Topic

Cigna

A collection of 1278 issues

How to Get Uptravi (selexipag) Covered by Cigna in Texas: Prior Authorization, Appeals, and Cost Assistance

Quick Answer: Getting Uptravi (selexipag) Covered by Cigna in Texas Cigna requires prior authorization for Uptravi (selexipag) to treat WHO Group I pulmonary arterial hypertension (PAH). You'll need confirmed PAH diagnosis via right heart catheterization, functional class II-IV status, and documentation of prior therapy failures. Submit through your

How to Get Translarna (Ataluren) Covered by Cigna in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Translarna (Ataluren) Covered by Cigna in Texas Translarna (ataluren) requires prior authorization from Cigna/Express Scripts and is typically non-formulary, requiring a formulary exception for nonsense mutation Duchenne muscular dystrophy (DMD). The fastest path: 1) Confirm genetic testing shows nonsense mutation, 2) Have your neuromuscular specialist submit

How to Get Kymriah (tisagenlecleucel) Covered by Cigna in Virginia: Complete Prior Authorization Guide with Forms and Appeals

Answer Box: Getting Kymriah Covered by Cigna in Virginia Cigna requires prior authorization for Kymriah (tisagenlecleucel) via their Gene Therapy Program form. Submit through CoverMyMeds or call 855-678-0051. Standard review takes 15-30 business days; expedited takes 72 hours. If denied, Virginia offers internal appeals (180 days) then external review through

Renewing Rinvoq (Upadacitinib) Approval with Cigna in Ohio: Complete Timeline and Documentation Guide

Answer Box: Renewing Rinvoq Coverage with Cigna in Ohio Rinvoq (upadacitinib) requires prior authorization renewal every 90-180 days with Cigna through Express Scripts. Submit renewal requests 2-4 weeks before expiration with documented clinical response, current labs (CBC, liver enzymes, lipids), and prescriber attestation of ongoing medical necessity. If denied, Ohio

The Complete Checklist to Get Crysvita (Burosumab) Covered by Cigna in California: Forms, Appeals, and Requirements

Answer Box: Fastest Path to Approval Getting Crysvita (burosumab) covered by Cigna in California requires prior authorization through Express Scripts/Accredo with specific documentation: confirmed XLH diagnosis (PHEX gene mutation or elevated FGF23), baseline low serum phosphorus, endocrinologist prescription, and failed oral phosphate therapy. First step today: Have your specialist

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

Answer Box: Getting Givlaari Covered by Cigna in North Carolina To get Givlaari (givosiran) approved by Cigna in North Carolina, you need: (1) Confirmed acute hepatic porphyria with elevated ALA/PBG levels or genetic testing, (2) Documentation of ≥2 attacks in 6 months requiring hospitalization/hemin, and (3) Prescription by

How to Get Evrysdi (Risdiplam) Covered by Cigna in California: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Evrysdi Covered by Cigna in California Yes, Cigna covers Evrysdi (risdiplam) with prior authorization. You need genetic confirmation of SMA (SMN1 mutations), baseline motor assessment scores, and prescription by a neuromuscular specialist. Fastest path: Have your neurologist submit the completed Cigna Evrysdi PA form with genetic test

Myths vs. Facts: Getting Hemgenix (Etranacogene Dezaparvovec) Covered by Cigna in New York

Answer Box: Getting Hemgenix Covered by Cigna in New York Eligibility: Male patients ≥18 with severe hemophilia B (Factor IX ≤2%), ≥150 exposure days, negative AAV5 antibodies, and normal liver function qualify for Cigna coverage under policy IP_0535. Fastest path: Submit prior authorization with complete lab documentation (Factor IX

How to Get Hemlibra (emicizumab-kxwh) Covered by Cigna in Ohio: Prior Authorization Forms, Appeal Scripts & Alternatives

Answer Box: Getting Hemlibra Covered by Cigna in Ohio Cigna requires prior authorization for Hemlibra (emicizumab-kxwh) in Ohio. To get approved: 1) Submit Cigna's Hemlibra PA form with inhibitor testing results and weight-based dosing plan, 2) Document failure/intolerance of FVIII concentrates or bypassing agents, 3) Include prescriber

Work With Your Doctor to Get Takhzyro (lanadelumab-flyo) Covered by Cigna in Georgia: Complete Prior Authorization and Appeal Guide

Answer Box: Getting Takhzyro (lanadelumab-flyo) Covered by Cigna in Georgia Cigna requires prior authorization for Takhzyro (lanadelumab-flyo) with documented HAE types I/II, specialist involvement, and attack history. Work with an allergist or immunologist to submit PA documentation including C1-INH labs (<50% functional), C4 levels, and attack logs. If