluate your insurance plan: During the next enrollment period, consider switching to a different insurance plan that covers your required medication. Open enrollment periods allow you to make changes to your coverage, so take this opportunity to explore other options.
• Consider out-of-pocket payments: If none of the above options work, you may have to pay for the medication out of pocket. However, keep in mind that this should be a last resort, as it can be expensive.

How to switch from using insurance to paying out of pocket

To switch from using insurance to paying out of pocket on Nurx, follow these steps:

• Log in to your Nurx account.
• Click on "Account," then "Subscriptions."
• You will see a list of your active subscriptions. Under each medication you want to edit, click "Manage Subscription."
• Under "Insurance," you'll see the option to stop billing your insurance.
• If you turn off insurance billing, your prescription will be charged to your credit card on file.

There are several reasons why someone might choose to pay out of pocket for medical services instead of using their health insurance. Here are a few examples:

• When the deductible year is almost over, and you're far from meeting it: Deductibles often reset annually, so it may be more cost-effective to pay out of pocket if you need to see a doctor towards the end of the year and haven't incurred many medical expenses.
• When you want to see an out-of-network provider: Depending on your insurance policy, out-of-network providers may not be covered or may have higher costs associated with them. In these cases, it might be cheaper to pay out of pocket.
• When you can find a better price for prescription drugs: Some insurance policies have high deductibles for prescription medications, so it may be more affordable to pay out of pocket, especially if the deductible year is coming to a close.

It's important to note that while it may be tempting to avoid using insurance to keep premiums from going up, this could lead to unexpected costs in the future. Comprehensive health insurance can help you avoid high out-of-pocket costs and provide peace of mind in case of an expensive medical crisis.

Additionally, when it comes to car insurance, there are times when paying out of pocket instead of filing a claim might be preferable. For example, if you're in a minor accident and the repairs are inexpensive, it might be better to pay out of pocket to avoid a potential increase in insurance rates. However, it's always essential to report an accident if someone is injured or if there is significant damage.

Frequently asked questions