Topic

Aetna (CVS Health)

A collection of 1074 issues

Work With Your Doctor to Get Opzelura (ruxolitinib cream) Approved by Aetna (CVS Health) in Texas: Complete Provider Collaboration Guide

Answer Box: Getting Opzelura (ruxolitinib cream) Approved by Aetna (CVS Health) in Texas Aetna (CVS Health) requires prior authorization for Opzelura with mandatory step therapy documentation showing failure of topical corticosteroids and calcineurin inhibitors. Your doctor must submit a medical necessity letter through the Aetna provider portal with detailed treatment
6 min read

The Requirements Checklist to Get Ocrevus (ocrelizumab) Covered by Aetna (CVS Health) in Pennsylvania: Forms, Appeals, and Approval Timeline

Answer Box: Getting Ocrevus Covered by Aetna in Pennsylvania Fastest path to approval: Submit Aetna's Ocrevus Medication Precertification Request form with neurologist documentation of MS diagnosis, prior therapy failures, and MRI evidence of disease activity. If denied, you can appeal internally within 180 days, then request Pennsylvania'
5 min read

Work With Your Doctor to Get Upstaza (Kebilidi) Covered by Aetna in Pennsylvania: Complete Provider Partnership Guide

Answer Box: Getting Aetna to Cover Upstaza (Kebilidi) in Pennsylvania Upstaza (Kebilidi) requires prior authorization from Aetna with genetic confirmation of AADC deficiency, treatment at a designated center, and comprehensive medical documentation. Your doctor must submit genetic testing results, enzyme assays, and clinical notes showing failed standard therapies. If denied,
6 min read

Aetna CVS Health's Coverage Criteria for Vitrakvi (Larotrectinib) in Virginia: What Counts as "Medically Necessary"?

Answer Box: Getting Vitrakvi (Larotrectinib) Covered by Aetna CVS Health in Virginia Aetna CVS Health requires prior authorization for Vitrakvi with three key requirements: confirmed NTRK gene fusion via validated testing, metastatic/unresectable solid tumor status, and documented failure or unsuitability of standard therapies. The fastest path to approval: (1)
5 min read

How to Get Mavenclad (Cladribine) Covered by Aetna CVS Health in Michigan: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Mavenclad Covered by Aetna CVS Health in Michigan Mavenclad (cladribine tablets) requires prior authorization from Aetna CVS Health for relapsing MS coverage. Key requirements: documented failure of ≥2 DMTs, baseline lymphocyte count ≥800 cells/μL, neurologist prescriber, and comprehensive safety screening. Submit PA via Aetna provider portal
5 min read