Topic

Cigna

A collection of 1125 issues

How to Get Elaprase (idursulfase) Covered by Cigna in Ohio: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Elaprase Covered by Cigna in Ohio Cigna requires prior authorization for Elaprase (idursulfase) with no step therapy alternatives. To get approved in Ohio: 1) Submit PA with enzymatic and genetic test results confirming Hunter syndrome (MPS II), 2) Include specialist prescription with weight-based dosing (0.5 mg/

Myths vs. Facts: Getting Imbruvica (ibrutinib) Covered by Cigna in Texas

Answer Box: Cigna Imbruvica Coverage in Texas Cigna requires prior authorization for Imbruvica (ibrutinib) with mandatory step therapy—you must try acalabrutinib or zanubrutinib first unless contraindicated. Submit PA through Express Scripts/Accredo with complete diagnosis documentation and prior BTK inhibitor trial records. If denied, file internal appeal within 180

Getting Tagrisso (Osimertinib) Covered by Cigna in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Quick Path to Approval Cigna requires prior authorization for Tagrisso (osimertinib) with documented EGFR mutation testing and oncologist prescribing. Fastest approval path: Submit PA through Express Scripts/Accredo with EGFR mutation results, pathology report, and medical necessity letter. If denied, file internal appeal within 180 days, then request

Do You Qualify for Nourianz Coverage by Cigna in Florida? Complete Decision Tree & Appeal Guide

Answer Box: To get Nourianz (istradefylline) covered by Cigna in Florida, you need: (1) Parkinson's disease diagnosis with documented "OFF" episodes, (2) current levodopa/carbidopa therapy, and (3) failed trials of at least two step therapy drugs (amantadine, MAO-B inhibitors, or COMT inhibitors). Your neurologist submits

Getting Lamzede (Velmanase Alfa-tycv) Covered by Cigna in Texas: Prior Authorization, Appeals, and Alternative Options

Answer Box: Getting Lamzede Covered by Cigna in Texas Lamzede requires prior authorization from Cigna. Your fastest path: Have your specialist submit a PA request with confirmed alpha-mannosidosis diagnosis (enzyme deficiency + MAN2B1 gene variants), failed alternative treatments, and medical necessity documentation. If denied, you have 180 days to appeal internally,

How to Get Orladeyo (berotralstat) Covered by Cigna in New Jersey: Complete Appeals Guide

Answer Box: Getting Orladeyo (berotralstat) Covered by Cigna in New Jersey Fastest path to approval: Submit prior authorization through Cigna's Express Scripts portal with HAE diagnosis confirmation (C1-INH deficiency labs), specialist prescription, and attack frequency documentation. If denied, file internal appeal within 180 days, request peer-to-peer review, then

How to Get Emgality (galcanezumab-gnlm) Covered by Cigna in Georgia: Complete Timeline, Forms & Appeal Guide

Answer Box: Getting Emgality Covered by Cigna in Georgia Timeline: 7-30 days for initial approval; up to 120 days if appeals are needed. Requirements: Document failure of topiramate and a beta blocker, plus ≥4 migraine days/month. First step: Have your doctor submit prior authorization through Cigna's provider

Lowering Out-of-Pocket for Xembify with Cigna in Ohio: Copay, Tiering & Assistance Programs

Answer Box: Getting Xembify Covered by Cigna in Ohio Xembify (immune globulin, SC) requires prior authorization from Cigna and is typically placed on a specialty tier with high copays. To minimize costs: (1) Apply for the Xembify Connexions copay card (up to $10,000 annually for commercial insurance), (2) coordinate

How to Get Turalio (Pexidartinib) Covered by Cigna in Washington: Complete Timeline and Appeals Guide

Answer Box: Getting Turalio Approved by Cigna in Washington Cigna requires prior authorization (PA) for Turalio (pexidartinib) to treat TGCT in Washington, with both prescriber and patient enrolled in the FDA-mandated REMS program before dispensing. Standard PA approval takes 3-14 days; expedited review within 24 hours for urgent cases. Fastest

How to Get Eloctate Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Eloctate Covered by Cigna in Washington Eloctate requires prior authorization from Cigna, typically with step therapy requirements favoring preferred Factor VIII products. To get coverage in Washington: 1. Submit PA through Accredo Specialty Pharmacy with hematologist prescription and complete clinical documentation 2. Document step therapy failures if