Topic

Cigna

A collection of 1089 issues

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

How to Get Busulfex (Busulfan Injection) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Busulfex (busulfan injection) typically requires prior authorization from Cigna in Washington, billed under medical benefit with HCPCS J0594. Submit PA through Cigna provider portal or EviCore with complete conditioning regimen details, diagnosis codes, and medical necessity letter. If denied, file internal appeal within 180 days, then request external

How to Get Takhzyro (lanadelumab-flyo) Covered by Cigna in Ohio: Decision Tree, Forms, and Appeals

Answer Box: Qualifying for Takhzyro (lanadelumab-flyo) Coverage in Ohio Yes, you can get Takhzyro covered by Cigna in Ohio if you have confirmed hereditary angioedema (HAE) type I or II with documented attacks. Three-step path: (1) Confirm your HAE diagnosis with required lab tests (C4, C1-INH levels), (2) Have your

How to Get Joenja (leniolisib) Approved by Cigna in Florida: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Joenja (leniolisib) covered by Cigna in Florida requires genetic confirmation of APDS with pathogenic PIK3CD/PIK3R1 variants, specialist prescriber involvement, and documentation of failed standard therapies. Submit prior authorization via Cigna's portal or Florida PA form (fax 866-873-8279). Expect 72-hour standard review, 24-hour expedited. If

Get Ilaris (Canakinumab) Covered by Cigna in Virginia: Complete Prior Authorization & Appeals Guide

Answer Box: Getting Ilaris (Canakinumab) Covered by Cigna in Virginia Cigna covers Ilaris (canakinumab) for FDA-approved conditions like Still's disease and periodic fever syndromes under Policy IP0235, requiring prior authorization with specific criteria. To get approval in Virginia: 1. Gather documentation: CRP ≥10 mg/L (within 3 months)

How to Get Crysvita (burosumab) Covered by Cigna in Ohio: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Crysvita Covered by Cigna in Ohio Crysvita (burosumab) requires prior authorization from Cigna in Ohio, typically placed on Tier 4-5 specialty with 20-33% coinsurance. You'll need genetic confirmation (PHEX mutation or elevated FGF23), low baseline serum phosphorus, and specialist prescriber. Submit PA through Cigna'

How to Get Lamzede (Velmanase Alfa-Tycv) Approved by Cigna in California: Complete Prior Authorization Guide

Answer Box: Getting Lamzede Covered by Cigna in California Cigna requires prior authorization for Lamzede (velmanase alfa-tycv) in California. Submit via eviCore, CoverMyMeds, or Accredo's iAssist with confirmed alpha-mannosidosis diagnosis (enzyme/genetic testing), specialist letter, and clinical documentation. Standard review: 5 business days; expedited: 24 hours for urgent

Cigna's Coverage Criteria for Therakos CELLEX Photopheresis in Michigan: What Counts as "Medically Necessary"?

Answer Box: Getting Therakos CELLEX Covered by Cigna in Michigan Cigna requires prior authorization for Therakos CELLEX photopheresis system for CTCL and GVHD treatments. To qualify, you need documented steroid-refractory or progressive disease after standard therapies. Submit via CoverMyMeds ePA or Cigna's precertification portal with diagnosis, prior therapy

How to Get Opzelura (Ruxolitinib Cream) Covered by Cigna in New York: Appeals, Forms & State Protections

Quick Answer: Getting Opzelura Covered by Cigna in New York Eligibility: Opzelura (ruxolitinib cream) requires prior authorization from Cigna for atopic dermatitis and vitiligo. Fastest path: Have your dermatologist submit a PA request documenting failed topical steroids and calcineurin inhibitors. First step today: Call the number on your Cigna ID

Myths vs. Facts: Getting Oxlumo (lumasiran) Covered by Cigna in Virginia - Complete Appeals Guide

Answer Box: Getting Oxlumo (lumasiran) Covered by Cigna in Virginia Myth: If your doctor prescribes Oxlumo, Cigna automatically covers it. Fact: Cigna requires prior authorization with genetic confirmation of Primary Hyperoxaluria Type 1 (PH1), elevated urinary oxalate levels, and specialist prescriber documentation. In Virginia, if denied, you have 180 days