Topic

Cigna

A collection of 1059 issues

How to Get Alecensa (alectinib) Covered by Cigna in Texas: Appeals Process, State Laws, and Approval Strategies

Answer Box: Getting Alecensa (alectinib) Covered by Cigna in Texas To get Alecensa (alectinib) approved by Cigna in Texas: Your oncologist must submit a prior authorization request through Express Scripts/Accredo with ALK-positive test results, prior therapy documentation, and medical necessity justification. If denied, you have 180 days to appeal

Renewing Isturisa (Osilodrostat) Approval with Cigna in New Jersey: 2025 Guide to Timelines, Documentation & Appeals

Answer Box: Renewing Isturisa (Osilodrostat) with Cigna in New Jersey Cigna requires prior authorization renewal for Isturisa (osilodrostat) annually or through plan year-end, prescribed by an endocrinologist with documented treatment response. Submit renewal 30-60 days before expiration via EviCore portal with updated cortisol labs, clinical response documentation, and prescriber attestation.

How to Get HyperHEP (Hepatitis B Immune Globulin) Covered by Cigna in Texas: Appeals Guide and Medical Necessity Templates

Answer Box: Getting HyperHEP Covered by Cigna in Texas Cigna requires prior authorization for HyperHEP (hepatitis B immune globulin) based on CDC post-exposure prophylaxis guidelines. Submit PA within 24-48 hours of exposure with documentation including incident report, source HBsAg status, and vaccination history. If denied, file Level 1 appeal within

How to Get Naglazyme (Galsulfase) Covered by Cigna in Virginia: Complete Coding, Prior Authorization, and Appeals Guide

Quick Answer: Getting Naglazyme Covered by Cigna in Virginia Naglazyme (galsulfase) requires Cigna prior authorization with confirmed MPS VI diagnosis (ICD-10 E76.29), specialist prescription, and functional assessments. Submit using HCPCS J1458 (1 mg = 1 unit), include enzyme assay results and baseline 6-minute walk test. If denied, file internal appeal

Work With Your Doctor to Get Thiola / Thiola EC (Tiopronin) Covered by Cigna in Michigan: Complete Provider Partnership Guide

Answer Box: Your Path to Thiola Coverage in Michigan Cigna requires prior authorization for Thiola/Thiola EC (tiopronin) through Express Scripts, with step therapy requiring generic tiopronin trial first. Your urologist or nephrologist must document cystinuria diagnosis (24-hour urine cystine >400 mg/day), conservative therapy failure, and patient weight

How to Get Hetlioz (Tasimelteon) Covered by Cigna in New York: Complete Prior Authorization Guide and Appeals Process

Answer Box: Getting Hetlioz Covered by Cigna in New York Cigna requires prior authorization for Hetlioz (tasimelteon) with documented failure of 6 months of daily melatonin therapy for Non-24-hour sleep-wake disorder in totally blind adults. The fastest path to approval: (1) Gather sleep logs showing irregular patterns and melatonin trial

How to Get Haegarda (C1-Esterase Inhibitor) Covered by Cigna in Washington: Complete Guide with Forms and Appeals Process

Answer Box: Getting Haegarda Covered by Cigna in Washington Haegarda requires prior authorization from Cigna with documented HAE diagnosis (low C4 and C1-INH levels), specialist consultation, and clinical need for prophylaxis. Fastest path: Have your allergist/immunologist submit the PA request with lab results and attack history via Cigna'

Get Trikafta Covered by Cigna in North Carolina: Complete Prior Authorization & Appeals Guide

Answer Box: Getting Trikafta Covered by Cigna in North Carolina Cigna requires prior authorization for Trikafta (elexacaftor/tezacaftor/ivacaftor) with documented cystic fibrosis diagnosis, CFTR genetic testing, and CF specialist prescription. Submit electronically via CoverMyMeds or fax the official Cigna PA form with ICD-10 code E84.0, genetic test results,

How to Get Uptravi (Selexipag) Covered by Cigna in Illinois: Appeal Guide with Forms and Timelines

Answer Box: Getting Uptravi (Selexipag) Covered by Cigna in Illinois Cigna requires prior authorization for Uptravi (selexipag) for pulmonary arterial hypertension (PAH). Your doctor must submit clinical documentation proving WHO Group 1 PAH diagnosis with functional class II-III symptoms and prior therapy trials. If denied, you have 180 days for

How to Get Kalydeco (ivacaftor) Covered by Cigna in New Jersey: Complete Prior Authorization & Appeals Guide

Answer Box: Getting Kalydeco Covered by Cigna in New Jersey Kalydeco (ivacaftor) requires prior authorization from Cigna via Express Scripts for cystic fibrosis patients with documented CFTR responsive mutations. Submit genetic test results proving responsive mutations (G551D, R117H, etc.) plus CF specialist's medical necessity letter through CoverMyMeds or