Counterforce Health

Latest — 15 Nov 2025

How to Get Uptravi (Selexipag) Covered by UnitedHealthcare in New York: Complete Prior Authorization & Appeals Guide

Answer Box: Getting Uptravi Covered by UnitedHealthcare in New York Uptravi (selexipag) requires prior authorization from UnitedHealthcare for pulmonary arterial hypertension (PAH) patients in New York. Your fastest path to approval: 1. Confirm WHO Group I PAH diagnosis with right heart catheterization results 2. Document step therapy (failed PDE5 inhibitors

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How to Get Helixate (rFVIII) Covered by Aetna CVS Health in North Carolina: Complete Prior Authorization Guide

Answer Box: Helixate (rFVIII) requires prior authorization from Aetna CVS Health in North Carolina. However, Helixate and Kogenate FS have been discontinued—you'll need to request coverage for alternatives like Advate, Kovaltry, or Jivi. Submit the Medical Exception/Prior Authorization form with complete hemophilia A documentation via Availity

How to Get Rylaze (Asparaginase Erwinia Chrysanthemi) Covered by Cigna in New York: Complete Appeals Guide with State Protections

Answer Box: Getting Rylaze Covered by Cigna in New York Rylaze (asparaginase erwinia chrysanthemi) requires prior authorization from Cigna, with specific documentation of hypersensitivity to E. coli-derived asparaginase. Your fastest path to approval: (1) Gather proof of allergic reaction to Oncaspar/pegaspargase, (2) Have your oncologist complete Cigna's

How Long Does It Take to Get Revcovi (Elapegademase) Approved by Cigna in Florida? Complete Timeline & Appeal Guide

Answer Box: Revcovi Approval Timeline with Cigna in Florida Standard Cigna approval for Revcovi (elapegademase) takes 7-30 days in Florida, depending on documentation completeness and review complexity. Fastest path: Submit complete prior authorization with genetic ADA-SCID confirmation, immunologist letter, and treatment history through Cigna's provider portal. Start today:

How to Get Procysbi (Cysteamine Bitartrate DR) Covered by Cigna in Texas: Prior Authorization, Appeals, and Step Therapy Guide

Answer Box: Getting Procysbi Covered by Cigna in Texas Cigna requires prior authorization for Procysbi (cysteamine bitartrate delayed-release) and mandates step therapy with immediate-release cysteamine (Cystagon) first. To get coverage in Texas: (1) Document failed/intolerant trial of Cystagon, (2) Submit PA with genetic testing and WBC cystine levels, (3)

Myths vs. Facts: Getting Xyrem (Sodium Oxybate) Covered by UnitedHealthcare in California - Complete 2024 Guide

Quick Answer: Getting Xyrem Covered by UnitedHealthcare in California Yes, UnitedHealthcare covers Xyrem (sodium oxybate) in California with prior authorization. You'll need confirmed narcolepsy diagnosis, sleep study results, failed trials of stimulants/modafinil, and REMS enrollment. If denied, California's Independent Medical Review (IMR) offers strong appeal

How to Get Zolgensma Covered by UnitedHealthcare in Georgia: Prior Authorization, Appeals, and Alternative Strategies

Answer Box: Getting Zolgensma Covered by UnitedHealthcare in Georgia UnitedHealthcare requires prior authorization for Zolgensma with strict medical criteria: genetic confirmation of bi-allelic SMN1 mutations, documentation of failed alternative treatments (Spinraza or Evrysdi), and prescriber expertise in SMA. If denied, you have 180 days for internal appeals and 60 days

If Gamifant (Emapalumab-lzsg) Isn't Approved by Cigna in Florida: Formulary Alternatives & Exception Paths

Answer Box: If Cigna denies Gamifant (emapalumab-lzsg) for primary HLH in Florida, your options include: 1) Trying conventional HLH therapy (etoposide + dexamethasone ± cyclosporine) if clinically appropriate, 2) Requesting a formulary exception with detailed clinical rationale, or 3) Filing an internal appeal within 180 days. Start by having your hematologist submit

Get Takhzyro (Lanadelumab-flyo) Covered by UnitedHealthcare in Ohio: Prior Authorization Guide and Appeal Strategies

Quick Answer: Getting Takhzyro Covered by UnitedHealthcare in Ohio Yes, Takhzyro (lanadelumab-flyo) is covered by UnitedHealthcare in Ohio, but requires prior authorization. To get approved: (1) Have your allergist/immunologist document confirmed HAE diagnosis with C1-INH lab results and attack frequency ≥1 per month, (2) Submit PA through UnitedHealthcare Provider

Myths vs. Facts: Getting Hetlioz (Tasimelteon) Covered by Cigna in Washington

Answer Box: Hetlioz Coverage Through Cigna in Washington Myth: If your doctor prescribes Hetlioz, Cigna automatically covers it. Fact: Cigna requires prior authorization with documented step therapy (ramelteon + one other sleep medication failure) and specialist confirmation of Non-24-Hour Sleep-Wake Disorder or Smith-Magenis Syndrome. Submit PA forms through the Cigna provider