Topic

Crysvita (burosumab)

A collection of 38 issues

Myths vs. Facts: Getting Crysvita (Burosumab) Covered by Cigna in Pennsylvania

Answer Box: Getting Crysvita Covered by Cigna in Pennsylvania Eligibility: Cigna requires prior authorization for Crysvita (burosumab) in Pennsylvania with specific criteria: confirmed XLH diagnosis via PHEX gene mutation or elevated FGF23, age 6+ months, specialist prescription, and attestation of no concurrent phosphate/vitamin D use. Fastest path: Submit complete

How to Get Crysvita (burosumab) Covered by UnitedHealthcare in Pennsylvania: Complete Guide with Forms, Appeals, and Contacts

Answer Box: Getting Crysvita Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Crysvita (burosumab) in Pennsylvania. Submit through the UnitedHealthcare Provider Portal with required documentation: XLH diagnosis confirmation (genetic testing or elevated FGF23), specialist prescription, and for adults, evidence of failed oral phosphate/calcitriol therapy. If denied, use

Lowering Out-of-Pocket for Crysvita (burosumab) with Aetna (CVS Health) in Ohio: Copay Assistance, Tiering & Appeals

Quick Answer: Reducing Crysvita (burosumab) Costs with Aetna (CVS Health) in Ohio Crysvita costs $4,451-$13,354 per vial depending on dose. With Aetna (CVS Health), expect 50% coinsurance on this specialty-tier medication. Three key cost-reduction strategies: 1) Enroll in Kyowa Kirin Cares copay assistance (commercial insurance only), 2)

Get Crysvita (Burosumab) Covered by UnitedHealthcare in Georgia: Complete Guide with Forms, Appeals, and Contacts

Answer Box: Getting Crysvita Covered by UnitedHealthcare in Georgia Fastest path to approval: Submit a prior authorization through UnitedHealthcare's provider portal with genetic testing or elevated FGF23 results, specialist prescription, and documented low serum phosphorus. Adults need proof of failed oral phosphate plus calcitriol therapy first. If denied,

How to Get Crysvita (burosumab) Covered by Cigna in North Carolina: Appeals Guide & Templates

Answer Box: Getting Crysvita (burosumab) Covered by Cigna in North Carolina For Medicare Advantage: Crysvita requires no prior authorization when billed under Medical Oncology (HCPCS J0584). For Commercial plans: Prior authorization is required with specific XLH or TIO diagnosis documentation, phosphate monitoring plan, and specialist oversight. If denied, appeal internally

Crysvita (Burosumab) Approval with UnitedHealthcare in New York: Complete Guide to Prior Authorization, Appeals, and Coverage

Answer Box: Getting Crysvita Covered by UnitedHealthcare in New York UnitedHealthcare covers Crysvita (burosumab) for X-linked hypophosphatemia (XLH) and tumor-induced osteomalacia (TIO) with prior authorization in New York. Key requirements include confirmed diagnosis via genetic testing or elevated FGF23, specialist prescribing, and documented clinical need. First step today: Contact your

Get Crysvita (Burosumab) Covered by UnitedHealthcare in Florida: Complete Decision Tree & Appeal Guide

Quick Answer: Do You Qualify for Crysvita Coverage? Yes, if you have: Confirmed X-linked hypophosphatemia (XLH) or tumor-induced osteomalacia (TIO), genetic/biochemical testing showing PHEX mutations or elevated FGF23, specialist prescription, and serum phosphorus below normal range. First step: Have your endocrinologist submit prior authorization through UnitedHealthcare's provider

How to Get Crysvita (burosumab) Covered by Blue Cross Blue Shield in Ohio: Prior Authorization, Appeals & Step Therapy Guide

Answer Box: Getting Crysvita Covered in Ohio Blue Cross Blue Shield Ohio requires prior authorization for Crysvita (burosumab), with step therapy requiring failure of oral phosphate and vitamin D first. Coverage is restricted to FDA-approved uses (X-linked hypophosphatemia and tumor-induced osteomalacia) with specialist prescription. If denied, you have 180 days