Topic

Cigna

A collection of 1135 issues

How to Get Givlaari (givosiran) Covered by Cigna in Virginia: Complete Coding, Appeals & External Review Guide

Quick Answer: Getting Givlaari (givosiran) Covered by Cigna in Virginia Eligibility: Adults with acute hepatic porphyria (AHP) who have documented elevated ALA/PBG levels and ≥2 attacks in 6 months. Fastest path: Have your specialist submit prior authorization with ICD-10 code E80.21, attack logs, and lab results showing elevated

How to Get Entresto (sacubitril/valsartan) Covered by Cigna in Illinois: Prior Authorization, Appeals, and Cost Savings

Answer Box: Getting Entresto Covered by Cigna in Illinois Entresto (sacubitril/valsartan) requires prior authorization from Cigna and typically involves step therapy—you must try a generic ACE inhibitor or ARB first. In Illinois, if denied, you have 180 days for internal appeals and 30 days for external review after

Myths vs. Facts: Getting Filsuvez (Birch Triterpenes Topical Gel) Covered by Cigna in Illinois

Quick Answer: What You Need to Know Getting Filsuvez covered by Cigna in Illinois requires prior authorization with specific documentation: genetic confirmation of dystrophic epidermolysis bullosa, patient age ≥6 months, and at least one open wound. Cigna responds within 72 hours for standard requests. If denied, you have strong appeal

Myths vs. Facts: Getting Hemgenix (etranacogene dezaparvovec) Covered by Cigna in Georgia

Answer Box: Getting Hemgenix (etranacogene dezaparvovec) Covered by Cigna in Georgia Eligibility: Adults with hemophilia B, Factor IX activity ≤2%, currently on prophylaxis OR history of serious bleeding, no inhibitors, normal liver function. Fastest approval path: Submit complete prior authorization through Accredo specialty pharmacy with all required labs and hematologist

How to Get Trikafta Covered by Cigna in Ohio: Complete Prior Authorization and Appeals Guide

Answer Box: Quick Path to Trikafta Coverage To get Trikafta covered by Cigna in Ohio: Submit prior authorization with CFTR genotype documentation (F508del mutation), baseline liver function tests, and prescription from a CF specialist. If denied, file internal appeal within 180 days, then external review through Ohio Department of Insurance.

How to Get Elevidys Covered by Cigna in Georgia: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting Elevidys Covered by Cigna in Georgia Elevidys requires prior authorization from Cigna in Georgia. Your fastest path to approval: (1) Have your doctor submit PA electronically via CoverMyMeds with complete DMD genetic testing and clinical documentation, (2) If denied, file an internal appeal within 180 days, and

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

Answer Box: Getting Cerezyme Covered by Cigna in Michigan Eligibility: Cigna covers Cerezyme (imiglucerase) for confirmed Type 1 Gaucher disease with prior authorization through the medical benefit. No step therapy is required. Fastest path: Have your specialist submit a PA request via CoverMyMeds or Cigna's provider portal with

How to Renew Rylaze Coverage with Cigna in New Jersey: Forms, Timelines, and Appeal Process

Answer Box To renew Rylaze (asparaginase erwinia chrysanthemi [recombinant]-rywn) coverage with Cigna in New Jersey: Submit your prior authorization renewal 2-3 weeks before expiration through the Cigna Provider Portal or Express Scripts specialty pharmacy. Include updated clinical notes showing treatment response, current ALL/LBL status, and continued hypersensitivity to

How to Get Cometriq (Cabozantinib) Covered by Cigna in North Carolina: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting Cometriq (Cabozantinib) Covered by Cigna in North Carolina Cometriq (cabozantinib) requires prior authorization through Cigna and must be filled at Accredo specialty pharmacy for coverage. Your oncologist submits clinical documentation proving medical necessity for metastatic medullary thyroid carcinoma. If denied, you have 180 days for internal appeals,

How to Get Alprolix (Factor IX) Covered by Cigna in New York: PA Requirements, Appeals Process, and State Protections

Answer Box: Getting Alprolix Covered by Cigna in New York Cigna typically requires prior authorization (PA) for Alprolix through Express Scripts/Accredo, with decisions within 24-72 hours under New York law. If denied, you have 180 days to file internal appeals, followed by New York's external review process