Topic

Cigna

A collection of 1057 issues

How to Get Ozempic and Mounjaro Covered by Cigna in North Carolina: Complete Prior Authorization Timeline and Appeal Guide

Answer Box: Getting Ozempic/Mounjaro Covered by Cigna in North Carolina Cigna typically decides prior authorization requests for Ozempic (semaglutide) and Mounjaro (tirzepatide) within 72 hours for standard reviews or 24 hours for urgent cases. For Type 2 diabetes patients in North Carolina, the fastest path to approval requires: (1)

How to Get Amondys 45 (Casimersen) Covered by Cigna in Ohio: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Amondys 45 Covered by Cigna in Ohio Cigna requires prior authorization for Amondys 45 (casimersen) with strict eligibility criteria: genetic confirmation of exon 45-amenable DMD mutation, age under 14 at start, 6-minute walk test ≥300 meters, and specialist prescription. Submit through CoverMyMeds or Cigna provider portal with

Work With Your Doctor to Get Cystadane (Betaine Anhydrous) Approved by Cigna in California: Complete Provider Collaboration Guide

Quick Answer: Getting Cystadane (Betaine Anhydrous) Covered by Cigna in California Cystadane (betaine anhydrous) requires Cigna prior authorization with genetic confirmation, elevated homocysteine levels, and vitamin co-therapy documentation. Your physician must submit medical necessity evidence through Cigna's provider portal within 72 hours (24 hours expedited). If denied, California&

The Requirements Checklist to Get Brensocatib (BRINSUPRI) Covered by Cigna in Michigan

Answer Box: Getting Started in Michigan Cigna requires prior authorization for Brensocatib (BRINSUPRI) with step therapy through macrolide antibiotics. Your pulmonologist submits via CoverMyMeds or fax (866-873-8279) with CT scan confirming bronchiectasis, documented exacerbations (≥2/year for adults), and failed macrolide trials. Standard approval takes 5-10 business days. If denied,

Myths vs. Facts: Getting Poteligeo (mogamulizumab-kpkc) Covered by Cigna in New Jersey

Answer Box: Getting Poteligeo (mogamulizumab-kpkc) Covered by Cigna in New Jersey Cigna requires prior authorization for Poteligeo (mogamulizumab-kpkc) for relapsed/refractory mycosis fungoides or Sézary syndrome after ≥1 prior systemic therapy failure. Submit through Express Scripts/Accredo with complete TNMB staging, prior therapy documentation, and specialist oversight. If denied, file

How to Get Eylea or Lucentis Covered by Cigna in Illinois: Appeals Guide with Forms and Timelines

Quick Answer: Getting Eylea or Lucentis Approved by Cigna in Illinois Cigna requires prior authorization for Eylea (aflibercept) and Lucentis (ranibizumab) with step therapy requiring bevacizumab trial first. Submit PA requests through CoverMyMeds or call 1-800-882-4462. If denied, you have 180 days to appeal internally, then 4 months for Illinois

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

Quick Answer: Getting Xospata (Gilteritinib) Covered by Cigna in North Carolina Xospata requires prior authorization from Cigna for relapsed/refractory AML with confirmed FLT3 mutation. Your fastest path: 1) Verify FLT3 test results (ITD or TKD via FDA-approved assay), 2) Have your hematologist/oncologist submit PA via Cigna portal with

How to Get Firdapse (amifampridine) Covered by Cigna in Pennsylvania: Complete Guide to Prior Authorization and Appeals

Quick Answer: Getting Firdapse Covered by Cigna in Pennsylvania Yes, Cigna covers Firdapse (amifampridine) with prior authorization for confirmed Lambert-Eaton Myasthenic Syndrome (LEMS) in patients ≥6 years old. Your neurologist must submit a PA request through CoverMyMeds or Cigna's provider portal with EMG results showing ≥60% CMAP increment

Work With Your Doctor to Get Trikafta Approved by Cigna in New York: Complete PA Guide and Appeal Process

Answer Box: Getting Trikafta Approved by Cigna in New York Cigna requires prior authorization for Trikafta (elexacaftor/tezacaftor/ivacaftor) in New York. Your CF specialist must submit genetic testing showing F508del or responsive CFTR mutation, diagnosis confirmation (ICD-10 E84.0), and medical necessity documentation. Submit electronically via CoverMyMeds for fastest

How to Get Cometriq (cabozantinib) Covered by Cigna in Michigan: Complete PA and Appeals Guide

Answer Box: Getting Cometriq (cabozantinib) Covered by Cigna in Michigan Cometriq requires prior authorization through Cigna and must be dispensed through Accredo specialty pharmacy. Your oncologist submits clinical documentation proving medullary thyroid carcinoma (MTC) diagnosis with standard review completed within 72 hours. If denied, you have 180 days for internal