Topic

Cigna

A collection of 1065 issues

Myths vs. Facts: Getting Carbaglu (Carglumic Acid) Covered by Cigna in Florida

Answer Box: The Reality Check Getting Carbaglu (carglumic acid) covered by Cigna in Florida requires prior authorization with specific documentation—not just a prescription. The fastest path: your metabolic specialist submits a PA request with genetic testing results, ammonia levels above normal, and confirmation of protein-restricted diet. If denied, you

Getting Hetlioz LQ Covered by Cigna in Virginia: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Hetlioz LQ Covered by Cigna in Virginia Cigna requires prior authorization for Hetlioz LQ (tasimelteon oral suspension) for Smith-Magenis Syndrome sleep disturbance in children 3-15 years. Virginia law provides strong protections including step therapy medical exceptions, 72-hour PA decisions, and binding external review through the State Corporation

How to Get Besponsa (Inotuzumab Ozogamicin) Covered by Cigna in Texas: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Besponsa Covered by Cigna in Texas Cigna requires prior authorization for Besponsa (inotuzumab ozogamicin) with CD22-positive B-cell precursor ALL documentation. Submit the Cigna Besponsa CCRD PA form with pathology confirming CD22 status, relapsed/refractory disease history, and medical necessity letter. If denied, file internal appeal within 180

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

Answer Box: Getting Tagrisso Covered by Cigna in Washington Cigna covers Tagrisso (osimertinib) for EGFR-mutated NSCLC with prior authorization. First step today: Have your oncologist submit PA through Cigna's provider portal with EGFR mutation test results, staging, and treatment history. Standard decisions take 72 hours; expedited reviews 24

Myths vs. Facts: Getting Trikafta (elexacaftor/tezacaftor/ivacaftor) Covered by Cigna in Pennsylvania

Answer Box: Getting Trikafta Covered by Cigna in Pennsylvania Eligibility: Cigna requires prior authorization for Trikafta with documented cystic fibrosis, CFTR genotype showing F508del or responsive mutation, and prescription by a CF specialist. Fastest path: Have your CF center submit complete PA packet with genetic testing, medical necessity letter, and

The Requirements Checklist to Get Koselugo (Selumetinib) Covered by Cigna in Michigan: Forms, Appeals, and Clinical Criteria

Answer Box: Quick Path to Koselugo Coverage Cigna requires prior authorization (PA) for Koselugo (selumetinib) in pediatric NF1 patients with symptomatic, inoperable plexiform neurofibromas. Initial approvals last 1 year with reauthorization requiring evidence of benefit. Key requirements: confirmed NF1 diagnosis (ICD-10 Q85.01), baseline LVEF evaluation, ophthalmologic exam, and MRI

How to Get Haegarda (C1-esterase inhibitor, SC) Covered by Cigna in New York: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting Haegarda Covered by Cigna in New York Cigna requires prior authorization for Haegarda with specialist diagnosis, lab confirmation (low C4), and documented HAE attack history. Submit through your HAE specialist using Cigna's C1-esterase inhibitor PA form. If denied, you have 180 days for internal appeals

How to Get Tremfya (Guselkumab) Covered by Cigna in Florida: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Tremfya (Guselkumab) Covered by Cigna in Florida Cigna requires prior authorization for Tremfya with step therapy through traditional agents (methotrexate, cyclosporine) or TNF inhibitors for 3+ months. If denied, you have 180 days to file an internal appeal, with 30-day review times for future treatments. External review

How to Get Rebif (Interferon Beta-1a) Covered by Cigna in Michigan: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Rebif Covered by Cigna in Michigan Rebif (interferon beta-1a) requires prior authorization from Cigna, typically managed through Express Scripts/Accredo specialty pharmacy. Submit initial PA via CoverMyMeds or Cigna provider portal with MS diagnosis, prior DMT failures, and medical necessity documentation. If denied, file internal appeal within

How to Get Synagis (Palivizumab) Covered by Cigna in Pennsylvania: Complete Prior Authorization Guide

Answer Box: Cigna requires prior authorization for Synagis (palivizumab) through Express Scripts/Accredo for high-risk infants meeting AAP criteria. Submit PA using CoverMyMeds or fax (855) 840-1678 with specialist documentation (gestational age, chronic lung disease, congenital heart disease). If denied, use Cigna's internal appeals within 180 days, then