Topic

Cigna

A collection of 1058 issues

How to Get Enhertu (fam-trastuzumab deruxtecan-nxki) Covered by Cigna in Washington: Appeals Guide with State Protections

Answer Box: Getting Enhertu Covered by Cigna in Washington Eligibility: Enhertu (fam-trastuzumab deruxtecan-nxki) requires prior authorization through Cigna's Express Scripts/Accredo for HER2-positive cancers. Fastest path: Submit PA with HER2+ test results, prior therapy failures, and oncologist's medical necessity letter. First step today: Call Cigna (number
5 min read

How to Get Onivyde (Irinotecan Liposome) Covered by Cigna in Ohio: Forms, Appeals, and Approval Timeline

Answer Box: Quick Path to Onivyde Coverage Cigna requires prior authorization for Onivyde (irinotecan liposome) in Ohio. Most approvals need: metastatic pancreatic cancer diagnosis, prior gemcitabine or fluoropyrimidine failure, ECOG 0-2 performance status, and adequate organ function. Submit the Cigna Onivyde PA form via fax (855-840-1678) or CoverMyMeds. Standard review
5 min read

Renewing Raxone (Idebenone) Approval with Cigna in Virginia: Timeline, Documentation, and Coverage Lapse Solutions

Answer Box: Renewing Your Raxone (Idebenone) Approval Cigna requires annual prior authorization renewals for Raxone (idebenone) through Express Scripts/Accredo, typically 30-60 days before current approval expires. Submit renewal via CoverMyMeds, Evicore ePA, or MyAccredoPatients with updated clinical documentation proving ongoing LHON progression, visual response monitoring, and adherence. If coverage
5 min read

Do You Qualify for Strensiq (asfotase alfa) Coverage by Cigna in Virginia? Decision Tree & Next Steps

Answer Box: Your Path to Strensiq Coverage in Virginia Yes, Cigna covers Strensiq (asfotase alfa) for perinatal/infantile- and juvenile-onset hypophosphatasia when criteria are met. To qualify, you need confirmed HPP diagnosis (low ALP + ALPL gene mutation OR elevated substrates), pediatric-onset symptoms, and specialist involvement. Start today: Contact your endocrinologist/
5 min read

Myths vs. Facts: Getting Arcalyst (rilonacept) Covered by Cigna in Michigan (2025 Appeal Guide)

Quick Answer: Arcalyst (rilonacept) Coverage by Cigna in Michigan Arcalyst requires prior authorization from Cigna for CAPS, DIRA, or recurrent pericarditis. Coverage depends on specialist prescription, documented prior therapy failures (colchicine, NSAIDs, steroids), and medical necessity documentation. If denied, Michigan residents have 180 days for internal appeals and 127 days
5 min read

Getting Symdeko/Symkevi (Tezacaftor/Ivacaftor) Covered by Cigna in Pennsylvania: Complete Prior Authorization and Appeals Guide

Answer Box: Quick Path to Coverage Symdeko/Symkevi (tezacaftor/ivacaftor) requires prior authorization from Cigna in Pennsylvania. Submit genetic testing showing F508del mutation, CF diagnosis, and specialist prescription via Cigna's provider portal. If denied, use internal appeals within 180 days, then Pennsylvania's Independent External Review (50%
6 min read