Topic

Cerezyme (imiglucerase)

A collection of 26 issues

How to Get Cerezyme (Imiglucerase) Covered by Aetna CVS Health in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Cerezyme Covered by Aetna CVS Health in Texas Aetna CVS Health requires prior authorization for Cerezyme (imiglucerase) with Elelyso as preferred step therapy. Texas law provides strong appeal protections with 180-day filing deadlines and binding external review through Independent Review Organizations (IROs). Fastest path to approval: 1.

How to Get Cerezyme (Imiglucerase) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Cerezyme (Imiglucerase) Covered by Cigna in Washington Fastest Path to Approval: Submit Cigna's Cerezyme/Elelyso/VPRIV prior authorization form with documented Gaucher disease (enzyme assay or genetic testing), prescription from a metabolic/lysosomal storage disorder specialist, and clinical notes showing symptoms. No step therapy required.

How Long Does It Take to Get Cerezyme (Imiglucerase) Approved by Humana in New York? Complete Timeline Guide

Answer Box: Getting Cerezyme Approved by Humana in New York Timeline: 2-3 weeks total if all documentation is complete. Humana requires prior authorization with step therapy to Elelyso or Vpriv first, unless medically contraindicated. Fastest path: Have your prescriber submit a complete PA with enzyme/genetic testing, step therapy documentation,

How to Get Cerezyme (Imiglucerase) Covered by Humana in Pennsylvania: Complete Coverage Guide

Answer Box: Your Path to Coverage Humana classifies Cerezyme (imiglucerase) as a nonpreferred drug requiring prior authorization and step therapy to preferred agents (Elelyso or Vpriv) first. To get coverage in Pennsylvania: (1) Submit PA request with Type 1 Gaucher disease diagnosis and step therapy documentation, (2) If denied, file

How to Get Cerezyme (Imiglucerase) Covered by Aetna CVS Health in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Cerezyme Covered by Aetna CVS Health in Washington Cerezyme (imiglucerase) requires prior authorization from Aetna CVS Health in Washington, with many plans requiring step therapy (trying Elelyso first). The fastest path to approval: Have your Gaucher specialist complete Aetna's Cerezyme precertification form with confirmed Type

How to Get Cerezyme (Imiglucerase) Covered by Blue Cross Blue Shield in Georgia: Complete Appeals Guide with Forms & Timelines

Answer Box: Getting Cerezyme Covered by Blue Cross Blue Shield in Georgia Blue Cross Blue Shield in Georgia (Anthem) typically covers Cerezyme (imiglucerase) for Type 1 Gaucher disease under the medical benefit with prior authorization. First step: Call the pharmacy member services number on your ID card to confirm coverage

Myths vs. Facts: Getting Cerezyme (Imiglucerase) Covered by Humana in New Jersey

Answer Box: Getting Cerezyme Covered by Humana in New Jersey Eligibility: Humana requires prior authorization for Cerezyme (imiglucerase) under billing code J1786 for Type 1 Gaucher disease patients. Fastest approval path: Submit complete medical necessity documentation including confirmed enzyme deficiency test results, specialist evaluation, and FDA-approved dosing plan (2.5-60

How to Get Cerezyme (imiglucerase) Covered by Aetna in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Cerezyme Covered by Aetna in New Jersey Aetna covers Cerezyme (imiglucerase) for confirmed Gaucher disease Types 1-3 with prior authorization. You'll need enzyme deficiency test results or genetic testing, plus documentation that Elelyso was ineffective or contraindicated. If denied, you have 180 days for internal

How to Get Cerezyme (Imiglucerase) Covered by Humana in North Carolina: Complete Guide with Appeals Process

Answer Box: Getting Cerezyme Covered by Humana in North Carolina Cerezyme (imiglucerase) requires prior authorization from Humana in North Carolina for all plan types. The fastest path to approval: (1) Gather diagnostic confirmation (enzyme deficiency test + GBA1 genetic testing), (2) Submit prior authorization through Humana's provider portal with

The Complete Requirements Checklist to Get Cerezyme (Imiglucerase) Covered by UnitedHealthcare in Michigan

Answer Box: Getting Cerezyme Covered by UnitedHealthcare in Michigan Fastest path to approval: Submit prior authorization through OptumRx with confirmed Type 1 Gaucher disease diagnosis (ICD-10: E75.22), evidence of VPRIV failure/intolerance (step therapy requirement), and complete medical necessity documentation. Use HCPCS code J1786 for billing. If denied, Michigan