Topic

Breyanzi (lisocabtagene maraleucel)

A collection of 26 issues

Myths vs. Facts: Getting Breyanzi (lisocabtagene maraleucel) Covered by Aetna (CVS Health) in Florida

Quick Answer: Aetna (CVS Health) requires prior authorization for Breyanzi (lisocabtagene maraleucel) under Clinical Policy Bulletin #986, covering FDA-approved B-cell lymphoma indications for patients ≥18 with ECOG ≤2 after documented treatment failures. Submit PA via Availity portal or fax 1-877-269-9916 with complete clinical documentation. If denied, file internal appeal within
5 min read

How to Get Breyanzi (lisocabtagene maraleucel) Covered by UnitedHealthcare in Texas: Renewal Guide, Appeals Process & Timeline

Answer Box: Renewing Breyanzi Coverage with UnitedHealthcare in Texas Breyanzi (lisocabtagene maraleucel) renewals with UnitedHealthcare typically require reauthorization every 12 months with documented clinical response evidence. Start the renewal process 60-90 days before expiration by gathering recent labs, imaging showing disease control, and updated performance status documentation. If denied, you
5 min read

How to Get Breyanzi Covered by Blue Cross Blue Shield of Michigan: Prior Authorization Guide and Appeals Process

Answer Box: Getting Breyanzi Covered in Michigan Blue Cross Blue Shield of Michigan requires prior authorization for Breyanzi (lisocabtagene maraleucel) under their medical benefit, with coverage limited to FDA-approved indications after documented failure of prior therapies. Submit requests using the BCBSM Medication Authorization Request Form (fax to 1-877-325-5979), including cardiac
5 min read

Breyanzi (Lisocabtagene Maraleucel) Approval with UnitedHealthcare in Michigan: Answers to the Most Common Questions

Answer Box: Getting Breyanzi Covered by UnitedHealthcare in Michigan Breyanzi (lisocabtagene maraleucel) requires prior authorization from UnitedHealthcare for all Michigan plans. Your oncologist must submit documentation proving you meet FDA criteria: relapsed/refractory large B-cell lymphoma after ≥2 lines, or CLL/SLL after BTK and BCL-2 inhibitor failure. Treatment must
6 min read

How to Get Breyanzi (lisocabtagene maraleucel) Covered by Cigna in Pennsylvania: Complete Prior Authorization and Appeals Guide

Answer Box: Fastest Path to Breyanzi Coverage with Cigna in Pennsylvania To get Breyanzi (lisocabtagene maraleucel) covered by Cigna in Pennsylvania: (1) Have your CAR-T center submit prior authorization through Cigna's LifeSOURCE transplant program with complete documentation of diagnosis, prior therapy failures, and facility certification; (2) If denied,
6 min read

Getting Breyanzi (Lisocabtagene Maraleucel) Covered by Aetna CVS Health in Ohio: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting Breyanzi Covered by Aetna CVS Health in Ohio Breyanzi (lisocabtagene maraleucel) requires mandatory prior authorization from Aetna CVS Health before coverage. To qualify, you need confirmed relapsed/refractory large B-cell lymphoma after ≥2 prior therapies, ECOG performance status 0-2, and treatment at a certified CAR-T center. First
7 min read

How to Get Breyanzi (lisocabtagene maraleucel) Covered by Blue Cross Blue Shield in New Jersey: Appeals, Alternatives & Success Strategies

Answer Box: Getting Breyanzi Covered in New Jersey Eligibility: Adults with relapsed/refractory large B-cell lymphoma after ≥2 lines of therapy, or CLL/SLL after ≥2 lines including BTK and BCL2 inhibitors. Fastest Path: Your oncologist submits prior authorization through Prime Therapeutics with complete treatment history and medical necessity letter.
6 min read

Blue Cross Blue Shield North Carolina's Coverage Criteria for Breyanzi (Lisocabtagene Maraleucel): What Counts as "Medically Necessary"?

Answer Box: Getting Breyanzi Covered by BCBS North Carolina Eligibility: Breyanzi requires prior authorization from Blue Cross Blue Shield of North Carolina for specific B-cell lymphomas after multiple treatment lines. Fastest path: Have your oncologist submit a PA request through the Blue e provider portal with complete documentation of diagnosis,
6 min read