Topic

Cigna

A collection of 128 issues

Getting Zolgensma Covered by Cigna in Washington: Complete Guide to Prior Authorization, Appeals, and IRO Process

Answer Box: Your Fastest Path to Approval To get Zolgensma (onasemnogene abeparvovec-xioi) covered by Cigna in Washington, you need: (1) genetic confirmation of bi-allelic SMN1 mutation, (2) anti-AAV9 antibody titer ≤ 1:50, and (3) steroid protocol documentation. Submit Cigna's prior authorization form with all clinical records to their

How to Get Palynziq (pegvaliase) Covered by Cigna in New Jersey: Prior Authorization Forms, Appeal Process, and REMS Requirements

Quick Answer: Getting Palynziq Covered by Cigna in New Jersey Palynziq (pegvaliase) requires prior authorization from Cigna and strict compliance with FDA REMS requirements. Your fastest path to approval: (1) Ensure your prescriber is REMS-certified and you're enrolled in the program, (2) Submit prior authorization through the Cigna

How to Get Uptravi (Selexipag) Covered by Cigna in New Jersey: Prior Authorization, Appeals, and Cost Assistance

Quick Answer: Getting Uptravi Covered by Cigna in New Jersey Uptravi requires prior authorization from Cigna and is typically dispensed through specialty pharmacy Accredo. Most denials stem from incomplete PAH documentation or missing step therapy trials. Your fastest path: Have your doctor submit Cigna's PA form with complete

Getting Strimvelis Gene Therapy Covered by Cigna in Virginia: Complete Decision Tree and Appeals Guide

Answer Box: Your Path to Strimvelis Coverage Strimvelis eligibility requires confirmed ADA-SCID diagnosis via genetic testing and enzyme levels, plus documentation that no suitable matched donor is available. Since Strimvelis is only administered at SR-TIGET in Milan, you'll need Cigna's out-of-network international coverage approval. First step

How to Get Enbrel (etanercept) Covered by Cigna in Washington: Complete Approval Guide with Appeals Process

Quick Answer: Cigna Enbrel Coverage in Washington Most likely covered if: You have moderate-to-severe rheumatoid arthritis or plaque psoriasis, failed at least one conventional therapy, and completed required TB/hepatitis B screening. First step: Have your rheumatologist or dermatologist submit a prior authorization request with detailed medical necessity documentation. Timeline:

How to Get Ibrance (Palbociclib) Covered by Cigna in Illinois: Requirements, Appeals, and Forms

Answer Box: Getting Ibrance Covered by Cigna in Illinois To get Ibrance (palbociclib) covered by Cigna in Illinois, you need prior authorization showing: HR+/HER2- metastatic breast cancer diagnosis, combination with aromatase inhibitor or fulvestrant, and ovarian suppression if premenopausal. Submit through Cigna's provider portal with pathology reports

How to Get Alecensa (Alectinib) Covered by Cigna in Ohio: Complete Prior Authorization Guide

Answer Box: Getting Alecensa (Alectinib) Covered by Cigna in Ohio Fastest path to approval: Submit Cigna's prior authorization form with ALK-positive test results, complete diagnosis documentation, and medical necessity letter citing NCCN guidelines. If denied, you have 180 days for internal appeal and 120 days for Ohio external

How to Get Dojolvi (triheptanoin) Covered by Cigna in Virginia: Complete Appeals Guide

Answer Box: Getting Dojolvi (triheptanoin) Covered by Cigna in Virginia Cigna requires prior authorization for Dojolvi with molecular confirmation of long-chain fatty acid oxidation disorder (LC-FAOD). Submit through CoverMyMeds or ExpressPAth with genetic test results, diagnosis codes, and clinical rationale. If denied, Virginia law provides step therapy override protections and

How to Get Tavalisse (Fostamatinib) Covered by Cigna in North Carolina: Prior Authorization Guide with Appeals Process

Quick Answer: Getting Tavalisse Covered by Cigna in North Carolina Tavalisse (fostamatinib) requires prior authorization from Cigna for chronic ITP treatment. You'll need documented failure of at least one prior therapy (steroids, IVIG, or TPO receptor agonists), hematologist involvement, and baseline labs. The fastest path: have your hematologist

How to Get Oxervate (Cenegermin) Covered by Cigna in Ohio: Complete Approval Guide

Answer Box: Getting Oxervate Covered by Cigna in Ohio Oxervate (cenegermin) requires prior authorization from Cigna for stage 2 or 3 neurotrophic keratitis. The fastest path to approval: (1) Have your ophthalmologist document failed conventional treatments and confirm your NK stage, (2) Submit the PA request through Cigna's