Topic

Cigna

A collection of 1134 issues

How to Get Photrexa (Riboflavin) Covered by Cigna in New York: Complete Cost-Cutting Guide

Answer Box: Getting Photrexa Covered by Cigna in New York Cigna requires prior authorization for Photrexa (riboflavin ophthalmic solution) and classifies it as a specialty medication in Tier 4 or 5. Your out-of-pocket costs can range from hundreds to thousands of dollars per eye, but multiple cost-reduction strategies exist. Three

Get Daybue (Trofinetide) Covered by Cigna in Michigan: Complete Appeal Guide with Forms and Timelines

Answer Box: Getting Daybue (Trofinetide) Covered by Cigna in Michigan Cigna requires prior authorization for Daybue (trofinetide) through their specialty pharmacy Accredo. If denied, you have strong appeal rights in Michigan. Fastest path: 1) Submit complete PA request with genetic testing confirming Rett syndrome diagnosis, 2) If denied, file internal

Getting Tagrisso (Osimertinib) Covered by Cigna in Illinois: Complete PA Guide with Forms and Appeal Templates

Answer Box: Getting Tagrisso (Osimertinib) Covered by Cigna in Illinois Cigna requires prior authorization for Tagrisso (osimertinib) with documented EGFR mutation testing and oncology management. Illinois banned step therapy in 2025 for state-regulated plans, but ERISA plans may still require it. If denied, you have 4 months to request external

How to Get Hemgenix (Etranacogene Dezaparvovec) Covered by Cigna in Ohio: Complete Appeal Guide and Timeline

Answer Box: Getting Hemgenix Covered by Cigna in Ohio Hemgenix (etranacogene dezaparvovec) requires prior authorization from Cigna with specific clinical criteria including confirmed hemophilia B diagnosis, negative Factor IX inhibitors, and prescriber specialization. First step: Have your hematologist submit a prior authorization request with complete documentation of bleeding history and

How to Renew Epidiolex (Cannabidiol) Coverage with Cigna in Georgia: 2025 Requirements and Timeline

Answer Box: Renewing Epidiolex Coverage with Cigna in Georgia Cigna approves Epidiolex (cannabidiol) for 1-year periods and requires documented treatment response for renewal. Start your renewal 60-90 days early by gathering seizure frequency data, adherence records, and liver function labs. If denied, you have 180 days for internal appeal and

Getting Alecensa (Alectinib) Covered by Cigna in Georgia: Prior Authorization, Appeals, and Formulary Alternatives

Answer Box: Getting Alecensa Covered by Cigna in Georgia Cigna covers Alecensa (alectinib) for ALK-positive NSCLC in Georgia, but requires prior authorization and may impose step therapy. Your fastest path: 1) Have your oncologist submit a prior authorization request with ALK-positive test results and medical necessity documentation, 2) If denied,

Renewing Rinvoq (Upadacitinib) Approval with Cigna in Washington: Complete Timeline and Documentation Guide

Answer Box: Renewing Rinvoq with Cigna in Washington Cigna requires annual reauthorization for Rinvoq (upadacitinib) with documented clinical improvement and ongoing specialist oversight. Submit renewal 30-60 days before expiration with objective response measures (labs, symptom scores) and current monitoring results. If denied, Washington residents have 180 days for internal appeals

How to Get Onpattro (Patisiran) Covered by Cigna in North Carolina: Complete Timeline, Forms & Appeal Guide

Answer Box: Getting Onpattro (Patisiran) Covered by Cigna in North Carolina Eligibility: Adults with hereditary transthyretin amyloidosis polyneuropathy (hATTR-PN) confirmed by genetic testing and neurologist evaluation. Fastest Path: Submit complete prior authorization through Cigna's provider portal with genetic test results, neurologist consultation notes, and mNIS+7 scores. Standard

How to Get Evkeeza (Evinacumab) Covered by Cigna in North Carolina: Complete Prior Authorization Guide

Answer Box: Quick Path to Evkeeza Coverage Evkeeza (evinacumab) requires prior authorization from Cigna in North Carolina. To get approved, you need: (1) confirmed homozygous familial hypercholesterolemia diagnosis with genetic testing or clinical criteria, (2) documentation of maximally tolerated statin, ezetimibe, and PCSK9 inhibitor trials (if age ≥10), and (3)

Getting Opfolda (miglustat) Covered by Cigna in New York: Medical Necessity Criteria and Appeal Guide

Answer Box: Your Path to Coverage Cigna covers Opfolda (miglustat) in New York only when prescribed with Pombiliti for adults with late-onset Pompe disease (LOPD) who aren't improving on standard enzyme replacement therapy. You must be ≥18 years old, weigh >40 kg, and have documented ERT failure