Topic

Cigna

A collection of 1119 issues

How to Get Krystexxa (Pegloticase) Covered by Cigna in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Krystexxa Covered by Cigna in New York Fastest path to approval: Document failed trials of allopurinol AND febuxostat (3+ months each at max doses), get G6PD testing, and have your rheumatologist submit Cigna's Krystexxa PA form with detailed medical necessity letter. If denied, file internal

How to Get Opdivo (Nivolumab) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Opdivo Covered by Cigna in Washington Cigna requires prior authorization for Opdivo (nivolumab) with specific medical necessity criteria. Your fastest path: Have your oncologist submit a complete PA request through CoverMyMeds or Cigna's provider portal including diagnosis, staging, biomarker results, and prior treatment history. If

Getting Alprolix Covered by Cigna in New Jersey: Complete Guide with Forms, Appeals, and Success Strategies

Quick Answer: Alprolix requires prior authorization from Cigna in New Jersey. Your hematologist submits the PA through Cigna's provider portal or Express Scripts, typically taking 3-5 business days. If denied, you have 180 days for internal appeals, then can file an external review through New Jersey's

Myths vs. Facts: Getting Cabometyx (Cabozantinib) Covered by Cigna in Pennsylvania

Answer Box: To get Cabometyx covered by Cigna in Pennsylvania, you need prior authorization based on specific FDA-approved cancer indications (RCC, HCC, or DTC). Submit documentation showing diagnosis, prior therapy failures, and imaging evidence through your oncologist. If denied, Pennsylvania's new external review program has overturned ~50% of

The Complete Checklist to Get Eylea or Lucentis Covered by Cigna in New York: Forms, Appeals, and Timeline Guide

Answer Box: Your Path to Coverage Eligibility: Cigna typically covers Eylea and Lucentis for wet AMD, diabetic macular edema, and retinal vein occlusion with prior authorization. Most plans require step therapy with bevacizumab first unless contraindicated. Fastest approval path: Have your retina specialist submit electronic prior authorization through Cigna'

How to Get Krystexxa (pegloticase) Covered by Cigna in New Jersey: Complete Authorization Guide

Answer Box: Getting Krystexxa (pegloticase) Covered by Cigna in New Jersey Eligibility: Adults with chronic refractory gout who've failed allopurinol and febuxostat at maximum tolerated doses, with documented G6PD testing and serum uric acid ≥6 mg/dL despite treatment. Fastest path: Submit Cigna's prior authorization form

Getting Raxone (Idebenone) Covered by Cigna in Texas: Prior Authorization, Appeals, and Formulary Exception Guide

Answer Box: How to Get Raxone (Idebenone) Covered by Cigna in Texas Raxone (idebenone) requires a formulary exception from Cigna in Texas since it's not FDA-approved for LHON. Your prescriber must submit the Texas Standard Prior Authorization Request Form with genetic testing confirming LHON, visual field studies, and

How to Get Ofev (nintedanib) Covered by Cigna in Texas: Prior Authorization Guide and Appeal Strategies

Answer Box: Getting Ofev (nintedanib) Covered by Cigna in Texas Quick Path to Approval: Cigna requires prior authorization for Ofev (nintedanib) with specific diagnostic and clinical criteria. Your pulmonologist must submit documentation showing confirmed IPF or progressive fibrosing ILD via high-resolution CT, pulmonary function tests meeting minimum thresholds (typically FVC

Myths vs. Facts: Getting Ilaris (Canakinumab) Covered by Cigna in Pennsylvania

Quick Answer: Cigna requires prior authorization for Ilaris (canakinumab) in Pennsylvania with specific criteria including specialist prescription, elevated CRP levels, and documented failure of standard therapies. If denied, you have 180 days for internal appeals, then 4 months for Pennsylvania's external review program, which overturns 50% of denials.

How to Get Fintepla (Fenfluramine) Covered by Cigna in Florida: Prior Authorization, Appeals & Exception Strategies

Answer Box: Getting Fintepla (Fenfluramine) Covered by Cigna in Florida Fastest path: Submit a complete prior authorization through your neurologist with diagnosis documentation (Dravet syndrome or Lennox-Gastaut syndrome), failed alternative ASM trials, and REMS enrollment proof. Most Cigna Florida plans require PA and may need formulary exceptions for this specialty