Topic

Duopa (carbidopa/levodopa enteral)

A collection of 27 issues

How to Get Duopa Covered by Humana in North Carolina: Prior Authorization, Appeals, and State Protection Guide

Quick Answer: Duopa requires prior authorization from Humana with step therapy requirements. Submit PA through Humana Clinical Pharmacy Review at 1-800-555-2546. If denied, you have 65 days to appeal internally, then use federal Medicare appeals (not North Carolina Smart NC for Medicare plans). Document advanced Parkinson's with motor

Do You Qualify for Duopa Coverage by Humana in Washington? Decision Tree & Next Steps

Answer Box: To qualify for Duopa coverage by Humana in Washington, you need advanced Parkinson's disease with documented motor fluctuations (≥3 hours daily OFF time) despite optimized oral therapy. Submit prior authorization with neurologist assessment, failed treatment history, and surgical candidacy documentation. If denied, use Humana's

How to Get Duopa Covered by Blue Cross Blue Shield in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Duopa Covered by Blue Cross Blue Shield in New Jersey Duopa requires prior authorization from Blue Cross Blue Shield in New Jersey under the medical benefit (not pharmacy). Submit through your neurologist with documented advanced Parkinson's disease, ≥2-3 hours daily "OFF" time, failed

How to Get Duopa Covered by Humana in Florida: Complete Guide to Prior Authorization, Appeals, and State Protections

Quick Answer: Getting Duopa Covered by Humana in Florida Duopa requires prior authorization from Humana Medicare Advantage plans in Florida. Your fastest path to approval: (1) Have your neurologist submit a complete PA request through Humana's provider portal with documented motor fluctuations (≥3 hours "OFF" time

How to Get Duopa Covered by UnitedHealthcare in Ohio: Complete Appeals Guide with Forms and Timelines

Quick Answer: Getting Duopa Covered by UnitedHealthcare in Ohio UnitedHealthcare requires prior authorization for Duopa with documented advanced Parkinson's disease, motor fluctuations ("OFF" time), and failed oral therapy optimization. If denied, you have 180 days to appeal internally, then 180 days for external review through the

How to Get Duopa Covered by Blue Cross Blue Shield in New York: Appeals Guide & Templates

Answer Box: Getting Duopa Covered by Blue Cross Blue Shield in New York Duopa requires prior authorization and is classified as a specialty medication on Blue Cross Blue Shield formularies in New York. To get coverage approved: (1) Submit a prior authorization request with documentation of advanced Parkinson's

How to Get Duopa (Carbidopa/Levodopa Enteral) Covered by Aetna CVS Health in Ohio: Complete 2025 Guide with Forms and Appeals

Answer Box: Duopa Coverage by Aetna CVS Health in Ohio Yes, Aetna CVS Health covers Duopa (carbidopa/levodopa enteral) in Ohio, but requires prior authorization and specialty pharmacy dispensing. The medication is typically placed in Tier 5 (Specialty) with 25% coinsurance up to $150 per fill. Three steps to get

How to Get Duopa (Carbidopa/Levodopa Enteral) Covered by Cigna in New Jersey: Complete Requirements Guide and Appeals Process

Answer Box: Getting Duopa Covered by Cigna in New Jersey Eligibility: Cigna requires prior authorization for Duopa (carbidopa/levodopa enteral) for members with advanced Parkinson's disease experiencing at least 3 hours daily of "OFF" episodes despite optimized oral therapy. Fastest Path to Approval: 1. Have your

Myths vs. Facts: Getting Duopa (carbidopa/levodopa enteral) Covered by Blue Cross Blue Shield in Florida

Quick Answer: Duopa (carbidopa/levodopa enteral) requires prior authorization from Blue Cross Blue Shield Florida. Success depends on documenting advanced Parkinson's disease with ≥2 hours daily "OFF" time, failed oral therapies, and surgical candidacy for PEG-J tube placement. Submit via CoverMyMeds or call 1-877-719-2583. If denied,

Complete Guide to Getting Duopa Covered by Blue Cross Blue Shield in Washington: Requirements, Forms, and Appeals Process

Answer Box: Getting Duopa Covered by Blue Cross Blue Shield in Washington Duopa requires prior authorization from Blue Cross Blue Shield (BCBS) in Washington. To get approved: (1) Your neurologist submits a PA request with documentation of advanced Parkinson's disease, failed oral therapies, and 2+ hours daily "