Topic

Aetna (CVS Health)

A collection of 651 issues

How to Get Givlaari (givosiran) Covered by Aetna (CVS Health) in Illinois: Prior Authorization Guide and Appeal Process

Answer Box: Getting Givlaari Covered by Aetna in Illinois Aetna (CVS Health) requires prior authorization for Givlaari (givosiran) with documentation of at least 4 acute hepatic porphyria attacks per year and elevated urine ALA/PBG levels. Submit requests via phone (855-582-2025), fax (855-330-1716), or mail to Aetna PA, 1300 E.

How to Get Trikafta Covered by Aetna CVS Health in Ohio: Complete Prior Authorization and Appeals Guide 2024

Quick Answer: Getting Trikafta Covered by Aetna CVS Health in Ohio Trikafta requires prior authorization from Aetna CVS Health in Ohio. The fastest path to approval: 1) Have your CF specialist submit a PA request with complete CFTR genotype documentation and ICD-10 diagnosis code E84.0-E84.9, 2) Ensure CVS

Aetna CVS Health Coverage for Besponsa (Inotuzumab Ozogamicin) in California: Medical Necessity Requirements and Appeal Process

Quick Answer: Getting Besponsa Covered by Aetna CVS Health in California Aetna requires prior authorization for Besponsa (inotuzumab ozogamicin) with strict medical necessity criteria: CD22-positive B-cell ALL diagnosis, relapsed/refractory status, and hepatic monitoring plan. Submit PA through CVS Specialty at 1-888-267-3277. If denied, California patients have strong appeal rights

How to Get Crysvita (Burosumab) Covered by Aetna CVS Health in Florida: Complete PA Guide with Appeals Timeline

Answer Box: Getting Crysvita Approved by Aetna CVS Health in Florida Crysvita (burosumab) requires prior authorization from Aetna CVS Health. Your fastest path to approval: Submit the Aetna Crysvita precertification form with genetic testing (PHEX mutation) or elevated FGF23 levels, plus radiographic evidence of bone disease. First step today: Call

How to Get Acthar Gel Covered by Aetna CVS Health in Georgia: Prior Authorization Guide and Appeals Process

Answer Box: Getting Acthar Gel Covered by Aetna in Georgia Aetna CVS Health only covers Acthar Gel (repository corticotropin injection) for infantile spasms in patients under 2 years old. All other uses require appeals based on medical necessity. Your fastest path: 1) Submit prior authorization with complete failure documentation of

How Long Does It Take to Get Retevmo (selpercatinib) Approved by Aetna (CVS Health) in Florida? Timeline & Milestones

Answer Box: What to Expect Getting Retevmo (selpercatinib) approved by Aetna (CVS Health) in Florida typically takes 14 calendar days for standard prior authorization, or 72 hours for expedited requests. The process requires documented RET alteration testing via FDA-approved companion diagnostics, complete clinical records, and submission through CVS Specialty Pharmacy.

How to Get Rylaze Covered by Aetna CVS Health in Texas: Complete Prior Authorization and Appeal Guide

Answer Box: Getting Rylaze Covered by Aetna CVS Health in Texas Rylaze requires prior authorization from Aetna CVS Health in Texas. You need documented hypersensitivity to E. coli asparaginase, confirmed ALL/LBL diagnosis, and use in multi-agent chemotherapy. Start today: Have your oncologist submit PA with detailed hypersensitivity documentation via

Getting Firazyr (Icatibant) Covered by Aetna in Washington: Complete Prior Authorization & Appeals Guide

Quick Answer: To get Firazyr (icatibant) covered by Aetna in Washington, you need prior authorization through an HAE specialist with lab-confirmed C1-INH deficiency. Submit Aetna's precertification form with diagnosis documentation to 1-888-267-3277. If denied, appeal within 180 days, then request independent external review through Washington's IRO

How to Get Trikafta Covered by Aetna CVS Health in California: Complete Prior Authorization and Appeals Guide 2024

Answer Box: Fastest Path to Trikafta Approval Trikafta requires prior authorization from Aetna CVS Health in California. Submit CFTR genotype results showing F508del mutation, baseline liver function tests, and CF specialist attestation through Aetna's provider portal. Standard approval takes 5-10 business days. If denied, file internal appeal within

How to Get Evrysdi (risdiplam) Covered by Aetna (CVS Health) in California: Prior Authorization, Appeals, and State Protections

Answer Box: Getting Evrysdi Covered in California Getting Evrysdi (risdiplam) covered by Aetna (CVS Health) in California requires prior authorization with genetic confirmation of SMA, baseline motor assessments, and specialist prescription. If denied, California's robust appeal protections give you strong reversal odds—about 68% of specialty drug appeals