Topic

Cigna

A collection of 128 issues

How to Get Revlimid (Lenalidomide) Covered by Cigna in Virginia: Appeals Process and Alternative Options

Answer Box: Getting Revlimid Covered by Cigna in Virginia Quick Path to Coverage: If Cigna denies your Revlimid (lenalidomide) prescription, you have three main options: (1) Request a formulary exception with medical necessity documentation, (2) Consider generic lenalidomide as an alternative, or (3) Appeal through Cigna's internal process

Myths vs. Facts: Getting Upstaza (eladocagene exuparvovec) Covered by Cigna in Virginia

Quick Answer: Getting Upstaza Covered by Cigna in Virginia Myth: If your doctor prescribes Upstaza, Cigna automatically covers it. Fact: Cigna requires prior authorization with genetic confirmation of AADC deficiency, documented treatment failures, and administration at a certified neurosurgical center. In Virginia, if denied, you have 180 days for internal

Do You Qualify for Pemazyre (Pemigatinib) Coverage by Cigna in Washington? Decision Tree & Next Steps

Answer Box: Your Fastest Path to Pemazyre Coverage Yes, you can get Pemazyre (pemigatinib) covered by Cigna in Washington if you have unresectable/metastatic cholangiocarcinoma with FGFR2 fusion/rearrangement and prior systemic therapy. The fastest path: 1) Confirm FGFR2 testing is complete, 2) Submit Cigna's prior authorization with

How to Get Givlaari (givosiran) Covered by Cigna in Florida: Complete Appeals Guide

Answer Box: Getting Givlaari (givosiran) Covered by Cigna in Florida Cigna requires prior authorization for Givlaari (givosiran) in Florida with strict medical necessity criteria. To get approved: (1) Your specialist must document confirmed acute hepatic porphyria with elevated ALA/PBG levels and at least one attack in the past 6

Work With Your Doctor to Get Evrysdi (risdiplam) Covered by Cigna in North Carolina: Complete Appeals Guide

Answer Box: Getting Evrysdi (risdiplam) Covered by Cigna in North Carolina Eligibility: Patients with genetically confirmed spinal muscular atrophy (SMA) can get Evrysdi covered by Cigna with proper documentation. Fastest path: Your doctor submits a prior authorization with genetic test results showing SMN1 mutations, motor function assessments (CHOP INTEND or

How to Get Elaprase (idursulfase) Covered by Cigna in Illinois: Complete Requirements Checklist and Appeal Guide

Answer Box: Getting Elaprase Covered by Cigna in Illinois Elaprase (idursulfase) requires prior authorization from Cigna in Illinois, with approval typically taking 5 business days when complete documentation is submitted. The fastest path involves three steps: (1) Submit electronic PA through CoverMyMeds or Surescripts with enzymatic/genetic confirmation of Hunter

How to Get Epidiolex (Cannabidiol) Covered by Cigna in California: Prior Authorization Guide and Appeals Process

Answer Box: Fastest Path to Epidiolex Coverage To get Epidiolex (cannabidiol) covered by Cigna in California, you need: 1) Confirmed diagnosis of LGS, Dravet syndrome, or TSC by a neurologist, 2) Documentation of failed trials with 2+ other seizure medications, and 3) Prior authorization submitted by your doctor. Cigna must

How to Get Therakos CELLEX Photopheresis Covered by Cigna in Florida: Prior Authorization, Appeals & Access Guide

Quick Answer: Getting Therakos CELLEX Covered by Cigna in Florida Therakos CELLEX photopheresis requires prior authorization from Cigna as a medical benefit procedure (not pharmacy). Submit clinical documentation showing steroid-refractory GVHD or advanced CTCL, specialist oversight, and failed conventional therapies. If denied, you have 180 days to appeal internally, followed

How to Get Galafold (migalastat) Covered by Cigna in Washington: Alternative Treatments and Appeal Options

Answer Box: Galafold (migalastat) Coverage by Cigna in Washington Getting Galafold covered by Cigna requires genetic confirmation of an amenable GLA variant plus prior authorization. If denied, you have strong appeal rights in Washington, including external review through an Independent Review Organization (IRO). Your 3-step path: 1. Confirm eligibility: Genetic

How to Get Kuvan (Sapropterin) Covered by Cigna in Washington: Appeals, Alternatives & Success Strategies

Answer Box: Getting Kuvan Covered by Cigna in Washington Cigna requires prior authorization for Kuvan (sapropterin dihydrochloride) for PKU treatment. Your fastest path to approval: (1) Have your metabolic specialist submit a PA request through Cigna's provider portal with documented PKU diagnosis, BH4 responsiveness testing showing ≥30% phenylalanine