More issues

Work With Your Doctor to Get Luxturna Covered by UnitedHealthcare in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Luxturna Covered by UnitedHealthcare in Texas UnitedHealthcare covers Luxturna (voretigene neparvovec-rzyl) for patients with confirmed biallelic RPE65 mutations causing inherited retinal dystrophy, requiring prior authorization and treatment at qualified centers. Your fastest path: (1) Confirm genetic testing shows biallelic RPE65 mutations, (2) Schedule with a retinal specialist
6 min read

How to Get Elfabrio (pegunigalsidase alfa-iwxj) Covered by Cigna in Texas: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Elfabrio Covered by Cigna in Texas Elfabrio (pegunigalsidase alfa-iwxj) requires prior authorization through Cigna's Express Scripts/Accredo specialty pharmacy network. Start by calling Chiesi Total Care at 1-833-656-1056 for PA submission assistance. If denied, file internal appeals within 180 days, then request Texas Independent Review
6 min read

How to Get Juxtapid (Lomitapide) Covered by UnitedHealthcare in Washington: Complete Coverage Guide with Forms and Appeals

Answer Box: UnitedHealthcare requires prior authorization for Juxtapid (lomitapide) in Washington with strict criteria: confirmed HoFH diagnosis (genetic testing or untreated LDL-C >400 mg/dL plus clinical markers), documented failure of both Repatha and Evkeeza, REMS-certified specialist prescriber, and baseline liver function tests. Submit via OptumRx portal with genetic
6 min read

Complete Requirements Checklist to Get Mavenclad (Cladribine Tablets) Covered by UnitedHealthcare in New Jersey: Forms, Timelines, and Appeal Process

Answer Box: Getting Mavenclad Covered by UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization for Mavenclad (cladribine tablets) through OptumRx, with step therapy requiring documented failure of at least one other MS disease-modifying therapy. Submit electronically via the UnitedHealthcare Provider Portal with complete clinical documentation for 24-72 hour processing. If
6 min read

How to Get Strensiq (Asfotase Alfa) Covered by UnitedHealthcare in New Jersey: Complete Prior Authorization Guide with Appeals

Quick Answer: UnitedHealthcare covers Strensiq (asfotase alfa) for pediatric-onset hypophosphatasia through OptumRx with prior authorization. Submit PA documentation including diagnosis confirmation, low alkaline phosphatase levels, and specialist prescription. If denied, you have 60 days for internal appeals and 4 months for New Jersey's external review through Maximus Federal
6 min read

How to Get Hemgenix (etranacogene dezaparvovec) Covered by UnitedHealthcare in Pennsylvania: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Hemgenix Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Hemgenix (etranacogene dezaparvovec) with strict eligibility criteria including age 18+, severe/moderately severe hemophilia B, 50+ factor IX exposure days, and treatment at a hemophilia center. If denied, Pennsylvania's Independent External Review Program offers
6 min read

Work With Your Doctor to Get Tavalisse (Fostamatinib) Covered by Blue Cross Blue Shield in Pennsylvania: Complete Prior Authorization Guide

Quick Answer: Getting Tavalisse Covered in Pennsylvania To get Tavalisse (fostamatinib) covered by Blue Cross Blue Shield in Pennsylvania, you'll need prior authorization from a hematologist or oncologist documenting chronic ITP diagnosis, platelet count below 30,000/μL, and failure of first-line therapies (corticosteroids, IVIG, or TPO agonists)
6 min read