Topic

Aetna (CVS Health)

A collection of 1076 issues

Do You Qualify for Alprolix Coverage by Aetna CVS Health in Ohio? Decision Tree & Next Steps

Answer Box: Fast Track to Alprolix Coverage Most Ohio patients with hemophilia B qualify for Alprolix coverage through Aetna CVS Health if they have: moderately severe to severe factor IX deficiency (≤2% activity), no inhibitors, hematologist prescription, and documented bleeding episodes or prior therapy failures. Fastest path: Submit prior authorization

Myths vs. Facts: Getting Rezlidhia (olutasidenib) Covered by Aetna (CVS Health) in North Carolina

Answer Box: Fast Path to Rezlidhia Coverage in North Carolina Rezlidhia (olutasidenib) requires prior authorization from Aetna (CVS Health) for adults ≥18 with confirmed relapsed/refractory IDH1-mutated AML. Submit complete documentation including FDA-approved IDH1 mutation test results, treatment history, and oncologist prescription via CVS Caremark (1-855-344-0930) or Aetna provider portal.

Do You Qualify for Orfadin (Nitisinone) Coverage by Aetna CVS Health in California? Decision Tree & Next Steps

Answer Box: Quick Qualification Check Most likely eligible: Confirmed hereditary tyrosinemia type 1 (HT-1) with elevated succinylacetone (>2 μmol/L) and supporting genetic testing. Fastest path: Submit Aetna's prior authorization form through your specialist with HT-1 diagnosis, lab results, and dietary management plan. First step today: Contact

How to Get Humira (adalimumab) Covered by Aetna (CVS Health) in Washington: Complete Appeals Guide with State Protections

Quick Answer: Getting Humira (adalimumab) Approved by Aetna (CVS Health) in Washington Most Aetna CVS Health plans in Washington require prior authorization for Humira (adalimumab) and often prefer biosimilars first. Your fastest path: 1) Download the Humira PA form for CVS Health (Aetna) specific to your plan, 2) Document any

Work With Your Doctor to Get Defitelio (Defibrotide) Approved by Aetna (CVS Health) in California: Complete Guide With Forms and Appeals

Answer Box: Getting Defitelio (Defibrotide) Approved by Aetna (CVS Health) in California Defitelio (defibrotide) requires prior authorization from Aetna (CVS Health) for severe hepatic veno-occlusive disease (VOD/SOS) with organ dysfunction post-stem cell transplant. The fastest path to approval: (1) Have your transplant team submit the PA through Aetna'

Myths vs. Facts: Getting Voydeya (danicopan) Covered by Aetna (CVS Health) in New York

Answer Box: Getting Voydeya (danicopan) Covered by Aetna (CVS Health) in New York Voydeya (danicopan) requires prior authorization from Aetna CVS Health for PNH patients with extravascular hemolysis. Key requirements include confirmed PNH diagnosis by flow cytometry, current C5 inhibitor therapy, documented EVH evidence (labs showing persistent anemia/hemolysis), REMS

How to Get Zokinvy (lonafarnib) Covered by Aetna (CVS Health) in Ohio: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Zokinvy (lonafarnib) Covered by Aetna (CVS Health) in Ohio Zokinvy (lonafarnib) requires prior authorization from Aetna (CVS Health) and must be dispensed through CVS Specialty Pharmacy. Key requirements include genetic confirmation of HGPS or progeroid laminopathy, patient age ≥12 months with BSA ≥0.39 m², and specialist

How to Get Vitrakvi (Larotrectinib) Covered by Aetna CVS Health in Illinois: PA Forms, Appeal Scripts & Timeline Guide

Quick Answer: Aetna CVS Health requires prior authorization for Vitrakvi (larotrectinib) with documented NTRK gene fusion testing and evidence of metastatic/unresectable disease. Submit PA via CVS Specialty at 1-888-267-3277 with molecular pathology report, oncologist notes, and prior therapy documentation. If denied, appeal within 180 days using medical necessity letter

How to Get Ozempic and Mounjaro Covered by Aetna CVS Health in Georgia: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Ozempic/Mounjaro Covered by Aetna CVS Health in Georgia To get Ozempic or Mounjaro covered by Aetna CVS Health in Georgia: Your doctor must submit prior authorization showing type 2 diabetes diagnosis, recent A1c, and documented metformin trial/failure. If denied, file internal appeal within 180 days,

How to Get Helixate (Antihemophilic Factor, rFVIII) Covered by Aetna CVS Health in Michigan: Complete Coverage Guide with Appeals Process

Quick Answer: Getting Helixate Covered by Aetna CVS Health in Michigan Important Update: Helixate (antihemophilic factor, rFVIII) has been discontinued by the manufacturer. Aetna CVS Health now covers alternative factor VIII products like Kovaltry, Advate, and Jivi with prior authorization. First step: Contact your hematologist to select an alternative and