Topic

Cigna

A collection of 1125 issues

How to Get Strensiq (Asfotase Alfa) Covered by Cigna in Florida: Prior Authorization Guide and Appeals Strategy

Answer Box: Getting Strensiq Covered by Cigna in Florida Strensiq (asfotase alfa) requires prior authorization from Cigna for hypophosphatasia (HPP) treatment. No step therapy is required since no alternatives exist. Key requirements: genetic testing showing ALPL mutation, low serum alkaline phosphatase, and pediatric-onset HPP documentation. First step: Have your specialist

How to Get Strimvelis Gene Therapy Covered by Cigna in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Strimvelis Covered by Cigna in New York Strimvelis requires prior authorization from Cigna as a non-formulary, investigational gene therapy available only at SR-TIGET in Milan, Italy. The fastest path to approval involves: (1) confirming your plan covers international/out-of-network care, (2) submitting Cigna's Commercial Drug

How to Get Qinlock (ripretinib) Covered by Cigna in Pennsylvania: Prior Authorization Guide and Appeal Process

Quick Answer: Getting Qinlock Covered by Cigna in Pennsylvania Qinlock (ripretinib) requires prior authorization from Cigna and must follow strict step therapy rules. Your oncologist needs to document failure of three prior treatments: imatinib, sunitinib, and regorafenib. Submit complete PA documentation through Express Scripts/Accredo specialty pharmacy. If denied, Pennsylvania&

How to Get Prolastin-C Covered by Cigna in New Jersey: Appeals, Forms & Alternative Options

Quick Answer: Getting Prolastin-C Covered by Cigna in New Jersey Eligibility: Adults with severe alpha-1 antitrypsin deficiency (serum level <11 mcM/<80 mg/dL) and emphysema. Fastest path: Submit prior authorization with pulmonologist's medical necessity letter including genotype, lung function tests, and smoking cessation documentation. First

How to Get Helixate (Factor VIII) Covered by Cigna in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Helixate Covered by Cigna in Texas Helixate (recombinant Factor VIII) requires prior authorization from Cigna and is typically non-formulary, requiring specialty pharmacy dispensing through Accredo. Your fastest path to approval: 1) Have your hematologist submit a comprehensive PA request with hemophilia A diagnosis, Factor VIII levels, and

How to Get Crysvita (burosumab) Covered by Cigna in Georgia: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Crysvita (burosumab) Covered by Cigna in Georgia Eligibility: Crysvita requires prior authorization from Cigna for X-linked hypophosphatemia (XLH) or tumor-induced osteomalacia (TIO). Fastest path: Submit complete documentation including genetic testing (PHEX mutation), low serum phosphorus labs, and specialist attestation through Cigna's provider portal or Accredo

Do You Qualify for Vimizim (Elosulfase Alfa) Coverage by Cigna in Pennsylvania? Decision Tree & Next Steps

Answer Box: Quick Qualification Check To get Vimizim (elosulfase alfa) covered by Cigna in Pennsylvania, you need: (1) confirmed MPS IVA diagnosis with reduced GALNS enzyme activity and genetic testing, (2) baseline functional measures like 6-minute walk test, and (3) specialist prescriber (geneticist/metabolic specialist). Submit prior authorization through Cigna

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

Answer Box: Getting Naglazyme (Galsulfase) Covered by Cigna in Texas Fast Path: Naglazyme requires prior authorization from Cigna. Submit via CoverMyMeds portal or Cigna provider portal with confirmed MPS VI diagnosis, enzyme/genetic testing, and medical necessity letter. If denied, file internal appeal within 180 days, then Texas Independent Review

How Long Does It Take to Get Advate (Octocog Alfa) Approved by Cigna in Michigan? Complete Timeline Guide

Answer Box: Getting Advate (Octocog Alfa) Approved by Cigna in Michigan Cigna requires prior authorization for Advate (octocog alfa) in Michigan, with decisions mandated within 72 hours for standard requests and 24 hours for urgent cases. The fastest path to approval involves submitting complete documentation through Accredo Specialty Pharmacy or

How to Get Jakafi (Ruxolitinib) Covered by Cigna in North Carolina: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Jakafi (Ruxolitinib) Covered by Cigna in North Carolina Cigna requires prior authorization for Jakafi (ruxolitinib) with strict documentation requirements. For polycythemia vera, you must prove hydroxyurea failure or intolerance. If denied, you have 180 days for internal appeals, then 120 days for external review through North Carolina&