Topic

Cigna

A collection of 1135 issues

Renewing Carbaglu (Carglumic Acid) Coverage with Cigna in Washington: Complete Timeline and Documentation Guide

Answer Box: Renewing Carbaglu Coverage with Cigna in Washington Renewal Trigger: Start 2-4 weeks before your current authorization expires. Required Documentation: Updated plasma ammonia levels, weight documentation, and specialist letter confirming ongoing medical necessity for NAGS deficiency treatment. First Step: Contact Accredo at 877-826-7657 to check your renewal date and

Renewing Qalsody (Tofersen) Approval with Cigna in Virginia: 2025 Guide to Documentation, Timelines, and Appeals

Answer Box: Renewing Your Qalsody (Tofersen) Coverage with Cigna Quick Summary: Cigna typically requires Qalsody (tofersen) renewal every 6 months for SOD1-ALS patients. Submit renewal documentation 2-4 weeks before your current authorization expires using CoverMyMeds or the EviCore portal. Required documents include updated ALSFRS-R scores, neurofilament light chain (NfL) levels,

Do You Qualify for Enbrel (Etanercept) Coverage by Cigna in California? Complete Decision Tree & Appeals Guide

Answer Box: Your Fastest Path to Enbrel Coverage Most Cigna California members can get Enbrel (etanercept) covered if they meet three key criteria: confirmed moderate-to-severe rheumatoid arthritis or psoriasis, failure of at least one conventional therapy, and completed TB/hepatitis B screening. First step today: Have your rheumatologist or dermatologist

Myths vs. Facts: Getting Crysvita (Burosumab) Covered by Cigna in Florida - Appeals Guide 2024

Answer Box: Your Path to Crysvita Coverage in Florida Myth-busting fact: Cigna covers Crysvita (burosumab) for X-linked hypophosphatemia (XLH) with proper documentation, not automatic denials. Requirements: genetic confirmation (PHEX mutation) or biochemical evidence (elevated FGF23 + low phosphate), specialist prescriber, baseline labs, and prior therapy documentation for adults. Fastest path: Submit

How to Get Mycapssa (Octreotide Oral) Covered by Cigna in Ohio: Complete Prior Authorization Guide

Quick Answer: Getting Mycapssa Approved by Cigna in Ohio Mycapssa (octreotide oral) requires prior authorization from Cigna in Ohio. You'll need documented acromegaly (ICD-10: E22.0), prior response to injectable octreotide or lanreotide, and an endocrinologist's prescription. Submit through CignaForHCP.com with complete clinical documentation. If

Renewing Tagrisso (Osimertinib) Coverage with Cigna in California: Essential Timeline and Documentation Guide

Answer Box: Renewing Tagrisso Coverage with Cigna Cigna requires annual renewal of prior authorization for Tagrisso (osimertinib) in California. Start the renewal process 4-6 weeks before your current authorization expires. You'll need updated EGFR mutation documentation, current oncologist assessment showing treatment benefit, and recent imaging/labs. Submit through

Do You Qualify for Pomalyst (pomalidomide) Coverage by Cigna in Michigan? Decision Tree & Next Steps

Answer Box: Quick Qualification Check Most likely to qualify: Patients 18+ with multiple myeloma who've failed both lenalidomide (Revlimid) and a proteasome inhibitor (like bortezomib), with documented progression within 60 days of last therapy. Fastest path: Have your oncologist submit prior authorization through Cigna's provider portal

How to Get Dojolvi (Triheptanoin) Covered by Cigna in Michigan: Appeals Guide and PA Requirements

Answer Box: Getting Dojolvi Covered by Cigna in Michigan Fastest path to approval: Submit prior authorization with molecular confirmation of LC-FAOD, documentation of failed alternative therapies, and specialist letter of medical necessity. If denied, file internal appeal within 180 days, then Michigan DIFS external review within 127 days. Start today:

How to Get Pomalyst (Pomalidomide) Covered by Cigna in New Jersey: Timeline, Appeals, and Required Forms

Answer Box: Getting Pomalyst Covered by Cigna in New Jersey Cigna requires prior authorization for Pomalyst (pomalidomide) with specific documentation: proof of ≥2 prior therapies including lenalidomide and a proteasome inhibitor, disease progression within 60 days, and REMS program enrollment. Timeline: PA decisions within 1-2 business days after complete submission.

Myths vs. Facts: Getting Increlex (Mecasermin) Covered by Cigna in North Carolina

Answer Box: Getting Increlex (Mecasermin) Covered by Cigna in North Carolina Cigna requires prior authorization for Increlex (mecasermin) with strict criteria: severe primary IGF-1 deficiency, height ≤-3.0 SDS, normal/elevated growth hormone, and pediatric endocrinologist involvement. If denied, you have 180 days for internal appeals, then can request external