Topic

Cigna

A collection of 1113 issues

How to Get Vimizim (Elosulfase Alfa) Covered by Cigna in California: Complete Prior Authorization and Appeal Guide

Answer Box: Getting Vimizim Covered by Cigna in California Cigna requires prior authorization for Vimizim (elosulfase alfa) for MPS IVA patients in California. Success requires: (1) confirmed MPS IVA diagnosis via GALNS enzyme testing or genetic confirmation, (2) prescribing by a pediatric metabolic geneticist or specialist experienced in lysosomal storage

How to Get Qinlock (ripretinib) Covered by Cigna in Virginia: Prior Authorization, Appeals, and External Review Guide

Answer Box: Getting Qinlock (ripretinib) Covered by Cigna in Virginia Cigna requires prior authorization for Qinlock (ripretinib) as fourth-line GIST therapy after documented failure of imatinib, sunitinib, and regorafenib. Your fastest path to approval: 1) Have your oncologist submit complete PA documentation including pathology, treatment history, and progression evidence through

How Long Does It Take to Get Palynziq (pegvaliase-pqpz) Approved by Cigna in Illinois? Complete Timeline & Appeal Process

Answer Box: Getting Palynziq Approved by Cigna in Illinois Under Illinois' Prior Authorization Reform Act (effective January 2025), Cigna must approve or deny Palynziq within 24 hours for prescription medications. The fastest path requires: (1) Complete REMS enrollment at PALYNZIQREMS.com, (2) Submit full clinical documentation showing PKU diagnosis

Getting Brineura (Cerliponase Alfa) Covered by Cigna in Texas: Complete Guide to Forms, Appeals, and Approval

Answer Box: Your Path to Brineura Coverage in Texas Getting Brineura (cerliponase alfa) covered by Cigna in Texas requires prior authorization with strict medical necessity criteria. The fastest path: Have your child's specialist submit the Cigna Brineura PA form via CoverMyMeds or fax, including genetic testing confirming CLN2

How to Get Kesimpta (Ofatumumab) Covered by Cigna in North Carolina: Complete PA Guide with Appeals Process

Answer Box: Getting Kesimpta Covered by Cigna in North Carolina Fastest path to approval: Verify Kesimpta requires prior authorization through your Cigna plan, have your neurologist submit the Multiple Sclerosis CCRD Prior Authorization Form via CoverMyMeds or Surescripts ePA, and designate Accredo Specialty Pharmacy for dispensing. If denied, file internal

How to Get Arikayce (Amikacin Liposome Inhalation) Covered by Cigna in Washington: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting Arikayce Covered by Cigna in Washington Cigna requires prior authorization for Arikayce (amikacin liposome inhalation) with strict criteria: adult MAC lung disease, documented failure after ≥6 months of guideline-based multidrug therapy, and prescription by a pulmonologist or infectious disease specialist. If denied, you have 180 days to

How to Get Tepezza (Teprotumumab) Covered by Cigna in Georgia: Complete Prior Authorization Guide

Answer Box: Getting Tepezza Covered by Cigna in Georgia Cigna requires prior authorization for Tepezza (teprotumumab) in Georgia, with approval based on moderate-to-severe thyroid eye disease (TED) criteria. Standard review takes 5 business days; urgent cases can be expedited within 24-72 hours. If denied, you have 180 days to appeal

How to Get Darzalex / Darzalex Faspro (daratumumab) Covered by Cigna in Virginia: Prior Authorization, Appeals, and Cost Support

Answer Box: Getting Darzalex / Darzalex Faspro Covered by Cigna in Virginia Cigna requires prior authorization for Darzalex / Darzalex Faspro (daratumumab) in Virginia. Your oncologist must submit clinical documentation showing FDA-approved indication, prior therapy history, and compliance with Cigna's multiple myeloma criteria. If denied, you have internal appeal rights

If Pombiliti Isn't Approved by Cigna in California: Formulary Alternatives & Exception Paths

Quick Answer: Your Options When Cigna Denies Pombiliti If Cigna denies Pombiliti (cipaglucosidase alfa-atga) in California, Lumizyme or Nexviazyme are typically covered as first-line enzyme replacement therapies for late-onset Pompe disease. Most patients must try one of these alternatives before Cigna will consider Pombiliti approval. First step: Have your neurologist

How to Get Xyrem (Sodium Oxybate) Covered by Cigna in Illinois: Prior Authorization Guide and Appeals Process

Answer Box: Getting Xyrem Covered by Cigna in Illinois Fastest path to approval: Cigna requires prior authorization for Xyrem (sodium oxybate) with documented narcolepsy diagnosis, sleep study results, and failed trials of first-line treatments. Submit the Cigna Xyrem PA form with complete clinical documentation. If denied, you have 180 days