Topic

Aetna (CVS Health)

A collection of 1078 issues

How to Get Mycapssa (Octreotide Oral) Covered by Aetna CVS Health in North Carolina: Appeals, Prior Authorization, and State Protections

Answer Box: Getting Mycapssa Covered by Aetna CVS Health in North Carolina Fastest path to approval: Submit prior authorization through CVS Specialty (1-800-237-2767) with documented acromegaly diagnosis, prior response to injectable octreotide/lanreotide, and medical necessity letter. If denied, file internal appeal within 180 days citing North Carolina step therapy
6 min read

Aetna (CVS Health)'s Coverage Criteria for Tavneos (avacopan) in Washington: What Counts as "Medically Necessary"?

Answer Box: Getting Tavneos (avacopan) Covered by Aetna (CVS Health) in Washington Aetna (CVS Health) requires prior authorization for Tavneos (avacopan) with strict medical necessity criteria: severe active ANCA-associated vasculitis (GPA/MPA), specialist prescriber, and use as adjunctive therapy with rituximab or cyclophosphamide. Your fastest path to approval: Have your
6 min read

How to Get Rylaze (asparaginase erwinia chrysanthemi [recombinant]-rywn) Covered by Aetna CVS Health in Pennsylvania: Complete Prior Authorization and Appeals Guide

Answer Box: Quick Path to Rylaze Coverage Getting Rylaze covered by Aetna CVS Health in Pennsylvania requires prior authorization with documented hypersensitivity to E. coli asparaginase. Submit PA through Aetna's provider portal with oncology notes, hypersensitivity records, and multi-agent chemotherapy protocol. If denied, use Aetna's internal
6 min read

How to Get Adynovate (bdanocog alfa pegol) Approved by Aetna CVS Health in North Carolina: Complete Prior Authorization Guide

Answer Box: Getting Adynovate Approved by Aetna CVS Health in North Carolina Aetna CVS Health requires prior authorization for Adynovate (bdanocog alfa pegol) in North Carolina. Most requests are approved when you submit complete documentation showing hemophilia A diagnosis, factor VIII levels, bleeding history, and medical necessity for extended half-life
7 min read

How Long Does It Take to Get Symdeko (Tezacaftor/Ivacaftor) Approved by Aetna CVS Health in North Carolina? Complete Timeline Guide

Answer Box: Getting Symdeko Approved by Aetna CVS Health in North Carolina Typical timeline: 1-14 days for standard prior authorization, 24-72 hours for urgent requests. Aetna CVS Health requires prior authorization for Symdeko (tezacaftor/ivacaftor) with documented CF diagnosis, eligible CFTR genotype, and age ≥6 years. Fastest path: Submit complete
5 min read