Topic

Cigna

A collection of 607 issues

The Complete Guide to Getting Abecma (idecabtagene vicleucel) Covered by Cigna in Virginia: Prior Authorization, Appeals, and State Resources

Answer Box: Getting Abecma Covered by Cigna in Virginia Cigna requires prior authorization for Abecma (idecabtagene vicleucel) in Virginia. To get approval, you need: (1) confirmed relapsed/refractory multiple myeloma after ≥2 prior therapy lines including an IMiD, proteasome inhibitor, and anti-CD38 antibody, (2) treatment at a Bristol Myers Squibb-certified

How to Get Galafold (Migalastat) Covered by Cigna in North Carolina: Prior Authorization Guide and Appeal Scripts

Answer Box: Getting Galafold (Migalastat) Covered by Cigna in North Carolina Eligibility: Adults with Fabry disease and a confirmed amenable GLA variant (via genetic testing), adequate kidney function (eGFR ≥30), and specialist involvement. Fastest path: Submit prior authorization through Express Scripts/Accredo with genetic testing showing amenable variant, specialist letter,

Get Spinraza (Nusinersen) Covered by Cigna in New York: Complete Prior Authorization and Appeal Guide

Answer Box: Fast Track to Spinraza Coverage Getting Spinraza (nusinersen) covered by Cigna in New York requires prior authorization with genetic confirmation of 5q SMA, specialist prescription, and motor function documentation. Your fastest path: (1) Have your neurologist complete Cigna's Spinraza PA form with genetic test results and

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

Answer Box: Getting Opdivo Covered by Cigna in Texas You likely qualify for Opdivo (nivolumab) coverage if you have an FDA-approved cancer diagnosis, required biomarker testing, and your oncologist documents medical necessity. Fastest approval path: Have your doctor submit electronic prior authorization through CoverMyMeds with complete pathology, staging, and prior

How to Get Sumavel DosePro Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide (2024)

Important Update: Sumavel DosePro (needle-free sumatriptan injection) was discontinued in the U.S. in 2018. While this guide covers the approval process that would apply if it were available, patients seeking injectable sumatriptan should work with their doctor to access available needle-based auto-injector alternatives through Cigna's formulary. Quick

Cigna's Coverage Criteria for Xospata (Gilteritinib) in Pennsylvania: What Counts as "Medically Necessary"?

Answer Box: Getting Xospata Covered by Cigna in Pennsylvania Cigna requires prior authorization for Xospata (gilteritinib) in Pennsylvania. To qualify, you need: (1) confirmed relapsed/refractory AML with FLT3 mutation via FDA-approved test, (2) documented failure of prior AML therapy, and (3) prescription from a hematologist/oncologist. First step today:

Coding That Helps Get Galafold (Migalastat) Approved by Cigna in Virginia: ICD-10, HCPCS, and NDC Guide

Answer Box: Getting Galafold Covered by Cigna in Virginia Getting Galafold (migalastat) approved by Cigna requires precise coding and complete documentation. Use ICD-10 code E75.21 for Fabry disease, submit through pharmacy benefit (not medical), and include genetic confirmation of amenable GLA variant. Virginia patients have strong appeal rights through

How to Get Spinraza (Nusinersen) Covered by Cigna in California: Complete Prior Authorization and Appeals Guide

Answer Box: Quick Path to Spinraza Coverage Spinraza (nusinersen) requires prior authorization from Cigna in California. Submit genetic testing confirming SMA diagnosis, specialist evaluation, and clinical notes through CoverMyMeds or Cigna's provider portal. If denied, file an internal appeal within 180 days, then request California's Independent

Myths vs. Facts: Getting Rebif (Interferon Beta-1a) Covered by Cigna in Ohio

Quick Answer: Rebif (interferon beta-1a) requires prior authorization through Cigna, but coverage myths often prevent patients from getting needed approvals. The fastest path: have your neurologist submit a complete PA with diagnosis, MRI evidence, and prior therapy documentation. If denied, you have 180 days for internal appeals, then external review

Resources to Get Aldurazyme (laronidase) Approved with Cigna in Ohio: Forms, Appeals & Contact Guide

Answer Box: Getting Aldurazyme (laronidase) Covered by Cigna in Ohio Fastest path to approval: Have your prescriber submit electronic prior authorization through CoverMyMeds or Cigna's provider portal, including genetic/biochemical MPS I confirmation, baseline assessments, and specialist attestation. If denied, request formulary exception within 72 hours, then pursue