Topic

Cigna

A collection of 1137 issues

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

How to Get Keppra (Levetiracetam) Covered by Cigna in Ohio: Complete Appeals Guide and Success Templates

Answer Box: Getting Keppra (Levetiracetam) Covered by Cigna in Ohio Generic levetiracetam is typically Tier 1 on Cigna formularies and doesn't require prior authorization. Brand Keppra requires prior authorization with documented failure or intolerance to generic levetiracetam first (step therapy). If denied, you have 180 days to appeal

Work With Your Doctor to Get Onivyde (Irinotecan Liposome) Approved by Cigna in New Jersey

Answer Box: Getting Onivyde Covered by Cigna in New Jersey Cigna requires prior authorization for Onivyde (irinotecan liposome) with strict medical necessity criteria. Your oncologist must document metastatic pancreatic adenocarcinoma, ECOG performance status 0-1, adequate organ function, and either first-line NALIRIFOX eligibility or progression on prior gemcitabine therapy. Submit through

How to Get Rebif (Interferon Beta-1a) Covered by Cigna in New Jersey: Appeals Guide with Forms and Timelines

Answer Box: Getting Rebif Covered by Cigna in New Jersey Rebif (interferon beta-1a) requires prior authorization from Cigna and is subject to step therapy requirements. For treatment-naïve patients, you must first try either dimethyl fumarate or fingolimod unless contraindicated. The prescription must come from a neurologist or MS specialist. Fastest

Get Xenpozyme (olipudase alfa-rpcp) Covered by Cigna in North Carolina: Complete Prior Authorization Guide and Appeals Process

Answer Box: Quick Path to Approval Xenpozyme (olipudase alfa-rpcp) requires prior authorization from Cigna in North Carolina. To get approved: (1) Confirm ASMD diagnosis with genetic testing and enzyme assay, (2) Have a metabolic specialist submit the PA request through CoverMyMeds or Cigna's portal with required documentation, (3)

How to Get Skyrizi (risankizumab) Covered by Cigna in Pennsylvania: Prior Authorization, Appeals, and Alternative Options

Quick Answer: Getting Skyrizi (risankizumab) Covered by Cigna in Pennsylvania Skyrizi is excluded from the 2024 Express Scripts National Preferred Formulary, which most Cigna commercial plans follow. To get coverage in Pennsylvania, you'll need a formulary exception with documented failure of preferred alternatives like Humira, Cosentyx, or Tremfya.

How to Get Qalsody (Tofersen) Covered by Cigna in New York: Complete Appeals Guide with Templates

Answer Box: Getting Qalsody (Tofersen) Covered by Cigna in New York Qalsody (tofersen) requires prior authorization from Cigna, with documented SOD1 mutation and step therapy completion. If denied, you have 180 days for internal appeals and 4 months for New York's external review through the Department of Financial

How to Get Acthar Gel Covered by Cigna in New York: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Acthar Gel Covered by Cigna in New York Cigna requires prior authorization for Acthar Gel (repository corticotropin injection) with documented failure or contraindication to corticosteroids for approved indications like infantile spasms and MS exacerbations. Submit your PA request through CoverMyMeds or fax Cigna's current PA

How to Get Tremfya (Guselkumab) Covered by Cigna in Virginia: PA Forms, Appeals, and Approval Timeline

Quick Answer: Getting Tremfya (Guselkumab) Covered by Cigna in Virginia Tremfya requires prior authorization from Cigna and is typically placed on Tier 5 (specialty) with step therapy requirements. To get coverage in Virginia: 1) Have your doctor submit the Cigna PA form with TB screening, PASI scores, and documented failure