Topic

Cigna

A collection of 1059 issues

How to Get Upstaza (Eladocagene Exuparvovec) Covered by Cigna in Pennsylvania: Complete Forms, Appeals, and Contact Guide

Answer Box: Getting Upstaza Covered by Cigna in Pennsylvania Cigna requires prior authorization for Upstaza (eladocagene exuparvovec) through Express Scripts/Accredo, with specific criteria including genetic confirmation of AADC deficiency and failed standard therapies. Submit via CoverMyMeds portal or call 800-753-2851 with genetic testing, severity assessment, and certified neurosurgical center

How to Get Voxzogo (Vosoritide) Covered by Cigna in Michigan: Forms, Appeals, and Approval Guide

Quick Answer: Cigna covers Voxzogo (vosoritide) for pediatric achondroplasia patients with confirmed FGFR3 mutations and open growth plates when prescribed by a pediatric endocrinologist or geneticist. Submit prior authorization via CoverMyMeds or EviCore portal with genetic testing, growth plate imaging, and specialist documentation. If denied, appeal within 180 days, then

Renewing Prolastin-C Coverage with Cigna in Pennsylvania: Complete 2025 Guide to Authorization, Appeals, and Timing

Answer Box: Fastest Path to Prolastin-C Renewal Cigna requires annual reauthorization for Prolastin-C in Pennsylvania. Start your renewal 60-90 days before expiration by gathering updated spirometry (within 6 months), recent clinical notes from your pulmonologist, and documentation of continued clinical benefit. Submit via your provider's Cigna portal or

How to Get Idelvion (albutrepenonacog alfa) Covered by Cigna in Virginia: Complete Appeals Guide with Forms and Timelines

Quick Answer: Getting Idelvion Covered by Cigna in Virginia Idelvion (albutrepenonacog alfa) requires prior authorization from Cigna/Express Scripts for Virginia patients with hemophilia B. Start by submitting through CoverMyMeds with complete clinical documentation including factor IX deficiency confirmation, inhibitor testing, and prior therapy history. If denied, file internal appeals

How to Get Eloctate Covered by Cigna in Georgia: Prior Authorization Guide, Appeals Process & Alternative Options

Quick Answer: Getting Eloctate Covered by Cigna in Georgia Eloctate (efmoroctocog alfa) requires prior authorization from Cigna and is classified as a specialty medication limited to 30-day supplies through Accredo pharmacy. Your hematologist must submit a Hemophilia Factor VIII CCRD Prior Authorization Form documenting your hemophilia A diagnosis, bleeding history,

How to Get Enhertu (fam-trastuzumab deruxtecan-nxki) Covered by Cigna in Pennsylvania: Complete Appeals Guide with Forms & Timelines

Answer Box: Getting Enhertu Covered by Cigna in Pennsylvania Fastest path to approval: Submit prior authorization through Cigna's provider portal with documented HER2-positive status, prior therapy failures, and NCCN guideline support. If denied, request peer-to-peer review within 7-14 days, then file internal appeals within 180 days. Pennsylvania residents

Myths vs. Facts: Getting Galafold (migalastat) Covered by Cigna in Ohio

Answer Box: Getting Galafold Covered by Cigna in Ohio Eligibility: Adults (18+) with Fabry disease and a confirmed amenable GLA variant. Fastest path: Have your Fabry specialist submit prior authorization with genetic test results showing amenable mutation, medical necessity letter, and confirmation you're not on concurrent ERT. First

How to Get Sylvant (siltuximab) Covered by Cigna in Virginia: Appeals Process, Forms, and Medical Necessity Templates

Quick Answer: Getting Sylvant (siltuximab) Covered by Cigna in Virginia Cigna requires prior authorization for Sylvant (siltuximab) using their specific PA form, which must document HIV-negative and HHV-8-negative status for multicentric Castleman disease. If denied, you have 180 days to appeal internally, then 120 days to file external review with

Myths vs. Facts: Getting Ozempic and Mounjaro Covered by Cigna in Michigan (2025 Appeal Guide)

Quick Answer: Cigna requires prior authorization for Ozempic (semaglutide) and Mounjaro (tirzepatide) in Michigan, with step therapy mandating metformin trials first. Most denials stem from incorrect diagnosis coding or missing documentation. If denied, you have 180 days to appeal internally, then 127 days for Michigan DIFS external review. Start by

How to Get Bylvay (odevixibat) Covered by Cigna in North Carolina: Forms, Appeals, and State Protections

Answer Box: Getting Bylvay (odevixibat) Covered by Cigna in North Carolina Cigna requires prior authorization for Bylvay (odevixibat) with strict criteria: confirmed PFIC (≥3 months) or Alagille syndrome (≥12 months) diagnosis, failed trials of ursodiol and pruritus medications, and specialist prescription. First step: Have your hepatologist submit PA through Cigna&