Topic

Exondys 51 (eteplirsen)

A collection of 24 issues

How to Get Exondys 51 (Eteplirsen) Covered by Cigna in California: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Exondys 51 Covered by Cigna in California Quick Path to Approval: Cigna requires genetic testing proving exon 51 amenability, specialist prescriber, and prior authorization through Express Scripts/Accredo. If denied, file internal appeal within 180 days, then request California Independent Medical Review (IMR) through DMHC. Success rates

How to Get Exondys 51 (Eteplirsen) Covered by Cigna in North Carolina: Appeals Guide, Forms & Timelines

Answer Box: Getting Exondys 51 Covered by Cigna in North Carolina Exondys 51 (eteplirsen) requires prior authorization from Cigna with genetic testing proving exon 51 skipping amenability. Submit PA request via fax to (855) 840-1678 with genetic test results, specialist prescription, and clinical documentation. If denied, you have 180 days

Getting Exondys 51 (Eteplirsen) Covered by Blue Cross Blue Shield in New York: Complete PA Guide

Answer Box: Quick Path to Coverage Exondys 51 (eteplirsen) requires prior authorization from Blue Cross Blue Shield in New York. Your fastest path: 1) Confirm genetic testing shows DMD with exon 51 mutation amenable to skipping, 2) Have a pediatric neurologist or neuromuscular specialist complete the BCBS Medical Authorization Request

Renewing Exondys 51 (Eteplirsen) Approval with UnitedHealthcare in North Carolina: 2025 Requirements & Timeline

Answer Box: Renewing Your Exondys 51 Coverage Quick Answer: UnitedHealthcare requires annual renewal of Exondys 51 (eteplirsen) prior authorization with updated clinical documentation. Start the renewal process 60-90 days before your current authorization expires. You'll need: neurologist evaluation showing continued benefit, updated cardiac/renal function tests, and proof