Topic

Cigna

A collection of 1135 issues

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

Answer Box: Getting Tavalisse (fostamatinib) Covered by Cigna in New Jersey Tavalisse (fostamatinib) requires prior authorization from Cigna and is typically covered as a specialty medication for chronic ITP after failed first-line treatments. Your fastest path to approval: 1) Have your hematologist document inadequate response to corticosteroids, IVIG, or TPO

Renewing Stelara (Ustekinumab) Coverage with Cigna in New York: Timeline, Forms, and Appeal Options

Answer Box: Renewing Stelara Coverage with Cigna in New York Cigna requires prior authorization renewal for Stelara every 6 months (initial) to 1 year (continuation). Start renewal 30-45 days before expiration. Submit updated clinical documentation showing continued response via PASI scores, CDAI, or Mayo scores through your prescriber. If coverage

How to Get Isturisa (Osilodrostat) Covered by Cigna in Pennsylvania: Appeals Process & Decision Tree

Answer Box: Getting Isturisa Covered by Cigna in Pennsylvania You'll likely qualify if you have documented Cushing's disease with abnormal cortisol tests (UFC, salivary cortisol, or DST) and either can't have pituitary surgery or surgery failed. First step today: Have your endocrinologist call Cigna

Do You Qualify for Hetlioz (Tasimelteon) Coverage by Cigna in North Carolina? Decision Tree & Next Steps

Answer Box: Qualifying for Hetlioz (Tasimelteon) Coverage You likely qualify for Cigna coverage of Hetlioz (tasimelteon) in North Carolina if you have: * Confirmed Non-24-Hour Sleep-Wake Disorder or Smith-Magenis Syndrome diagnosis * Sleep specialist evaluation with 14+ days of sleep logs/actigraphy * Documentation of failed alternative treatments (if step therapy applies) Fastest

How to Get Skyrizi (risankizumab) Covered by Cigna in New Jersey: Complete Prior Authorization Guide

Answer Box: Getting Skyrizi (risankizumab) Covered by Cigna in New Jersey Eligibility: Skyrizi requires prior authorization from Cigna for moderate-to-severe plaque psoriasis, psoriatic arthritis, Crohn's disease, or ulcerative colitis. You must document failure of preferred biologics (typically TNF inhibitors like Humira) and meet severity criteria (PASI ≥10 or

How to Get Vyondys 53 (Golodirsen) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Cigna requires prior authorization for Vyondys 53 (golodirsen) with genetic testing confirming exon 53-skippable DMD mutation, specialist prescription, baseline kidney function tests, and 6+ months of steroid stabilization. Submit through Express Scripts specialty pharmacy portal. If denied, Washington residents have 180 days for internal appeals, then external review

Cigna's Coverage Criteria for Poteligeo (mogamulizumab-kpkc) in Illinois: What Counts as "Medically Necessary"?

Answer Box: Getting Poteligeo Covered by Cigna in Illinois Cigna requires prior authorization for Poteligeo (mogamulizumab-kpkc) with three key criteria: (1) confirmed mycosis fungoides or Sézary syndrome with TNMB staging, (2) failure of at least one prior systemic therapy, and (3) prescription by an oncologist or dermatologist. First step today:

How to Get Keppra (Levetiracetam) Covered by Cigna in Pennsylvania: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Keppra (Levetiracetam) Covered by Cigna in Pennsylvania Most Cigna plans in Pennsylvania cover generic levetiracetam without prior authorization, but brand Keppra typically requires a formulary exception showing medical necessity. Your fastest path: Have your doctor submit a prior authorization through CoverMyMeds with documentation that generic versions failed

How Long Does It Take to Get Gattex (Teduglutide) Approved by Cigna in North Carolina? Complete Timeline Guide

Quick Answer: Cigna typically processes Gattex (teduglutide) prior authorization requests within 2 business days for standard cases, 24 hours for urgent situations. In North Carolina, if denied, you have 180 days for internal appeals and 120 days for Smart NC external review. Start by having your gastroenterologist submit complete parenteral

How to Get Upstaza (Eladocagene Exuparvovec) Covered by Cigna in Illinois: Complete Appeal Guide

Quick Answer: Getting Upstaza Covered by Cigna in Illinois Upstaza (eladocagene exuparvovec) requires prior authorization from Cigna and Express Scripts. The fastest path: 1) Have your doctor submit a complete PA request with genetic testing confirming AADC deficiency and enzyme activity results, 2) If denied, file an internal appeal within