Topic

Cigna

A collection of 1094 issues

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

How to Get Humate-P Covered by Cigna in New York: Prior Authorization Forms, Appeal Scripts, and Timeline Guide

Answer Box: Getting Humate-P Covered by Cigna in New York Humate-P requires prior authorization from Cigna in New York. The fastest path: (1) Have your hematologist complete Cigna's Clotting Factors CCRD Prior Authorization Form electronically via CoverMyMeds, (2) document VWD subtype or hemophilia A diagnosis with recent labs

How to Get Zolgensma (Onasemnogene Abeparvovec) Covered by Cigna in Georgia: Complete Prior Authorization and Appeals Guide

Answer Box: Fast Track to Zolgensma Coverage Getting Zolgensma (onasemnogene abeparvovec) covered by Cigna in Georgia requires meeting strict prior authorization criteria, but appeals often succeed with proper documentation. Your fastest path: 1) Gather genetic testing confirming bi-allelic SMN1 mutations, anti-AAV9 antibody titer ≤1:50, and recent labs, 2) Submit

How to Get Stelara (ustekinumab) Covered by Cigna in Virginia: Complete Prior Authorization and Appeals Guide

Quick Answer: To get Stelara (ustekinumab) covered by Cigna in Virginia, you'll need prior authorization showing failure of 2+ conventional therapies and specialist involvement. If denied, you have 180 days for internal appeals, then 120 days for Virginia's free external review through the State Corporation Commission.

Get Oxervate (cenegermin) Covered by Cigna in Florida: Complete Prior Authorization & Appeals Guide

Quick Answer: To get Oxervate (cenegermin) covered by Cigna in Florida, you'll need prior authorization through Express Scripts with documentation of stage 2 or 3 neurotrophic keratitis, failed conservative treatments (≥14 days artificial tears), and a medical necessity letter from your ophthalmologist. Submit via CoverMyMeds or Express Scripts

How to Get Mavenclad (Cladribine Tablets) Covered by Cigna in Florida: Complete PA and Appeals Guide

Answer Box: Getting Mavenclad Covered by Cigna in Florida Cigna requires prior authorization for Mavenclad (cladribine tablets) in Florida with strict step therapy requirements. You need documented failure/intolerance to either two MS disease-modifying therapies OR one high-efficacy agent (Ocrevus, Tysabri, Kesimpta, Lemtrada, or Briumvi). Your neurologist submits the PA