Topic

Cigna

A collection of 1139 issues

How to Get Revcovi (Elapegademase) Covered by Cigna in Illinois: Complete PA Forms, Appeals Guide & State Resources

Answer Box: Getting Revcovi Covered by Cigna in Illinois Eligibility: Cigna requires prior authorization for Revcovi (elapegademase) with confirmed ADA-SCID diagnosis through genetic testing and specialist oversight. Fastest path: Have your immunologist submit a PA request via Cigna's provider portal with genetic testing results, failed/contraindicated bone marrow

How to Get Tepezza (teprotumumab) Covered by Cigna in Michigan: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Tepezza (teprotumumab) Covered by Cigna in Michigan Cigna requires prior authorization for Tepezza (teprotumumab) for Thyroid Eye Disease (TED). To get coverage: 1) Complete Cigna's Tepezza Prior Authorization Form with detailed TED documentation including Clinical Activity Score (CAS), 2) If denied, file internal appeal within

Work With Your Doctor to Get Oxlumo (Lumasiran) Approved by Cigna in Illinois: Complete Provider Collaboration Guide

Quick Answer: Your Path to Oxlumo Approval Getting Oxlumo (lumasiran) approved by Cigna in Illinois requires strong physician partnership and complete documentation. Key requirements: genetic confirmation of PH1 (AGXT mutations), elevated urinary oxalate levels, specialist prescription (nephrology/urology), and eGFR ≥30 mL/min/1.73 m². Fastest path: Schedule a

How to Get Cometriq (Cabozantinib) Covered by Cigna in New Jersey: Prior Authorization Forms, Appeals, and Timeline

Answer Box: Getting Cometriq Covered by Cigna in New Jersey Cometriq (cabozantinib) requires prior authorization from Cigna in New Jersey for metastatic medullary thyroid carcinoma. The fastest path to approval: (1) Have your oncologist submit complete PA documentation including pathology confirming MTC diagnosis and ICD-10 code C73, (2) Ensure prescription

Cigna's Coverage Criteria for Exondys 51 (Eteplirsen) in Michigan: What Counts as "Medically Necessary"?

Answer Box: Getting Exondys 51 Covered by Cigna in Michigan To get Exondys 51 (eteplirsen) covered by Cigna in Michigan, you need genetic confirmation of a DMD mutation amenable to exon 51 skipping, baseline cardiac and pulmonary function tests, and prior authorization through Accredo Specialty Pharmacy. Your neurologist must submit

Getting Ibrance (Palbociclib) Approved by Cigna in Texas: Complete Coverage Guide with Forms and Appeals

Quick Answer: Ibrance (palbociclib) is typically covered by Cigna in Texas with prior authorization for HR+/HER2- metastatic breast cancer. Most approvals take 5-15 business days through Accredo specialty pharmacy. Start by having your oncologist submit the PA request with complete pathology reports and treatment history. If denied, Texas law

How to Get Oxbryta (Voxelotor) Covered by Cigna in Georgia: Appeals Guide After FDA Withdrawal

Important Update: Oxbryta (voxelotor) was withdrawn from the U.S. market in 2024 following FDA's request after confirmatory evidence review. Current claims are typically denied due to loss of FDA approval. However, if you're dealing with a prior denial or need alternative SCD treatments, Georgia'

How to Get Berinert (C1-Esterase Inhibitor, IV) Covered by Cigna in Illinois: PA Forms, Appeal Scripts & State Protections

Answer Box: Getting Berinert Covered by Cigna in Illinois Berinert (IV C1-esterase inhibitor) requires prior authorization from Cigna and may face step therapy or quantity limits. In Illinois, you have strong appeal rights: internal appeals must be decided within 15 business days (24 hours if expedited), and external reviews through

How to Get Elevidys (Delandistrogene Moxeparvovec-rokl) Covered by Cigna in Florida: Appeals, Forms & Timeline Guide

Answer Box: Getting Elevidys Covered by Cigna in Florida Fastest path to approval: Cigna requires prior authorization for Elevidys (delandistrogene moxeparvovec-rokl) within 72 hours for standard requests, 24 hours for urgent cases. Submit through Express Scripts ExpressPAth portal with complete DMD genetic confirmation, anti-AAV antibody results, and hepatic monitoring plan.

Getting Rapivab (Peramivir) Covered by Cigna in Michigan: Prior Authorization Forms, Appeals Timeline, and Approval Checklist

Answer Box: Fastest Path to Approval Rapivab (peramivir) requires prior authorization from Cigna for coverage in Michigan. The fastest approval path: (1) Submit PA request within 48 hours of flu symptom onset with documented medical necessity, (2) Include evidence why oral antivirals (Tamiflu) can't be used, and (3)