Topic

Alprolix (coagulation factor IX, rFIXFc; eftrenonacog alfa)

A collection of 31 issues

How to Get Alprolix Covered by UnitedHealthcare in North Carolina: Prior Authorization Forms, Appeals, and State Resources

Answer Box: Getting Alprolix Covered by UnitedHealthcare in North Carolina UnitedHealthcare requires prior authorization for Alprolix through OptumRx, typically requiring hematologist prescribing, documented hemophilia B diagnosis, and evidence of failed standard factor IX therapy. Submit PA via the UnitedHealthcare Provider Portal, prepare for potential step therapy requirements, and if denied,

How to Get Alprolix (Factor IX) Covered by Cigna in New York: PA Requirements, Appeals Process, and State Protections

Answer Box: Getting Alprolix Covered by Cigna in New York Cigna typically requires prior authorization (PA) for Alprolix through Express Scripts/Accredo, with decisions within 24-72 hours under New York law. If denied, you have 180 days to file internal appeals, followed by New York's external review process

Get Alprolix Covered by Humana in Virginia: Complete Prior Authorization Guide with Appeals Process

Answer Box: Getting Alprolix Covered by Humana in Virginia Yes, Alprolix can be covered by Humana Medicare Advantage and commercial plans in Virginia, but requires prior authorization. The fastest path: Have your hematologist submit a PA request with detailed bleeding history, factor IX levels, and medical necessity documentation. Most Humana

Get Alprolix (Coagulation Factor IX) Covered by Cigna in Georgia: Complete Prior Authorization Guide

Quick Answer: Getting Alprolix Covered by Cigna in Georgia Yes, Cigna covers Alprolix (eftrenonacog alfa) for hemophilia B in Georgia, but requires prior authorization with step therapy. You'll need to try preferred Factor IX products first unless medically contraindicated. Your hematologist submits the PA through Cigna's

Myths vs. Facts: Getting Alprolix Covered by UnitedHealthcare in Washington (Appeals Guide & Forms)

Quick Answer: UnitedHealthcare typically requires prior authorization and step therapy for Alprolix (eftrenonacog alfa) in Washington. Most patients must first try preferred Factor IX products. If denied, you have 180 days to file an internal appeal, then request external review through Washington's Independent Review Organization (IRO). Start by

How to Get Alprolix (Coagulation Factor IX) Covered by Humana in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Alprolix Covered by Humana in New Jersey Alprolix (coagulation factor IX, rFIXFc; eftrenonacog alfa) requires prior authorization from Humana and faces step therapy requirements—you'll likely need to try preferred alternatives like Idelvion or BeneFIX first. If denied, you have 65 days to appeal internally,

How to Get Alprolix (eftrenonacog alfa) Covered by Cigna in Virginia: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Alprolix Covered by Cigna in Virginia Cigna requires prior authorization for Alprolix (eftrenonacog alfa) with step therapy requirements. Your fastest path to approval: (1) Have your hematologist submit a prior authorization request through CoverMyMeds or Cigna's provider portal documenting hemophilia B diagnosis, failed preferred factor

Get Alprolix Covered by Cigna in Florida: Forms, Appeals & Approval Timeline

Answer Box: Getting Alprolix Covered by Cigna in Florida Cigna requires prior authorization for Alprolix (coagulation factor IX, rFIXFc; eftrenonacog alfa) in Florida. Your hematologist must submit the Clotting Factors Prior Authorization Form with diagnosis, bleeding history, and medical necessity documentation. Standard review takes 5 business days; expedited reviews complete

How to Get Alprolix Covered by Blue Cross Blue Shield in Washington: Timeline, Appeals, and Approval Strategies

Answer Box: Getting Alprolix Covered by Blue Cross Blue Shield in Washington Blue Cross Blue Shield plans in Washington (Premera, Regence) require prior authorization for Alprolix (coagulation factor IX, rFIXFc; eftrenonacog alfa), with approval typically taking 3-7 business days for complete submissions. The fastest path involves your hematologist submitting comprehensive

How to Get Alprolix Covered by Aetna CVS Health in New York: Formulary Status, Appeals Process & PA Requirements

Quick Answer: Getting Alprolix Covered by Aetna CVS Health in New York Challenge: Alprolix is excluded from Aetna's 2024 Advanced Control Formulary, meaning routine prior authorization isn't available. Path forward: Request a coverage exception with strong medical necessity documentation from your hematologist. First step today: Contact