Topic

Aetna (CVS Health)

A collection of 1137 issues

How to Get Kanuma (Sebelipase Alfa) Covered by Aetna CVS Health in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Kanuma Approved by Aetna CVS Health in New York Fastest path to approval: Kanuma (sebelipase alfa) requires prior authorization from Aetna CVS Health. Success depends on confirming LAL deficiency with enzyme testing and genetic analysis, documenting disease severity (elevated ALT, hepatomegaly, dyslipidemia), and submitting through their specialty

Work With Your Doctor to Get Therakos CELLEX Photopheresis Approved by Aetna CVS Health in California

Answer Box: Your Path to Approval Getting Therakos CELLEX photopheresis covered by Aetna CVS Health in California requires strong physician partnership and detailed documentation. Start by scheduling a visit with your specialist to review your diagnosis (CTCL or steroid-refractory GVHD), document all failed prior treatments, and prepare a comprehensive medical

Get Tecentriq (Atezolizumab) Covered by Aetna CVS Health in Virginia: Complete Prior Authorization and Appeals Guide

Answer Box: Your Fast Track to Tecentriq Coverage Getting Tecentriq (atezolizumab) covered by Aetna CVS Health in Virginia requires prior authorization with specific biomarker testing. Submit Aetna's Tecentriq precertification form with PD-L1 test results (≥1% for adjuvant NSCLC, ≥50% for first-line metastatic), negative EGFR/ALK mutation testing, and

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

Answer Box: Getting Translarna (Ataluren) Covered by Aetna CVS Health in California Important Update: Translarna (ataluren) is currently under FDA review with no approved status in the United States as of 2025. While the FDA accepted PTC Therapeutics' resubmitted application in November 2024, no decision timeline has been set.

How to Get Givlaari (Givosiran) Covered by Aetna CVS Health in Washington: Complete Forms, Appeals Guide & Contact Numbers

Quick Answer: Getting Givlaari (Givosiran) Covered by Aetna CVS Health in Washington Path to approval: Submit Aetna's Givlaari precertification form with biochemical confirmation (elevated ALA/PBG levels), documented attack history (≥2 qualifying attacks in 6-12 months), and specialist evaluation. If denied, file internal appeal within 180 days, then

How to Get Tagrisso (Osimertinib) Covered by Aetna CVS Health in Michigan: Prior Authorization Forms, Appeals, and State Rights

Answer Box: Getting Tagrisso Covered by Aetna CVS Health in Michigan Fastest path to approval: Submit prior authorization with documented EGFR mutation test results, specific NSCLC diagnosis/stage, and prescriber attestation that Tagrisso meets FDA labeling criteria. Aetna typically requires 30-45 days for standard decisions, 72 hours for urgent oncology

How to Get Opfolda (miglustat) Covered by Aetna in Florida: Forms, Appeals, and Contact Directory

Answer Box: Getting Opfolda (miglustat) Covered by Aetna in Florida Eligibility: Opfolda (miglustat) is only approved for adults with Late-Onset Pompe Disease (LOPD) weighing ≥40 kg when used with Pombiliti, and only if current enzyme replacement therapy isn't working effectively. Fastest Path: 1) Verify your exact Aetna plan

How to Get Joenja (leniolisib) Covered by Aetna CVS Health in Pennsylvania: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Joenja (leniolisib) Covered by Aetna CVS Health in Pennsylvania Fastest path to approval: Submit prior authorization with confirmed APDS genetic testing (pathogenic PIK3CD or PIK3R1 variant), specialist documentation, and prior therapy history. If denied, file internal appeal within 180 days, then pursue Pennsylvania's external review

The Requirements Checklist to Get Upstaza (eladocagene exuparvovec) Covered by Aetna (CVS Health) in New Jersey

Answer Box: Getting Upstaza Covered by Aetna in New Jersey Fast Track to Approval: Upstaza (eladocagene exuparvovec) requires prior authorization from Aetna CVS Health for confirmed AADC deficiency patients. Success depends on genetic confirmation, enzyme testing, and treatment at a qualified neurosurgical center. Start today: (1) Call Aetna member services

How to Get Vanflyta (Quizartinib) Covered by Aetna CVS Health in Ohio: Complete Forms, Appeals, and Approval Guide

Answer Box: To get Vanflyta (quizartinib) covered by Aetna CVS Health in Ohio, you'll need prior authorization with FLT3-ITD testing documentation, baseline EKG showing QTc ≤450ms, and hematologist/oncologist prescription. Submit through CVS Caremark's electronic portal or specialty pharmacy channels. If denied, use Aetna's