Topic

Firdapse (amifampridine)

A collection of 22 issues

Getting Firdapse (Amifampridine) Covered by Humana in Florida: PA Requirements, Appeals Timeline, and Cost Support

Quick Answer: Humana requires prior authorization for Firdapse (amifampridine) to treat Lambert-Eaton myasthenic syndrome (LEMS). You'll need confirmed LEMS diagnosis via antibody testing and EMG, neuromuscular specialist documentation, and evidence of medical necessity. If denied, file a redetermination appeal within 65 days. Start today: Call Humana member services
5 min read

How to Get Firdapse (Amifampridine) Covered by UnitedHealthcare in Texas: Appeals Process, Forms, and Approval Scripts

Answer Box: Getting Firdapse Covered by UnitedHealthcare in Texas UnitedHealthcare requires prior authorization for Firdapse (amifampridine) in Texas with no step therapy requirement. Submit via the UHC Provider Portal with confirmed LEMS diagnosis (P/Q-type VGCC antibodies + EMG showing ≥60% CMAP increment), neurologist prescription, and no seizure history. Standard approval
5 min read

UnitedHealthcare's Coverage Criteria for Firdapse (amifampridine) in New Jersey: What Counts as "Medically Necessary"?

Answer Box: Getting Firdapse Approved by UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization for Firdapse (amifampridine) through OptumRx with confirmed LEMS diagnosis by a neurologist, diagnostic testing (EMG and VGCC antibodies), and no seizure history. No step therapy is required. If denied, you have 60 days to appeal internally,
6 min read

How to Get Firdapse (Amifampridine) Covered by Blue Cross Blue Shield in New York: Forms, Appeals, and Success Strategies

Answer Box: Getting Firdapse Covered in New York Eligibility: Firdapse (amifampridine) requires prior authorization from Blue Cross Blue Shield plans in New York for patients with confirmed Lambert-Eaton myasthenic syndrome (LEMS). Fastest Path: Contact your BCBS member services to obtain the current prior authorization form, have your neurologist complete clinical
6 min read

Get Firdapse (Amifampridine) Covered by Blue Cross Blue Shield in Illinois: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Firdapse Approved in Illinois Eligibility: Blue Cross Blue Shield Illinois covers Firdapse (amifampridine) for confirmed Lambert-Eaton myasthenic syndrome (LEMS) in patients 6+ years old with prior authorization. Fastest path: Have your neurologist submit a comprehensive PA request including LEMS diagnostic proof (antibodies or EMG), failed alternative treatments,
6 min read

Getting Firdapse (Amifampridine) Covered by Humana in Texas: Prior Authorization Forms, Appeals, and Cost-Saving Strategies

Answer Box: Fastest Path to Firdapse (Amifampridine) Coverage Eligibility: Firdapse requires prior authorization from Humana for Lambert-Eaton myasthenic syndrome (LEMS) patients ≥6 years old. First step: Have your neurologist submit a medical necessity letter with LEMS diagnosis confirmation (antibodies/EMG), prior treatment failures, and dosing rationale. Timeline: Humana decides within
7 min read

The Complete Requirements Checklist to Get Firdapse (Amifampridine) Covered by UnitedHealthcare in Ohio: Forms, Appeals, and Approval Tips

Quick Answer: Getting Firdapse Covered by UnitedHealthcare in Ohio Yes, UnitedHealthcare covers Firdapse (amifampridine) for Lambert-Eaton myasthenic syndrome (LEMS) with prior authorization. The fastest path to approval requires: (1) confirmed LEMS diagnosis from a neurologist with EMG and antibody testing, (2) complete OptumRx prior authorization form with clinical documentation, and
6 min read