Topic

Cigna

A collection of 1134 issues

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

How to Get Rezlidhia (Olutasidenib) Covered by Cigna in Michigan: Appeal Templates and Success Strategies

Answer Box: Getting Rezlidhia (Olutasidenib) Covered by Cigna in Michigan Fastest path to approval: Submit prior authorization with IDH1 mutation test results, AML diagnosis documentation, and prior therapy failures. If denied, file internal appeal within 180 days, request peer-to-peer review (80-85% success rate), and prepare for Michigan's 127-day

How to Get Lumizyme Covered by Cigna in Florida: Prior Authorization, Appeals, and Alternative Options

Answer Box: Getting Lumizyme Covered by Cigna in Florida Cigna typically covers Lumizyme (alglucosidase alfa) for Pompe disease but requires prior authorization and step therapy documentation. To get approval: (1) Submit PA request with confirmed Pompe diagnosis via genetic testing or enzyme studies, (2) Document any prior ERT failures with

How to Get Koselugo (Selumetinib) Covered by Cigna in Illinois: Complete Appeal Guide with Forms and Timelines

Answer Box: Getting Koselugo (Selumetinib) Covered by Cigna in Illinois Koselugo requires prior authorization from Cigna for pediatric patients (≥2 years) with NF1 and symptomatic, inoperable plexiform neurofibromas. Start with your prescriber submitting a PA through CoverMyMeds or Accredo's portal with complete NF1 documentation, baseline LVEF results, and