Topic

Cigna

A collection of 1134 issues

How to Get Qinlock (Ripretinib) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Qinlock Covered by Cigna in Washington Qinlock (ripretinib) requires prior authorization from Cigna for fourth-line GIST treatment. You'll need documented failure of three prior kinase inhibitors (imatinib, sunitinib, regorafenib), pathology confirming GIST diagnosis, and recent imaging showing disease progression. Submit through your oncologist to Cigna&

Myths vs. Facts: Getting Eloctate Covered by Cigna in Pennsylvania (Appeals Guide & Documentation)

Answer Box: Get Eloctate Covered by Cigna in Pennsylvania Eloctate requires prior authorization from Cigna, even with a hematologist's prescription. The fastest path to approval: (1) Ensure your hematologist submits complete PA documentation including hemophilia A diagnosis, inhibitor status, and bleeding history through Cigna's provider portal

Getting HyperHEP Covered by Cigna in Illinois: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting HyperHEP Covered by Cigna in Illinois HyperHEP (hepatitis B immune globulin) is covered by Cigna as a Tier 4 specialty drug with prior authorization required. In Illinois, you have strong appeal rights including external review within 30 days of denial. Fastest path to approval: 1. Doctor submits

How to Get Joenja (leniolisib) Covered by Cigna in Virginia: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Joenja (leniolisib) Covered by Cigna in Virginia Cigna requires prior authorization for Joenja (leniolisib) with strict criteria: genetic confirmation of APDS via CLIA-certified testing, specialist prescription (immunologist/geneticist), patient age ≥12 years and weight ≥45 kg. Submit electronically via CoverMyMeds with complete documentation. If denied, Virginia residents

How to Get Besponsa (Inotuzumab Ozogamicin) Covered by Cigna in California: Complete Prior Authorization and Appeal Guide

Answer Box: Getting Besponsa Covered by Cigna in California Besponsa (inotuzumab ozogamicin) requires prior authorization from Cigna in California. Your fastest path to approval: 1) Have your oncologist submit a PA request through Cigna's provider portal with complete CD22+ B-cell ALL documentation, 2) If denied, file an internal

How to Get Filsuvez (Birch Triterpenes Topical Gel) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Filsuvez Covered by Cigna in Washington Eligibility: Cigna covers Filsuvez for dystrophic or junctional epidermolysis bullosa patients ≥6 months old with confirmed genetic diagnosis and clean wounds 10-50 cm² that are 21+ days but <9 months old. Fastest Path: Have your dermatologist submit prior authorization through

Lowering Out-of-Pocket for Voydeya (danicopan) with Cigna in New York: Copay, Tiering & Assistance

Answer Box: Quick Path to Lower Voydeya Costs Voydeya (danicopan) is a Tier 4 specialty drug on Cigna's formulary requiring prior authorization and costing 25-33% coinsurance or high copays. To reduce costs: (1) Apply for Alexion OneSource copay assistance (up to $15,000/year for commercial insurance), (2)

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

Answer Box: Getting Opzelura Covered by Cigna in North Carolina Cigna requires prior authorization for Opzelura (ruxolitinib cream) with mandatory step therapy in North Carolina. You must document failure of topical steroids (28+ days) OR calcineurin inhibitors (12+ weeks) before approval. Submit through your dermatologist via Cigna's provider

Myths vs. Facts: Getting Kalydeco (ivacaftor) Covered by Cigna in California

Quick Answer: To get Kalydeco (ivacaftor) covered by Cigna in California, you need prior authorization with CFTR genetic testing documentation and a CF specialist's prescription. If denied, file an internal appeal within 180 days, then request California's Independent Medical Review (IMR) through DMHC. Success rates for

How to Get Dojolvi (triheptanoin) Covered by Cigna in California: Complete PA Requirements and Appeals Guide

Quick Answer: Getting Dojolvi (triheptanoin) Covered by Cigna in California Cigna requires prior authorization for Dojolvi (triheptanoin) with molecular confirmation of LC-FAOD diagnosis, specialist prescribing, and documented MCT oil discontinuation. Submit through Express Scripts/Accredo with genetic testing results, treatment history, and medical necessity letter. If denied, file internal appeal