Topic

Cigna

A collection of 1058 issues

How to Get Dupixent (dupilumab) Covered by Cigna in Virginia: Complete Decision Tree & Appeal Guide

Answer Box: Getting Dupixent Covered by Cigna in Virginia Fastest path: Check if you meet Cigna's prior authorization criteria for your specific condition (atopic dermatitis, asthma, COPD, or eosinophilic esophagitis), gather required documentation of failed prior therapies, and have your specialist submit a complete PA request. If denied,

How to Get Filsuvez Covered by Cigna in North Carolina: Prior Authorization Forms, Appeal Scripts & External Review Guide

Answer Box: Fast-Track to Filsuvez Coverage Cigna requires prior authorization for Filsuvez (birch triterpenes topical gel) via Express Scripts/Accredo for epidermolysis bullosa patients ≥6 months with confirmed dystrophic or junctional subtypes. Submit through Cigna provider portal or CoverMyMeds with genetic testing, wound photos (10-50 cm², 21 days-9 months old)

How to Get Abecma (CAR-T Therapy) Covered by Cigna in Washington: Complete Appeals Guide with State Protections

Answer Box: Getting Abecma Covered by Cigna in Washington Abecma (idecabtagene vicleucel) requires prior authorization from Cigna for multiple myeloma patients who've had ≥4 prior therapies. Washington residents have strong appeal rights including binding external review after internal denials. Start today by: 1) Having your oncologist submit PA

How to Get Dupixent (Dupilumab) Covered by Cigna in Pennsylvania: Complete Guide with Forms, Appeals, and Coding

Answer Box: Getting Dupixent Covered by Cigna in Pennsylvania Cigna requires prior authorization for Dupixent (dupilumab) with specific clinical criteria including diagnosis documentation, prior treatment failures, and prescriber specialty. If denied, Pennsylvania's new Independent External Review program has overturned about 50% of appealed denials. First step: Gather your

How to Get Breyanzi (Lisocabtagene Maraleucel) Approved by Cigna in Ohio: Complete Prior Authorization Guide

Answer Box: Getting Breyanzi Approved by Cigna in Ohio Breyanzi (lisocabtagene maraleucel) requires prior authorization from Cigna for both LBCL and CLL/SLL patients in Ohio. Submit electronically via CoverMyMeds or EviCore by Evernorth with complete treatment history, diagnosis documentation, and proof of prior BTK/BCL2 inhibitor failure for CLL

How to Get Ultomiris (ravulizumab) Covered by Cigna in Washington: Forms, Appeals, and Patient Rights

Answer Box: Quick Path to Ultomiris Coverage To get Ultomiris (ravulizumab) covered by Cigna in Washington: Your doctor submits a prior authorization using Cigna's Ultomiris PA form via CoverMyMeds portal or fax (855) 840-1678. Include diagnosis-specific documentation (anti-AChR antibodies for gMG, anti-AQP4 for NMOSD), prior therapy failures, and

How to Get Gilenya (fingolimod) Covered by Cigna in Illinois: Forms, Appeals, and Alternative Paths

Answer Box: Getting Gilenya (fingolimod) Covered by Cigna in Illinois Cigna requires prior authorization for Gilenya (fingolimod) in Illinois and typically expects patients to try preferred MS drugs first. Your neurologist must submit a PA request with clinical justification, baseline testing results (EKG, eye exam, labs), and documentation of why

How to Renew Your Gilenya (Fingolimod) Approval with Cigna in New York: Complete Timeline and Checklist

Answer Box: Quick Start for New York Residents Your Gilenya (fingolimod) prior authorization with Cigna typically expires after 12 months and requires renewal with updated clinical documentation. Start the renewal process 60 days before expiration to avoid coverage gaps. First step: Check your PA expiration date in the Cigna member

How to Get Photrexa (Riboflavin) Covered by Cigna in North Carolina: Complete PA Guide and Appeals Timeline

Answer Box: Fastest Path to Approval Cigna covers FDA-approved epi-off corneal cross-linking with Photrexa riboflavin for progressive keratoconus when prior authorization criteria are met. Your ophthalmologist must document progression (≥1.0 D Kmax increase over 12-24 months) and corneal thickness ≥400 µm. Submit PA through Cigna provider portal with serial

How to Get Amondys 45 (casimersen) Covered by Cigna in California: Complete Prior Authorization, Appeals, and Forms Guide

Answer Box: Getting Amondys 45 Covered by Cigna in California Cigna covers Amondys 45 (casimersen) for Duchenne muscular dystrophy patients under 14 years old with confirmed exon 45-amenable gene mutations, but requires prior authorization via Coverage Policy IP0137. Fastest path: Have your neuromuscular specialist submit genetic test results showing "