Topic

Cigna

A collection of 1068 issues

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

Answer Box: Getting Kymriah (tisagenlecleucel) Covered by Cigna in Florida Kymriah requires prior authorization through Cigna's medical benefit in Florida. Start with the Florida Medical Prior Authorization Form and submit via fax (866-873-8279) or online portal. Your clinic must document CD19-positive disease, prior therapy failures, and treatment at

How to Get Qalsody (Tofersen) Covered by Cigna in Georgia: Complete PA Guide, Appeals Process & Approval Scripts

Answer Box: Fast Track to Qalsody (Tofersen) Approval Eligibility: Cigna covers Qalsody for SOD1-mutation ALS with prior authorization under Coverage Policy IP0567. Fastest path: (1) Confirm your Cigna plan type and whether you need a PCP referral to neurology, (2) Have your ALS neurologist submit complete PA via CoverMyMeds Cigna

How to Get Evrysdi (Risdiplam) Covered by Cigna in Texas: Complete PA Guide and Appeal Process

Answer Box: Getting Evrysdi (Risdiplam) Covered by Cigna in Texas Cigna requires prior authorization for Evrysdi (risdiplam) with genetic testing, motor assessment, and specialist involvement. Submit electronically via CoverMyMeds or Accredo's portal for fastest approval (72 hours). If denied, file internal appeal within 180 days, then Texas external

Work With Your Doctor to Get Rystiggo (rozanolixizumab-noli) Covered by Cigna in Pennsylvania: Complete Appeals Guide

Answer Box: Getting Rystiggo (rozanolixizumab-noli) Covered by Cigna in Pennsylvania Cigna requires prior authorization for Rystiggo (rozanolixizumab-noli) through Express Scripts. To get approval in Pennsylvania: (1) Have your neurologist submit a medical necessity letter documenting generalized myasthenia gravis with AChR or MuSK antibodies and prior therapy failures via CoverMyMeds or

How to Get Vyondys 53 (golodirsen) Covered by Cigna in New York: Complete Prior Authorization Guide

Answer Box: To get Vyondys 53 (golodirsen) covered by Cigna in New York, you need prior authorization with genetic testing confirming an exon 53-skippable DMD mutation, a neurologist's prescription, and baseline functional assessments. Submit through Express Scripts provider portal or call 1-800-882-4462. Standard review takes 2-7 business days;

How to Get Myozyme (Alglucosidase Alfa) Covered by Cigna in Ohio: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Myozyme (Alglucosidase Alfa) Covered by Cigna in Ohio Cigna requires prior authorization for Myozyme (alglucosidase alfa) in Ohio, typically approved within 5-7 business days when complete documentation is submitted. Essential requirements include confirmed Pompe disease diagnosis (enzyme/genetic testing), metabolic specialist prescriber, and dosing ≤20 mg/kg

How to Get Berinert (C1-Esterase Inhibitor) Covered by Cigna in North Carolina: Complete PA Guide with Appeal Scripts

Quick Answer: To get Berinert covered by Cigna in North Carolina, you'll need prior authorization with documented HAE diagnosis (low C4 and C1-INH levels), ICD-10 code D84.1, and prescription by an allergist/immunologist. Submit through Cigna's provider portal or Accredo specialty pharmacy. If denied, file

How to Get Qinlock (ripretinib) Covered by Cigna in Florida: Prior Authorization, Appeals, and Timeline Guide

Answer Box: Getting Qinlock Covered by Cigna in Florida Qinlock (ripretinib) requires prior authorization from Cigna for advanced GIST patients who've failed at least three kinase inhibitors (imatinib, sunitinib, regorafenib). Your oncologist must submit documentation proving prior TKI failures, current disease status, and NCCN guideline support. If denied,

Coding That Helps Get Juxtapid (lomitapide) Approved by Cigna in Michigan: ICD-10, HCPCS, and NDC Guide

Answer Box: Getting Juxtapid (lomitapide) Coded Correctly for Cigna Coverage in Michigan Juxtapid (lomitapide) requires precise coding to avoid Cigna denials in Michigan. Use ICD-10 code E78.010 (homozygous familial hypercholesterolemia) effective 2025, HCPCS code J8499 (oral non-chemotherapeutic drug, NOS), and verify NDC numbers for specific capsule strengths through the

Myths vs. Facts: Getting Firazyr (icatibant injection) Covered by Cigna in North Carolina

Answer Box: Getting Firazyr Covered by Cigna in North Carolina Cigna covers Firazyr (icatibant) for confirmed HAE Type I/II with prior authorization requiring specialist prescription, C1-INH/C4 lab documentation, and self-administration training proof. If denied, you have 180 days for internal appeals, then can use North Carolina's