Topic

Cigna

A collection of 1279 issues

Get Revlimid (Lenalidomide) Covered by Cigna in Florida: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Revlimid (Lenalidomide) Covered by Cigna in Florida Yes, Cigna covers Revlimid (lenalidomide) for FDA-approved indications with prior authorization (PA). Your oncologist submits the PA via CignaForHCP.com with clinical documentation, REMS compliance proof, and diagnosis codes. Standard review takes 30 days (72 hours if expedited). If denied,

How to Get Imbruvica (ibrutinib) Covered by Cigna in Illinois: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting Imbruvica Covered by Cigna in Illinois Imbruvica (ibrutinib) requires prior authorization from Cigna/Express Scripts for all oncology and non-oncology indications. Your fastest path to approval: have your oncologist submit PA documentation showing you meet NCCN guidelines for your specific condition (CLL/SLL, Waldenström macroglobulinemia, or chronic

How to Get Myozyme (Alglucosidase Alfa) Covered by Cigna in New York: Complete PA Guide and Appeals Process

Answer Box: Getting Myozyme Covered by Cigna in New York Myozyme (alglucosidase alfa) requires prior authorization from Cigna for Pompe disease coverage in New York. Your specialist must submit documentation confirming GAA enzyme deficiency or genetic testing, along with weight-based dosing calculations. Submit via CoverMyMeds or fax to 855-840-1678. If

How to Get Acthar Gel Covered by Cigna in Virginia: Complete Prior Authorization and Appeals Guide

Quick Answer: Cigna requires prior authorization for all Acthar Gel (repository corticotropin injection) indications, with mandatory step therapy proving corticosteroid failure or intolerance. Submit PA through Express Scripts/Accredo with comprehensive clinical documentation. If denied, Virginia residents can appeal internally within 180 days, then pursue external review through the State

Coding That Helps Get Ilaris (Canakinumab) Approved by Cigna in Georgia: ICD-10, HCPCS J0638, and NDC Requirements

Answer Box: Getting Ilaris Covered by Cigna in Georgia Ilaris (canakinumab) requires prior authorization from Cigna using HCPCS code J0638 (1 mg = 1 billing unit) with specific ICD-10 codes for Still's disease (M06.1), periodic fever syndromes (M04.1), or gout flares. Submit PA with CRP ≥10 mg/

Denied for Kalydeco (ivacaftor) by Cigna in Illinois? How to Appeal (Templates & Timelines)

Quick Answer: Cigna requires prior authorization for Kalydeco (ivacaftor) with CFTR genetic testing proof and CF specialist documentation. Submit via CoverMyMeds or fax (855) 840-1678; standard review takes 5 business days. If denied, file internal appeal within 180 days, then Illinois external review within 4 months. Contact Illinois DOI at

Get Darzalex Covered by Cigna in Illinois: Complete Prior Authorization and Appeal Guide

Answer Box: Getting Darzalex Covered by Cigna in Illinois Cigna requires prior authorization for both Darzalex IV and Darzalex Faspro (subcutaneous) under most commercial plans in Illinois. Submit the official PA form via CoverMyMeds or fax to (855) 840-1678. Standard approval takes 5 business days; expedited reviews process in 72

If Ferriprox (Deferiprone) Isn't Approved by Cigna in New Jersey: Formulary Alternatives & Exception Paths

Answer Box: When Ferriprox Isn't Covered If Cigna denies Ferriprox (deferiprone) in New Jersey, you have two main paths: try formulary alternatives like deferasirox (Jadenu/Exjade) or deferoxamine, or request a formulary exception citing medical necessity. Cigna typically covers deferasirox as a preferred oral iron chelator, while deferoxamine

Myths vs. Facts: Getting Signifor / Signifor LAR (pasireotide) Covered by Cigna in Texas

Answer Box: Getting Signifor / Signifor LAR (pasireotide) Covered by Cigna in Texas Cigna requires prior authorization for Signifor/Signifor LAR through Express Scripts/Accredo specialty pharmacy. For acromegaly, you must first try and fail octreotide LAR and lanreotide depot. For Cushing's disease, step therapy is less restrictive. Key

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

Answer Box: Getting Soliris Covered by Cigna in Pennsylvania Cigna requires prior authorization for Soliris (eculizumab) with specific diagnostic tests, meningococcal vaccinations ≥2 weeks before treatment, and prescriber REMS enrollment. For PNH, you need flow cytometry showing GPI-anchored protein deficiency; for myasthenia gravis, positive anti-AChR antibodies; for NMOSD, positive anti-AQP4