Topic

Cigna

A collection of 611 issues

How to Get Uplizna (Inebilizumab) Covered by Cigna in Texas: Complete Guide to Prior Authorization, Appeals, and Approval Strategies

Answer Box: Getting Uplizna (Inebilizumab) Covered by Cigna in Texas Uplizna (inebilizumab) requires prior authorization from Cigna and is typically covered for AQP4-positive NMOSD when prescribed by a neurologist with documented step therapy. Your fastest path: (1) Have your neurologist submit a prior authorization through CoverMyMeds or Cigna's

If Pombiliti (Cipaglucosidase Alfa-Atga) Isn't Approved by Cigna in Virginia: Formulary Alternatives & Exception Paths

Quick Answer: If Cigna denies Pombiliti (cipaglucosidase alfa-atga) coverage in Virginia, you'll likely need to try formulary alternatives like Lumizyme or Nexviazyme first due to step therapy requirements. Document any treatment failures carefully—this evidence becomes crucial for later exception requests or appeals. Virginia's external review

Work With Your Doctor to Get Elelyso (taliglucerase alfa) Covered by Cigna in Illinois: Complete Provider Collaboration Guide

Answer Box: Fast Track to Elelyso (taliglucerase alfa) Coverage To get Elelyso (taliglucerase alfa) covered by Cigna in Illinois, you'll need prior authorization with confirmed Type 1 Gaucher disease diagnosis, specialist prescriber, and documentation of failed or contraindicated preferred ERTs (Cerezyme, VPRIV). Your doctor submits via CoverMyMeds or

Getting Takhzyro (lanadelumab-flyo) Covered by Cigna in Florida: Complete Prior Authorization & Appeal Guide

Answer Box: Getting Takhzyro Covered by Cigna in Florida Eligibility: Cigna covers Takhzyro (lanadelumab-flyo) for hereditary angioedema (HAE) types I/II with prior authorization. You need documented low C1-INH levels (<50%) and low C4, plus prescription by an allergist/immunologist. Fastest path: Submit PA through your specialist with lab

Myths vs. Facts: Getting Onivyde (Irinotecan Liposome) Covered by Cigna in New York

Answer Box: Getting Onivyde Covered by Cigna in New York Eligibility: Cigna requires prior authorization for Onivyde (irinotecan liposome) with strict ECOG performance status (0-1), documented pancreatic adenocarcinoma, and specific organ function labs. Fastest path: Electronic submission via CoverMyMeds or provider portal with complete clinical documentation. First step today: Gather

How to Get Cabometyx (cabozantinib) Covered by Cigna in New York: Complete Prior Authorization and Appeals Guide

Quick Answer: Cigna requires prior authorization for Cabometyx (cabozantinib tablets) with documentation of FDA-approved diagnosis, prior therapy failures, and medical necessity. Your oncologist submits through Cigna's portal or CoverMyMeds within 72 hours standard review. If denied, you have 180 days for internal appeal, then 4 months for New

Myths vs. Facts: Getting Revlimid (Lenalidomide) Covered by Cigna in Pennsylvania - Appeals Guide 2025

Quick Answer: Getting Revlimid (lenalidomide) covered by Cigna in Pennsylvania requires prior authorization, REMS certification for both prescriber and pharmacy, and meeting specific clinical criteria. If denied, you have strong appeal options: Pennsylvania's new external review program overturns about 50% of denials. First step today: Check if your

How to Get Zolgensma Covered by Cigna in New Jersey: Complete Guide to Prior Authorization, Appeals, and IHCAP External Review

Answer Box: Getting Zolgensma Covered by Cigna in New Jersey Cigna covers Zolgensma (onasemnogene abeparvovec) for children under 24 months with genetically confirmed spinal muscular atrophy (SMA) through prior authorization. The fastest path: (1) Gather genetic test results showing bi-allelic SMN1 mutations and anti-AAV9 antibody titer ≤1:50, (2) Submit

How to Get Bylvay (odevixibat) Covered by Cigna in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Bylvay (odevixibat) Covered by Cigna in New Jersey Eligibility: Bylvay requires prior authorization from Cigna for PFIC (≥3 months) or Alagille syndrome (≥12 months) with documented moderate-to-severe pruritus and failed conventional therapies. Fastest path: Submit complete PA through Express Scripts portal with genetic testing, specialist consultation, and

Getting Pomalyst (Pomalidomide) Covered by Cigna in Texas: Prior Authorization, Appeals, and State Protection Guide

Answer Box: Your Fastest Path to Coverage Getting Pomalyst (pomalidomide) covered by Cigna in Texas requires prior authorization with proof of multiple myeloma diagnosis, failure of lenalidomide and a proteasome inhibitor, and REMS enrollment. If denied, you have 180 days to appeal internally, then can request Texas Independent Review Organization