Topic

Eylea / Lucentis (aflibercept / ranibizumab)

A collection of 30 issues

Myths vs. Facts: Getting Eylea and Lucentis Covered by Humana in Florida (Complete Appeals Guide)

Answer Box: Getting Eylea/Lucentis Covered by Humana in Florida Myth: A doctor's prescription guarantees Humana will cover Eylea or Lucentis. Fact: Humana requires prior authorization with specific documentation including OCT imaging, visual acuity data, and often step therapy with bevacizumab first. In Florida, you have 65 days

How to Get Eylea or Lucentis Covered by Cigna in Illinois: Appeals Guide with Forms and Timelines

Quick Answer: Getting Eylea or Lucentis Approved by Cigna in Illinois Cigna requires prior authorization for Eylea (aflibercept) and Lucentis (ranibizumab) with step therapy requiring bevacizumab trial first. Submit PA requests through CoverMyMeds or call 1-800-882-4462. If denied, you have 180 days to appeal internally, then 4 months for Illinois

Get Eylea and Lucentis Covered by Humana in California: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Started To get Eylea or Lucentis covered by Humana in California: First, check if your plan requires step therapy through bevacizumab (Avastin). If yes, document any prior anti-VEGF treatment failures or contraindications. Submit prior authorization via the Humana provider portal with OCT imaging, visual acuity measurements, and

Resources to Get Eylea and Lucentis Covered by Blue Cross Blue Shield in Florida: Complete Forms, Portals & Appeals Guide

Answer Box: Getting Started To get Eylea (aflibercept) or Lucentis (ranibizumab) covered by Blue Cross Blue Shield in Florida: Submit prior authorization through your ophthalmologist using Florida Blue's Availity portal or CoverMyMeds. Include OCT scans, visual acuity records, and documentation of failed bevacizumab if required by step therapy.

How to Get Eylea and Lucentis Covered by Blue Cross Blue Shield in Pennsylvania: Appeals, Forms, and State Protections

Answer Box: Getting Eylea/Lucentis Covered in Pennsylvania If Blue Cross Blue Shield denied your Eylea (aflibercept) or Lucentis (ranibizumab) for wet AMD or diabetic macular edema, you have strong appeal options in Pennsylvania. Submit prior authorization through your BCBS portal with complete OCT/visual acuity documentation. If denied, use

The Complete Checklist to Get Eylea or Lucentis Covered by Cigna in New York: Forms, Appeals, and Timeline Guide

Answer Box: Your Path to Coverage Eligibility: Cigna typically covers Eylea and Lucentis for wet AMD, diabetic macular edema, and retinal vein occlusion with prior authorization. Most plans require step therapy with bevacizumab first unless contraindicated. Fastest approval path: Have your retina specialist submit electronic prior authorization through Cigna'

How to Get Eylea and Lucentis Covered by UnitedHealthcare in California: Complete Prior Authorization and Appeal Guide

Quick Answer: UnitedHealthcare requires prior authorization for Eylea (aflibercept) and Lucentis (ranibizumab) in California. Submit requests through the UnitedHealthcare Provider Portal with OCT imaging, visual acuity measurements, and diagnosis documentation. If denied, file an internal appeal within 30 days, then request a California DMHC Independent Medical Review for binding external

Getting Eylea and Lucentis Covered by Aetna CVS Health in Ohio: Complete Prior Authorization Guide

Quick Answer: Getting Eylea/Lucentis Approved by Aetna CVS Health in Ohio Fastest path to approval: Submit prior authorization through your retinal specialist with current OCT imaging, visual acuity measurements, and documented diagnosis (wet AMD, diabetic macular edema, or retinal vein occlusion). Aetna typically requires 12 months of clinical documentation

Renewing Eylea and Lucentis Approval with Aetna CVS Health in Pennsylvania: Timeline, Documentation, and Appeal Options

Answer Box: Renewing Your Eylea or Lucentis Coverage To renew Eylea (aflibercept) or Lucentis (ranibizumab) approval with Aetna CVS Health in Pennsylvania, start the process 60-90 days before your current authorization expires. You'll need updated OCT imaging, visual acuity measurements, and documentation of treatment response. Submit renewal requests

How to Get Eylea and Lucentis Covered by UnitedHealthcare in Georgia: Prior Authorization Guide and Appeal Process

Answer Box: Get Eylea or Lucentis Covered by UnitedHealthcare in Georgia UnitedHealthcare requires prior authorization for both Eylea and Lucentis in Georgia. Your retina specialist must submit documentation including diagnosis codes, OCT imaging, visual acuity measurements, and evidence of bevacizumab trial or contraindication. First step today: Contact your eye doctor