Topic

Cigna

A collection of 1125 issues

Getting Lutathera Covered by Cigna in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Quick Path to Approval Lutathera (lutetium Lu-177 dotatate) requires prior authorization from Cigna in New York. Your oncologist must document SSTR-positive imaging, well-differentiated neuroendocrine tumor pathology, and progression on somatostatin analog therapy. Standard approval takes 72 hours; expedited review takes 24 hours for urgent cases. If denied, you

How to Get Hetlioz (Tasimelteon) Covered by Cigna in Michigan: Complete PA Guide and Appeals Process

Quick Answer: Getting Hetlioz Covered by Cigna in Michigan Hetlioz (tasimelteon) requires prior authorization from Cigna for both Non-24-Hour Sleep-Wake Disorder and Smith-Magenis Syndrome. Your physician must document failed step therapy with preferred sleep medications (typically ramelteon and melatonin), submit weight-based dosing calculations, and include genetic testing for SMS patients.

Getting Busulfex (Busulfan Injection) Covered by Cigna in Pennsylvania: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Busulfex Covered by Cigna in Pennsylvania Busulfex (busulfan injection) requires prior authorization through Cigna's specialty pharmacy network (Accredo/Express Scripts). First step: Verify your plan covers specialty injectables under medical benefit. Fastest path: Have your transplant center submit PA electronically via CoverMyMeds or EviCore, including

Getting Sylvant (Siltuximab) Covered by Cigna in Ohio: Medical Necessity Criteria and Appeals Guide

Answer Box: Getting Sylvant (Siltuximab) Covered by Cigna in Ohio Eligibility: Cigna covers Sylvant for HIV-negative, HHV-8-negative idiopathic multicentric Castleman disease (iMCD) with prior authorization. Fastest approval path: Submit complete PA with documented negative HIV/HHV-8 testing, lymph node biopsy confirming iMCD pathology, and weight-based dosing plan. First step today:

The Requirements Checklist to Get Jaypirca (Pirtobrutinib) Covered by Cigna in Texas: Complete Prior Authorization Guide

Answer Box: Getting Jaypirca (Pirtobrutinib) Covered by Cigna in Texas Eligibility: Adults 18+ with relapsed/refractory mantle cell lymphoma (after BTK inhibitor) or CLL/SLL (after BTK inhibitor + BCL-2 inhibitor). Fastest path: Submit prior authorization through CoverMyMeds or call Cigna at 1-800-882-4462 with complete treatment history. First step today: Gather

If Juxtapid (lomitapide) Isn't Approved by Cigna in Texas: Formulary Alternatives & Exception Paths

Quick Answer: Your Options When Cigna Denies Juxtapid (lomitapide) in Texas If Cigna denies Juxtapid (lomitapide) for homozygous familial hypercholesterolemia (HoFH), you have three main paths: try formulary alternatives first (like PCSK9 inhibitors), request a formulary exception with strong medical necessity documentation, or appeal the denial through Texas's

How to Get Rezlidhia (olutasidenib) Covered by Cigna in Texas: Appeals Guide with State Protections

Answer Box: Getting Rezlidhia (olutasidenib) Covered by Cigna in Texas Eligibility: Adults with relapsed/refractory AML and confirmed IDH1 mutation via FDA-approved diagnostic test, prescribed by a board-certified oncologist. Fastest Path: Your oncologist submits complete prior authorization to Cigna with IDH1 mutation results (FDA-approved test), medical necessity letter citing NCCN

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

Answer Box: Getting Bavencio Covered by Cigna in Washington Bavencio requires prior authorization from Cigna. The fastest path: 1) Have your oncologist submit the Cigna prior authorization form with complete platinum chemotherapy history and imaging within 8 weeks, 2) If denied, file internal appeal within 180 days emphasizing medical necessity,

Getting Helixate Factor VIII Covered by Cigna in New Jersey: Prior Authorization, Appeals, and Cost Assistance Guide

Quick Answer: Getting Helixate Covered by Cigna in New Jersey Helixate requires prior authorization and is typically non-formulary on Cigna plans. Your hematologist must submit comprehensive documentation including hemophilia A diagnosis (ICD-10: D66), recent Factor VIII levels, inhibitor status, and clinical justification. Standard review takes 72 hours; expedited review takes

How to Get Amvuttra (vutrisiran) Covered by Cigna in North Carolina: Appeals Guide & Formulary Alternatives

Answer Box: Getting Amvuttra (vutrisiran) Covered by Cigna in North Carolina Cigna covers Amvuttra with prior authorization for adults with confirmed TTR amyloidosis. Your fastest path: Have your cardiologist or amyloidosis specialist submit a prior authorization request with tissue biopsy confirmation, cardiac imaging, and NYHA class documentation. If denied, you