Topic

Aetna (CVS Health)

A collection of 147 issues

Myths vs. Facts: Getting HyperHEP (Hepatitis B Immune Globulin) Covered by Aetna (CVS Health) in New Jersey

Answer Box: Getting HyperHEP Covered by Aetna (CVS Health) in New Jersey Good news: HyperHEP (hepatitis B immune globulin) is typically covered by Aetna for post-exposure prophylaxis when medically necessary. Key facts: Prior authorization isn't routinely required for emergency post-exposure use, but documentation of exposure and vaccination history

How to Get Zolgensma Covered by Aetna in Texas: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Zolgensma Covered by Aetna in Texas Aetna requires prior authorization for Zolgensma (onasemnogene abeparvovec) in Texas. Your child must be under 2 years old with genetic confirmation of SMA (bi-allelic SMN1 mutations). The fastest path: 1) Have your neurologist submit prior authorization with genetic test results, 2)

Get Soliris (Eculizumab) Covered by Aetna CVS Health in North Carolina: Complete Prior Authorization Guide

Answer Box: Fastest Path to Soliris Coverage Getting Soliris (eculizumab) covered by Aetna CVS Health in North Carolina requires meeting strict diagnostic criteria and completing mandatory vaccinations. Step 1: Confirm your diagnosis with required lab tests (flow cytometry for PNH, anti-AChR antibodies for myasthenia gravis). Step 2: Complete meningococcal vaccination

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

Answer Box: Getting Opfolda Covered by Aetna in North Carolina Opfolda (miglustat) requires prior authorization from Aetna (CVS Health) when used with Pombiliti for late-onset Pompe disease (LOPD). The fastest path to approval: 1) Submit precertification via Availity portal with complete LOPD diagnosis documentation and ERT failure history, 2) Include

How to Get Ibrance (palbociclib) Covered by Aetna CVS Health in Virginia: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting Ibrance Covered by Aetna CVS Health in Virginia Ibrance (palbociclib) requires prior authorization from Aetna CVS Health and is typically covered as a Tier 4 specialty drug with $0 copay after deductible (thanks to Virginia's oral anti-cancer drug parity law). Your oncologist must submit clinical

Myths vs. Facts: Getting Mepsevii (vestronidase alfa-vjbk) Covered by Aetna (CVS Health) in New Jersey

Answer Box: Getting Mepsevii Covered by Aetna in New Jersey To get Mepsevii (vestronidase alfa-vjbk) covered by Aetna (CVS Health) in New Jersey, you need: (1) confirmed MPS VII diagnosis via enzyme assay and genetic testing, (2) elevated urinary GAG levels (2-fold above normal), and (3) prescription from a metabolic

Getting Strimvelis Gene Therapy Covered by Aetna in Georgia: Complete Guide to Forms, Appeals, and Approval

Quick Answer: Getting Strimvelis Covered by Aetna in Georgia Strimvelis (autologous CD34+ ADA-SCID gene therapy) requires prior authorization from Aetna. Since it's only available at SR-TIGET in Milan, Italy, you'll need out-of-network coverage approval. Start by having your doctor submit a prior authorization request with genetic