Topic

Exondys 51 (eteplirsen)

A collection of 28 issues

The Requirements Checklist to Get Exondys 51 (Eteplirsen) Covered by Blue Cross Blue Shield in Illinois

Answer Box: Getting Exondys 51 Covered in Illinois Fastest path to approval: Submit prior authorization with genetic testing confirming exon 51-amenable DMD mutation, specialist prescription, and 6-minute walk test results. First step today: Contact your neurologist or neuromuscular specialist to initiate genetic testing if not completed. Blue Cross Blue Shield

How to Get Exondys 51 (Eteplirsen) Covered by Humana in New York: Complete Guide to Prior Authorization, Appeals & Forms

Quick Answer: Getting Exondys 51 Covered by Humana in New York Eligibility: Patients with Duchenne muscular dystrophy (DMD) and confirmed genetic mutation amenable to exon 51 skipping can get Exondys 51 covered through Humana Medicare Advantage or commercial plans in New York. Fastest path: Submit prior authorization with complete genetic

How to Get Exondys 51 (Eteplirsen) Covered by Blue Cross Blue Shield in Virginia: Complete PA Guide with Appeal Forms and Timelines

Answer Box: Getting Exondys 51 Covered in Virginia Exondys 51 (eteplirsen) is covered by Blue Cross Blue Shield Virginia as a specialty pharmacy benefit but requires prior authorization with genetic confirmation of an exon 51-amenable DMD mutation. Your fastest path: 1) Confirm genetic testing shows exon 51 skipping eligibility, 2)

Work With Your Doctor to Get Exondys 51 (eteplirsen) Covered by UnitedHealthcare in New Jersey: Complete Guide

Answer Box: Getting Exondys 51 Covered by UnitedHealthcare in New Jersey Eligibility: Exondys 51 requires prior authorization from UnitedHealthcare for patients with Duchenne muscular dystrophy (DMD) and a confirmed mutation amenable to exon 51 skipping. Fastest approval path: 1. Ensure prescriber is a neurologist with DMD expertise 2. Gather genetic

Myths vs. Facts: Getting Exondys 51 (Eteplirsen) Covered by UnitedHealthcare in Texas - Appeals Guide

Quick Answer: Your Path to Exondys 51 Coverage in Texas Myth: If your neurologist prescribes Exondys 51, UnitedHealthcare automatically covers it. Fact: Prior authorization is mandatory, requiring genetic proof of exon 51-amenable DMD mutation, specialist prescriber credentials, and functional assessments (6-minute walk test ≥300 meters or equivalent). Most denials stem

How to Get Exondys 51 (Eteplirsen) Covered by Humana in Georgia: Prior Authorization, Appeals, and Billing Guide

Answer Box: Getting Exondys 51 Covered by Humana in Georgia Exondys 51 (eteplirsen) requires prior authorization from Humana Medicare Advantage plans in Georgia. The fastest path to approval: 1) Have your neurologist submit genetic testing confirming a DMD mutation amenable to exon 51 skipping, 2) Include baseline cardiac/pulmonary function

How to Get Exondys 51 (Eteplirsen) Covered by Cigna in New Jersey: Complete Forms, Appeals & Contact Guide

Answer Box: Getting Exondys 51 Covered by Cigna in New Jersey To get Exondys 51 (eteplirsen) approved by Cigna in New Jersey, you need genetic testing confirming a DMD mutation amenable to exon 51 skipping, specialist prescription, and proof of ambulatory status. The fastest path: 1) Complete Cigna's

Cigna's Coverage Criteria for Exondys 51 (Eteplirsen) in Michigan: What Counts as "Medically Necessary"?

Answer Box: Getting Exondys 51 Covered by Cigna in Michigan To get Exondys 51 (eteplirsen) covered by Cigna in Michigan, you need genetic confirmation of a DMD mutation amenable to exon 51 skipping, baseline cardiac and pulmonary function tests, and prior authorization through Accredo Specialty Pharmacy. Your neurologist must submit

Work With Your Doctor to Get Exondys 51 (Eteplirsen) Covered by Cigna in Washington: Complete Guide

Answer Box: Getting Exondys 51 Covered by Cigna in Washington What you need: Genetic testing confirming DMD with exon 51-amenable mutation, neurologist prescription, functional assessments (6-minute walk test), and cardiac/pulmonary baseline testing. Fastest path: 1) Schedule visit with neuromuscular specialist, 2) Gather genetic reports and functional testing, 3) Submit

Renewing Exondys 51 (Eteplirsen) Approval with Aetna CVS Health in Texas: 2025 Requirements and Timeline

Answer Box: Quick Renewal Guide Exondys 51 renewal with Aetna CVS Health requires 6-month prior authorization cycles with specific documentation. Start 60 days before expiration. Three key steps: (1) Schedule neurologist visit within 6 months, (2) Complete cardiac echo and renal labs within 12 months, (3) Document functional stability using