Topic

Cerezyme (imiglucerase)

A collection of 26 issues

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

Quick Answer: Cerezyme requires prior authorization from Aetna CVS Health and is subject to step therapy (Elelyso preferred first). To get coverage: 1) Confirm Gaucher disease diagnosis with enzyme/genetic testing, 2) Document Elelyso trial/failure or contraindication, 3) Submit PA via provider portal with specialist support. If denied, Illinois

How to Get Cerezyme (imiglucerase) Covered by UnitedHealthcare in North Carolina: Complete Appeals Guide with Forms and Timelines

Quick Answer: UnitedHealthcare covers Cerezyme (imiglucerase) for Type 1 Gaucher disease in North Carolina with prior authorization. You'll need confirmed diagnosis via enzyme assay and genetic testing, specialist oversight, and may face step therapy requiring trial of alternative ERTs first. If denied, use North Carolina's Smart

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

Answer Box: Getting Cerezyme Covered by Cigna in Michigan Eligibility: Cigna covers Cerezyme (imiglucerase) for confirmed Type 1 Gaucher disease with prior authorization through the medical benefit. No step therapy is required. Fastest path: Have your specialist submit a PA request via CoverMyMeds or Cigna's provider portal with

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

Quick Answer: Do You Qualify for Cerezyme Coverage by Cigna in Florida? Yes, if you have confirmed Type 1 Gaucher disease with clinical symptoms. Cigna covers Cerezyme (imiglucerase) through Express Scripts/Accredo with prior authorization. Your fastest path: Have your specialist submit a complete PA request via CoverMyMeds with enzyme/

Do You Qualify for Cerezyme (Imiglucerase) Coverage by Humana in Ohio? Decision Tree & Next Steps

Answer Box: Your Path to Cerezyme Coverage in Ohio Yes, Humana covers Cerezyme (imiglucerase) in Ohio with prior authorization. Most approvals require: confirmed Type 1 Gaucher disease diagnosis (enzyme + genetic testing), specialist evaluation, and documented medical necessity. First step today: Contact your prescribing physician to initiate the prior authorization request

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

Answer Box: To get Cerezyme (imiglucerase) covered by Cigna in Illinois, you need proper coding (ICD-10: E75.22, HCPCS: J1786), specialist documentation of Type 1 Gaucher disease with enzyme deficiency, and prior authorization through Cigna's specialty drug process. If denied, Illinois law gives you strong appeal rights including

How to Get Cerezyme (Imiglucerase) Covered by UnitedHealthcare in Georgia: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Cerezyme Covered by UnitedHealthcare in Georgia UnitedHealthcare requires prior authorization for Cerezyme (imiglucerase) for Gaucher disease. Key steps: 1) Confirm Type 1 Gaucher diagnosis with enzyme testing, 2) Submit PA through UnitedHealthcare Provider Portal with specialist documentation, 3) If denied, file internal appeal within 180 days, then

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

Answer Box: Getting Cerezyme (Imiglucerase) Covered by Cigna in North Carolina Yes, Cigna covers Cerezyme (imiglucerase) for Type 1 Gaucher disease with prior authorization. Your fastest path to approval requires: (1) confirmed Gaucher disease Type 1 diagnosis with enzyme testing and genetic confirmation, (2) specialist prescriber (hematologist/geneticist), and (3)

How to Get Cerezyme (Imiglucerase) Covered by Blue Cross Blue Shield of Michigan: 2024 PA Requirements, Appeals Process & Forms

Answer Box: Getting Cerezyme Covered by Blue Cross Blue Shield of Michigan Good news for Michigan patients: Blue Cross Blue Shield of Michigan (BCBSM) covers Cerezyme as its preferred enzyme replacement therapy for Type 1 Gaucher disease. As of January 1, 2024, no prior authorization is required for Medicare Advantage

How to Get Cerezyme (Imiglucerase) Approved by UnitedHealthcare in New Jersey: Complete Appeals Guide

Answer Box: Getting Cerezyme Covered by UnitedHealthcare in New Jersey Cerezyme (imiglucerase) requires prior authorization from UnitedHealthcare/OptumRx in New Jersey and may face step therapy requirements. To get coverage: 1. Submit PA request via UnitedHealthcare Provider Portal with Gaucher disease confirmation and specialist documentation 2. Request step therapy exception