Topic

Entresto (sacubitril/valsartan)

A collection of 21 issues

Renewing Entresto (Sacubitril/Valsartan) Approval with Blue Cross Blue Shield in New Jersey: 2025 Requirements & Timeline

Quick Answer: Renewing Your Entresto Coverage Entresto (sacubitril/valsartan) requires annual prior authorization renewal with Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ). Start your renewal 60-90 days before expiration. You'll need updated heart failure documentation, recent LVEF results, and proof of ongoing benefit. Submit through your

How to Get Entresto (sacubitril/valsartan) Covered by Cigna in Illinois: Prior Authorization, Appeals, and Cost Savings

Answer Box: Getting Entresto Covered by Cigna in Illinois Entresto (sacubitril/valsartan) requires prior authorization from Cigna and typically involves step therapy—you must try a generic ACE inhibitor or ARB first. In Illinois, if denied, you have 180 days for internal appeals and 30 days for external review after

How to Get Entresto (Sacubitril/Valsartan) Covered by Humana in Texas: Complete Requirements and Appeals Guide

Quick Answer: Getting Entresto Covered by Humana in Texas Entresto (sacubitril/valsartan) requires prior authorization from Humana and is typically placed on Tier 3 (preferred brand) with specific documentation requirements. Your fastest path to approval: (1) Ensure your cardiologist documents heart failure with LVEF ≤40% and ACE inhibitor/ARB failure

How to Get Entresto (sacubitril/valsartan) Covered by Blue Cross Blue Shield in Florida: Complete Forms, Appeals & Contact Guide

Answer Box: Getting Entresto Covered by Florida Blue Cross Blue Shield Entresto (sacubitril/valsartan) requires prior authorization from Florida Blue Cross Blue Shield in 2024. Your doctor must submit a PA request form showing you meet clinical criteria—typically heart failure with reduced ejection fraction and documented failure/intolerance to

How to Get Entresto (Sacubitril/Valsartan) Covered by Humana in New Jersey: Complete Appeals Guide with Templates

Quick Answer: Getting Entresto Covered by Humana in New Jersey Entresto requires prior authorization from Humana and is classified as a Tier 3 medication in New Jersey Medicare Advantage plans. Your fastest path to approval: (1) Have your cardiologist submit a prior authorization request with LVEF ≤40% documentation and evidence

How to Get Entresto (Sacubitril/Valsartan) Covered by Humana in New York: PA Guide, Appeals Process & Forms

Answer Box: Getting Entresto Covered by Humana in New York Entresto (sacubitril/valsartan) is covered by Humana Medicare plans in New York as a Tier 3 medication with prior authorization required. To get approved: (1) Your doctor must document heart failure with reduced ejection fraction (LVEF ≤40%), (2) Submit prior

How to Get Entresto (Sacubitril/Valsartan) Covered by Humana in Ohio: ICD-10 Codes, Prior Authorization, and Appeals Guide

Answer Box: Getting Entresto (Sacubitril/Valsartan) Covered by Humana in Ohio Entresto requires prior authorization from Humana in Ohio. Submit requests through CoverMyMeds or fax to 888-447-3430. Use ICD-10 code I50.22 (chronic systolic heart failure) with documented LVEF <40-50%. Include evidence of ACE inhibitor/ARB intolerance or failure.

How to Get Entresto (sacubitril/valsartan) Covered by Blue Cross Blue Shield in Virginia: PA Forms, Appeal Scripts & State Protections

Quick Answer: Getting Entresto Covered in Virginia Entresto (sacubitril/valsartan) is covered by Blue Cross Blue Shield Virginia (Anthem) but requires prior authorization. Your fastest path to approval: (1) Have your doctor submit a PA request with heart failure diagnosis, ejection fraction data, and documentation of ACE inhibitor trial/failure,

Getting Entresto (Sacubitril/Valsartan) Covered by UnitedHealthcare in New Jersey: Complete Guide to Prior Authorization and Appeals

Quick Answer: UnitedHealthcare requires prior authorization for Entresto in New Jersey with specific criteria: heart failure diagnosis, LVEF ≤40% or structural heart disease, NYHA Class II-IV, cardiologist prescription, and discontinuation of ACE inhibitors/ARBs. Submit through the UnitedHealthcare provider portal or fax to 1-866-434-5523. If denied, you have 180 days

How to Get Entresto (sacubitril/valsartan) Covered by Humana in Washington: Appeals Guide & Templates

Quick Answer: Getting Entresto Covered by Humana in Washington Entresto requires prior authorization from Humana and is typically covered as a Tier 3 medication. If denied, you have 65 days to appeal. The fastest path: 1) Have your cardiologist submit a medical necessity letter documenting your heart failure diagnosis with