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Jennifer Prekeges
Medical Writer
Jennifer Prekeges is the Program Chair for Radiation & Imaging Sciences with a background in nuclear medicine and teaching. She helped design the RAIS program, teaches Capstone courses, oversees radiation safety, and is committed to supporting students as they advance in their careers.
Migraine isn’t just a headache. It’s a complex neurological condition that can hijack days, disrupt careers, and strain relationships.1 For the nearly 40 million Americans affected, accessing timely, specialized care can feel like another battle entirely—long waits for neurologist appointments, navigating insurance hurdles, and the sheer difficulty of seeking help when debilitating symptoms strike.2
Enter Cove Migraine, a telehealth company that emerged with a singular focus: delivering specialized migraine care directly to patients, wherever they are. Cove promises convenience, access to licensed medical providers and modern treatments, all through a streamlined online platform.3 But in a landscape increasingly crowded with digital health solutions, does Cove truly deliver effective, affordable, and trustworthy migraine management? Or is it just another layer of complexity in an already challenging journey?
To find out, the Body Freedom Collaborative Health Team, including staff writers, editors, and a panel of testers, dedicated over 150 hours to rigorously evaluate Cove Migraine. We dove deep into their service model, analyzed treatment options, scrutinized costs, compared them against traditional care, and synthesized insights from hundreds of real user experiences and consultations with our medical reviewer, Dr. Natalia Murinova, M.D., M.H.A. This is our definitive, no-nonsense review.
Launched in 2018, Cove is a telemedicine company operating under the Thirty Madison umbrella (which also includes Keeps for hair loss and Evens for acid reflux).4 Cove’s mission is straightforward: to improve the quality of life for migraine sufferers by simplifying access to expert care and personalized treatment plans.5 Unlike general telehealth platforms, Cove is built specifically for migraine. They connect users with licensed doctors and healthcare providers in their state who specialize in diagnosing and treating this condition.6 Cove also boasts a Medical Advisory Board featuring neurologists and headache specialists, lending clinical credibility to their operations.7
How Cove Works: Our Step-by-Step Experience
Navigating a new healthcare platform can be daunting. Our testing team experienced the entire Cove process to understand the nuances:
1
The Intake:
It starts with a comprehensive online questionnaire. Expect to spend 15-20 minutes detailing your migraine history, symptoms, frequency, severity, previously tried treatments, and overall health.
Tester Insight: The depth here is crucial. The more detailed and accurate your information, the better equipped the Cove provider is to assess your situation without a real-time, face-to-face interaction.
2
Provider Match & Consultation:
Based on your location and needs, you’re matched with a licensed provider. The initial consultation is typically asynchronous – you submit your questionnaire, the provider reviews it, and responds via secure messaging within 1-2 business days (sometimes faster). They might ask clarifying questions before finalizing a diagnosis or treatment plan. While video consults aren’t the standard initial step, they may be used in certain situations or for follow-ups if deemed necessary by the provider.
3
Personalized Treatment Plan:
If Cove is deemed appropriate for you, the provider proposes a treatment plan. This could involve acute medication (for attacks), preventive medication (to reduce frequency/severity), anti-nausea options, or a combination.
4
Prescription & Delivery:
Prescriptions are sent electronically, often to Cove’s partner pharmacies (like Truepill or Capsule, depending on location and medication) or potentially to your local pharmacy, especially depending on insurance. Medications typically arrive via mail in discreet packaging within a few business days.
Pro Tip: Factor in potential shipping time when managing refills to avoid running out of medication.
5
Ongoing Care & Follow-Up:
Cove isn’t a one-off service. Follow-up consultations (usually via messaging, costing around $20 – $30 – verified) are scheduled to monitor treatment effectiveness, manage side effects, and make adjustments. The frequency depends on your treatment plan and provider’s assessment.
6
The Cove Migraine Tracker:
Cove strongly encourages using their mobile app to track migraine attacks, symptoms, triggers, and medication use. This data integrates directly with your provider consultations.
Tester Insight: Consistent tracking significantly enhances follow-up consultations. It provides concrete data for your provider to analyze trends and treatment efficacy, moving beyond subjective recall.8
This is where Cove’s specialization shines. They offer a wider range of migraine-specific medications than most general practitioners:
Acute Treatments (Taken During an Attack):
Triptans: Sumatriptan, Rizatriptan, Eletriptan, Naratriptan (Oral forms primarily). Work by constricting blood vessels and reducing inflammation.
CGRP Inhibitors (Oral “Gepants”): Nurtec® ODT (Rimegepant), Ubrelvy® (Ubrogepant). Newer class blocking CGRP protein activity. Often well-tolerated.
CGRP Inhibitor (Nasal Spray): Zavzpret™ (Zavegepant). A recent addition offering rapid relief via nasal administration (confirm current availability via Cove).
Preventive Treatments (Taken Regularly to Reduce Attacks):
Oral CGRP Inhibitor: Qulipta® (Atogepant). Daily pill for prevention.
Anti-Nausea Medication:
Ondansetron (Zofran ODT): Helps manage nausea and vomiting often accompanying migraines.
The Real Cost of Cove: Decoding the Price Tag
Understanding Cove’s cost requires looking at consultation fees and medication prices, heavily influenced by insurance:
Consultation Fees:
Initial Consultation: Typically around $60. This covers the provider’s review of your extensive intake form and initial treatment plan development.
Follow-Up Consultations: Usually $20 – $30 per session, required for ongoing care and refills.
Medication Costs: This is highly variable.
Using Insurance: Cove works with many major insurance plans. They attempt to bill your insurance directly for medications through their partner pharmacies or can help facilitate prior authorizations if needed. Your final cost is your copay. Crucially, verify Cove’s network status and medication coverage with your specific plan before committing.
Out-of-Pocket/Cash Prices: If you don’t have insurance, or your plan doesn’t cover a specific medication (especially newer ones), costs can be significant.
Generic Triptans/Preventives: Can be relatively affordable ($15 – $50/month range).
Newer CGRP Inhibitors (Nurtec, Ubrelvy, Qulipta, Injectables): Cash prices can range from $600 to over $1000 per month without insurance or manufacturer savings programs (which Cove may help facilitate access to).
Expert Insight: The Role of Telemedicine in Migraine Care “Telehealth platforms like Cove fill a crucial gap, particularly for patients in underserved areas or those needing access to newer CGRP medications,”9 notes Dr. Natalia Murinova, Neurologist and Body Freedom Collaborative Medical Reviewer. “However, they are best suited for patients with a relatively clear migraine diagnosis and pattern. Red flags like sudden onset of the ‘worst headache of life,’ neurological deficits, or rapidly changing symptoms always warrant immediate, in-person evaluation.”
Pro Tips for Maximizing Your Cove Experience:
Be Meticulously Honest: Fill out the initial questionnaire with complete accuracy and detail.10
Become a Master Tracker: Use the Cove app consistently. Data drives better treatment decisions.11
Insurance First, Always: Contact your insurance company before signing up to understand coverage for Cove consultations and specific medications. Ask about preferred pharmacies.12
Leverage Patient Assistance: If prescribed expensive branded medication, actively inquire with Cove support about manufacturer savings programs.13
Advocate Clearly: Communicate effectively via messaging. Be specific about symptoms, side effects, and what is/isn’t working.14
Know Cove’s Limits: Understand this is not for emergencies or complex workups. Have a plan for seeking in-person care if needed.15
Who Is Cove Migraine Right For (and Who Isn’t)?
Cove
Ideal Candidates:
Individuals with a previously established migraine diagnosis seeking ongoing, convenient care.
People living in areas with limited access to neurologists or headache specialists.
Busy professionals who find it difficult to take time off for appointments.
Patients interested in trying newer CGRP medications who have discussed them with a provider.
Those comfortable with telehealth technology and asynchronous communication.
Anyone experiencing a sudden, severe headache (“thunderclap”) or new neurological symptoms (weakness, vision loss, confusion) – Seek emergency care immediately.
Individuals needing a first-time diagnosis for headaches with atypical features.
Patients requiring in-office procedures like Botox or nerve blocks.
Those who strongly prefer face-to-face interaction with their doctor.
People whose insurance plans are not accepted by Cove or who cannot afford potential out-of-pocket medication costs.
Frequently Asked Questions (FAQs)
Is Cove legitimate?
Yes, Cove employs licensed medical providers in the states they operate and adheres to telehealth regulations.
What states is Cove available in?
Cove is available in most, but not all, US states. Check their website for the current list.
How does Cove handle side effects?
You can message your provider about side effects. They can advise on management or adjust your treatment plan. Severe reactions require immediate in-person medical attention.
Can Cove prescribe controlled substances?
No, Cove typically does not prescribe controlled substances like opioids or benzodiazepines.
Do I need a prior migraine diagnosis?
While helpful, Cove providers can diagnose migraine based on your history and symptoms provided via the questionnaire and consultation.
After extensive evaluation, Cove Migraine emerges as a highly convenient and legitimate option for specialized migraine care, particularly strong in providing access to modern treatments like CGRP inhibitors. Its integrated tracking app and focus solely on migraine are significant advantages over general telehealth.
However, the value proposition hinges heavily on cost and insurance. While consultation fees are reasonable, the price of newer medications without robust insurance coverage can be prohibitive for many. The asynchronous communication model, while efficient, may not suit patients desiring a deeper personal connection with their provider.
Body Freedom Collaborative Rating: 4.3 / 5 Stars
Bottom Line: For individuals with established migraine, good insurance coverage (or ability to afford cash prices/utilize assistance programs), and a preference for convenience, Cove offers a compelling service that effectively leverages technology to manage a challenging condition. If you require complex diagnostics, prefer in-person care, or face significant cost barriers with medication, exploring traditional neurologist care remains essential.
We recommend visiting the Official Cove Website to check state availability, browse treatments, and get the latest information directly.
Considering Cove?
We recommend visiting the Official Website to check state availability, browse treatments, and get the latest information directly.
Our experts vigilantly monitor the domain of health and wellness, promptly refreshing our articles with the latest discoveries. Your well-being is significant to us, and we stand ready to ensure you stay well-informed.
June 12, 2025
Current Version
June 12, 2025
June 12, 2025
Written By Jennifer Prekeges, MS, CNMT Edited By Suzanne Briggs Medically Reviewed By Robin M Voigt-Zuwala, PhD Copy Edited By Jun Xu
June 12, 2025
At Body Freedom, we rely solely on top-tier sources, such as peer-reviewed studies, to bolster the veracity of our content. Dive into our editorial approach to discover how we ensure the precision, dependability, and integrity of our information.
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