Topic

Aetna (CVS Health)

A collection of 1133 issues

Getting Ultomiris (Ravulizumab) Covered by Aetna CVS Health in California: Forms, Appeals, and Alternative Options

Answer Box: Fast Track to Ultomiris Coverage To get Ultomiris (ravulizumab) covered by Aetna CVS Health in California: Submit the Ultomiris Precertification Request form with complete clinical documentation showing FDA-approved indication, failed alternatives, and vaccination records. If denied, file internal appeal within 60 days, then request California Independent Medical Review

Renewing Zokinvy (lonafarnib) Approval with Aetna CVS Health in Virginia: Complete Guide to Prior Authorization Renewal, Appeals, and Bridge Options

Quick Answer: Renewing Your Zokinvy (lonafarnib) Approval Aetna CVS Health typically requires annual prior authorization renewal for Zokinvy (lonafarnib) with updated clinical documentation showing ongoing medical necessity and benefit. Submit your renewal request 30-45 days before your current PA expires to avoid treatment interruption. Required documents include: genetic testing confirmation,

The Requirements Checklist to Get Ferriprox (Deferiprone) Covered by Aetna (CVS Health) in Ohio: Complete Guide with Forms and Appeals

Answer Box: Getting Ferriprox (Deferiprone) Covered by Aetna (CVS Health) in Ohio Fastest path to approval: Submit prior authorization through Aetna's pharmacy benefit with documented transfusional iron overload (ferritin >1,000 mcg/L), step therapy failure/intolerance to deferasirox or deferoxamine, and weekly ANC monitoring plan. First

How to Get Brineura (cerliponase alfa) Covered by Aetna (CVS Health) in New Jersey: Complete PA Guide and Appeal Process

Answer Box: Getting Brineura Covered by Aetna in New Jersey Aetna requires prior authorization for Brineura (cerliponase alfa) in New Jersey. To get coverage, you need: (1) confirmed CLN2 disease diagnosis via enzyme assay or genetic testing, (2) treatment by a neurologist experienced in intraventricular administration, and (3) no acute

Getting Pombiliti (Cipaglucosidase Alfa-atga) Covered by Aetna CVS Health in Georgia: Prior Authorization Guide

Answer Box: Getting Pombiliti Covered by Aetna CVS Health in Georgia Pombiliti (cipaglucosidase alfa-atga) with Opfolda requires prior authorization from Aetna CVS Health for adults ≥40kg with late-onset Pompe disease who are not improving on current enzyme replacement therapy. Submit PA via Aetna's Availity portal with genetic confirmation,

Do You Qualify for Vitrakvi (Larotrectinib) Coverage by Aetna (CVS Health) in Ohio? Complete Decision Tree & Appeals Guide

Quick Answer: Your Path to Vitrakvi (Larotrectinib) Coverage in Ohio To qualify for Vitrakvi (larotrectinib) coverage through Aetna (CVS Health) in Ohio, you need: (1) documented NTRK gene fusion-positive solid tumor, (2) metastatic or unresectable disease, and (3) prescription by an in-network oncologist. Fastest approval path: Submit prior authorization through

Do You Qualify for Tavalisse Coverage by Aetna CVS Health in North Carolina? Decision Tree & Next Steps

Answer Box: Quick Path to Tavalisse Coverage Yes, you likely qualify if you have chronic ITP (platelets <100,000 for ≥12 months), failed corticosteroids/IVIG, have platelets <50,000 or bleeding symptoms, and see a hematologist. Fastest approval: Submit Aetna's PA through Availity portal with complete

How to Get Onivyde (Irinotecan Liposome) Covered by Aetna (CVS Health) in Ohio: Forms, Appeals, and Step-by-Step Approval Guide

Answer Box: Getting Onivyde (Irinotecan Liposome) Covered by Aetna (CVS Health) in Ohio Onivyde (irinotecan liposome) requires prior authorization from Aetna (CVS Health) for both first-line NALIRIFOX and second-line therapy in pancreatic cancer. First step: Have your oncologist submit a specialty drug PA request through Aetna's Availity portal

How to Get Sylvant (siltuximab) Covered by Aetna (CVS Health) in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Sylvant (siltuximab) Covered by Aetna (CVS Health) in North Carolina Sylvant requires prior authorization from Aetna (CVS Health) for idiopathic multicentric Castleman disease (iMCD). The fastest path: ensure your oncologist submits complete documentation showing HIV-negative/HHV-8-negative status, multicentric pathology, and active disease. If denied, North Carolina'

How to Get Voxzogo (vosoritide) Covered by Aetna (CVS Health) in Texas: Complete 2025 Guide with Forms and Appeals

Answer Box: Getting Voxzogo (vosoritide) Covered by Aetna (CVS Health) in Texas Eligibility: Children ≥2 years with achondroplasia, open growth plates, and specialist care. Fastest path: Submit complete prior authorization with genetic test, growth plate imaging, and specialist letter. Start today: Call Aetna specialty PA line at 1-800-294-5979 for current