Counterforce Health Team

How to Get Cometriq (cabozantinib) Covered by Cigna in Texas: Complete Cost-Saving and Appeals Guide

Answer Box: Cometriq (cabozantinib capsules) requires prior authorization from Cigna in Texas, typically approved for medullary thyroid carcinoma patients ≥18 years old through their specialty pharmacy network (Accredo). Start by having your oncologist submit a PA request via Cigna's provider portal with your MTC diagnosis (ICD-10 C73), progressive

How to Get Cometriq (cabozantinib) Covered by Blue Cross Blue Shield of Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Cometriq Covered in Texas Blue Cross Blue Shield of Texas (BCBSTX) covers Cometriq (cabozantinib) capsules for metastatic medullary thyroid carcinoma with prior authorization. The fastest path to approval: (1) Confirm your exact BCBSTX plan and verify Cometriq is on your formulary with PA status, (2) Have your

How Long Does It Take to Get Arikayce Approved by UnitedHealthcare in Pennsylvania? Complete Timeline Guide

Answer Box: Getting Arikayce Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Arikayce (amikacin liposome inhalation) with a standard review timeline of 7-14 days from complete submission. To qualify, you must have refractory MAC lung disease with positive cultures after ≥6 months of failed combination therapy (macrolide + ethambutol

How Long Does It Take to Get Crysvita (burosumab) Approved by Blue Cross Blue Shield of North Carolina? Complete Timeline & Appeals Guide

Answer Box: Fastest Path to Crysvita Coverage in North Carolina Blue Cross Blue Shield of North Carolina typically takes 15 business days for standard Crysvita prior authorization, 72 hours for expedited review. Submit complete PA via Blue e portal with genetic confirmation (PHEX mutation), baseline labs (low serum phosphorus), and

How to Get Waylivra (Volanesorsen) Covered by UnitedHealthcare in Washington: Appeals, Forms & State Protections

Answer Box: Getting Waylivra Covered by UnitedHealthcare in Washington Waylivra (volanesorsen) is typically non-formulary on UnitedHealthcare plans, requiring an individualized coverage exception. In Washington, you have strong appeal rights including independent external review after internal denials. Fastest path: Submit a detailed prior authorization request with genetic FCS confirmation, documented treatment

How Long Does It Take to Get Myozyme Approved by Cigna in Florida? Complete Timeline & Appeals Guide

Answer Box: Myozyme Approval Timeline with Cigna in Florida Standard Timeline: 72 hours to 14 days after complete documentation submitted. Expedited: 24-72 hours for urgent cases. First Steps: (1) Verify Cigna specialty pharmacy coverage, (2) Have your specialist complete Cigna's Florida PA form, (3) Submit via CoverMyMeds or

Renewing Haegarda (C1-Esterase Inhibitor) Approval with Blue Cross Blue Shield in Washington: Timeline, Forms & Appeal Process

Answer Box: Renewing Haegarda with Blue Cross Blue Shield in Washington Blue Cross Blue Shield plans in Washington require annual renewal for Haegarda (C1-esterase inhibitor) with documentation of continued HAE diagnosis and clinical benefit. Start your renewal 60-90 days before expiration by submitting updated attack logs, specialist notes showing reduced

How to Get Opfolda (miglustat) Covered by Aetna CVS Health in Virginia: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Opfolda Covered by Aetna CVS Health in Virginia Opfolda (miglustat) requires prior authorization from Aetna CVS Health and must be prescribed with Pombiliti for adults (≥18 years, ≥40 kg) with late-onset Pompe disease who aren't improving on current enzyme replacement therapy. Submit requests via Aetna&

If Xembify Isn't Approved by Cigna in Illinois: Formulary Alternatives & Exception Paths

Answer Box: When Cigna Denies Xembify in Illinois If Cigna denies Xembify (immune globulin, SC) for primary immunodeficiency in Illinois, you have alternatives. Covered options typically include Hizentra (SCIG), Gamunex-C (IVIG/SCIG), and Privigen (IVIG) under Cigna's immune globulin policy. First step: Request formulary exception through your prescriber,

Renewing Isturisa (Osilodrostat) Approval with UnitedHealthcare in Pennsylvania: What to Prepare & When

Answer Box: Renewing Isturisa Coverage with UnitedHealthcare in Pennsylvania UnitedHealthcare typically requires annual prior authorization renewal for Isturisa (osilodrostat), with submission needed 30-60 days before expiration. Key requirements include recent 24-hour urine free cortisol (UFC) levels showing response, endocrinologist notes confirming ongoing need, and safety monitoring documentation. If renewal is