Topic

Cigna

A collection of 1059 issues

How to Get Tavalisse (Fostamatinib) Covered by Cigna in New York: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Tavalisse Covered by Cigna in New York Tavalisse (fostamatinib) requires prior authorization from Cigna for adults with chronic ITP. You'll need a hematologist's prescription, platelet count <30,000/μL (or <50,000/μL with bleeding), and it's dispensed through

How to Get Rezlidhia (Olutasidenib) Covered by Cigna in Illinois: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Rezlidhia (Olutasidenib) Covered by Cigna in Illinois Rezlidhia (olutasidenib) requires prior authorization from Cigna for adults (≥18) with relapsed/refractory AML confirmed by FDA-approved IDH1 mutation testing. Key requirements: documented IDH1 mutation (R132H, R132C subtypes), monitoring plan for differentiation syndrome and liver function, and oncologist prescriber. Start

How to Get Elelyso (Taliglucerase Alfa) Covered by Cigna in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Elelyso (Taliglucerase Alfa) Covered by Cigna in New Jersey Elelyso (taliglucerase alfa) requires prior authorization from Cigna and is typically covered as a Tier 5 specialty drug for confirmed Type 1 Gaucher disease. Submit the Cerezyme/Elelyso/VPRIV Prior Authorization Form via CoverMyMeds with complete diagnostic documentation.

How to Get Arikayce (Amikacin Liposome Inhalation) Covered by Cigna in Illinois: Complete Prior Authorization and Appeal Guide

Answer Box: Fast Track to Arikayce Coverage Cigna requires prior authorization for Arikayce (amikacin liposome inhalation) through Accredo specialty pharmacy. To get approved in Illinois: (1) Your pulmonologist or infectious disease specialist submits PA documentation showing ≥6 months of failed MAC therapy with positive cultures, (2) Request goes through Express

Myths vs. Facts: Getting Soliris (eculizumab) Covered by Cigna in Georgia

Answer Box: Getting Soliris Covered by Cigna in Georgia A doctor's prescription does NOT guarantee Soliris (eculizumab) coverage. Cigna requires prior authorization with strict criteria: FDA-approved diagnosis confirmation (PNH, aHUS, gMG, NMOSD), meningococcal vaccination ≥2 weeks before treatment, REMS enrollment, and prior therapy documentation. If denied, Georgia law

How to Get Emflaza (Deflazacort) Covered by Cigna in New Jersey: Complete Guide with Appeals Process and State Protections

Answer Box: Getting Emflaza (Deflazacort) Covered by Cigna in New Jersey Eligibility: Patients with confirmed Duchenne muscular dystrophy (DMD) aged 2+ under specialist care can get Emflaza covered by Cigna, typically after trying prednisone/prednisolone first. Fastest path: Submit prior authorization via CoverMyMeds or Cigna's provider portal with

How to Get Opsumit (macitentan) Covered by Cigna in North Carolina: Complete Appeals Guide with Forms and Timelines

Answer Box: To get Opsumit (macitentan) covered by Cigna in North Carolina, you need prior authorization with WHO Group 1 PAH confirmed by right heart catheterization, WHO functional class II-IV documentation, and specialist prescribing. If denied, exhaust Cigna's internal appeals first, then file for North Carolina's

How to Get Zolgensma Covered by Cigna in Texas: Complete Prior Authorization and Appeal Guide

Answer Box: Getting Zolgensma Covered by Cigna in Texas Cigna requires prior authorization for Zolgensma (onasemnogene abeparvovec-xioi) via Express Scripts/Accredo for children under 2 with spinal muscular atrophy. Key requirements: bi-allelic SMN1 gene mutations, anti-AAV9 antibody titer ≤1:50, recent labs, and treatment at a certified site. If denied,

How to Get Tegsedi (inotersen) Covered by Cigna in Michigan: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Tegsedi (inotersen) Covered by Cigna in Michigan Tegsedi (inotersen) for hATTR polyneuropathy requires prior authorization from Cigna through Express Scripts, REMS program enrollment, and specialty pharmacy dispensing via Accredo. Michigan patients have strong appeal rights through DIFS external review (127 days to file after final denial). Start

How to Get Stelara (Ustekinumab) Covered by Cigna in Michigan: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Stelara (Ustekinumab) Approved by Cigna in Michigan Cigna requires prior authorization for all Stelara prescriptions. Submit a drug-specific PA form with documented prior therapy failures and disease severity scores. If denied, you have 180 days to appeal internally, then 127 days to file external review with Michigan