Topic

Florida

A collection of 417 issues

Oxbryta (Voxelotor) Coverage by UnitedHealthcare in Florida: Understanding the 2024 FDA Withdrawal and Your Options

Answer Box: Oxbryta Coverage Status Oxbryta (voxelotor) was voluntarily withdrawn from all U.S. markets in September 2024 due to increased risk of vaso-occlusive crises and deaths. UnitedHealthcare and all insurers have delisted the medication—no new claims or renewals are being approved. If you're currently taking Oxbryta,

Getting Symdeko/Symkevi Covered by UnitedHealthcare in Florida: Complete Prior Authorization Guide

Answer Box: Fastest Path to Approval Symdeko/Symkevi requires prior authorization from UnitedHealthcare in Florida. To get approved: (1) Have your CF specialist submit a PA request with genotype documentation showing F508del mutation via UnitedHealthcare's Provider Portal, (2) Include a medical necessity letter detailing your CF diagnosis and

How to Get Givlaari (Givosiran) Covered by UnitedHealthcare in Florida: Complete Prior Authorization Guide

Answer Box: Getting Givlaari Covered by UnitedHealthcare in Florida To get Givlaari (givosiran) covered by UnitedHealthcare in Florida, you must document acute hepatic porphyria with at least 2 qualifying attacks in the past 6 months, show failure/intolerance to hemin therapy, and obtain specialist prescribing. Submit prior authorization through the

How to Renew Enbrel (etanercept) Coverage with Cigna in Florida: Complete Timeline and Documentation Guide

Quick Answer: Renewing Enbrel Coverage with Cigna in Florida Start your Enbrel renewal 2-4 weeks before expiration. You'll need documented clinical benefit (improvement in disease activity scores), continued medical necessity from your rheumatologist, and recent lab results. Submit electronically via Cigna's provider portal or fax to

Renewing Vyondys 53 (Golodirsen) Coverage with Cigna in Florida: 2025 Requirements, Timeline & Evidence Guide

Answer Box: Vyondys 53 Renewal with Cigna in Florida Cigna requires annual renewal of Vyondys 53 (golodirsen) prior authorization for Duchenne Muscular Dystrophy patients in Florida. Start the renewal process 30-45 days before your current authorization expires to avoid treatment gaps. Required documentation includes updated clinical progress notes with current

How to Get Ibrance (Palbociclib) Covered by Cigna in Florida: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting Ibrance (Palbociclib) Covered by Cigna in Florida Fastest path to approval: Have your oncologist submit Cigna's prior authorization with documented HR+/HER2- metastatic breast cancer diagnosis, combination partner (aromatase inhibitor or fulvestrant), and any prior therapy failures. Use Accredo specialty pharmacy for coverage and cost

How to Get Jynarque (Tolvaptan) Covered by Humana in Florida: Complete Appeals Guide with Forms and Timelines

Quick Answer: Getting Jynarque Covered by Humana in Florida Yes, Humana covers Jynarque (tolvaptan) for ADPKD with prior authorization. Your fastest path: Submit PA request with Mayo Class 1C-1E documentation and eGFR decline >2.5 mL/min/year. If denied, file internal appeal within 65 days, then external review

Do You Qualify for Opsumit (Macitentan) Coverage by UnitedHealthcare in Florida? Decision Tree & Next Steps

Quick Answer: Opsumit Coverage by UnitedHealthcare in Florida Most likely eligible if: You have confirmed WHO Group 1 PAH, functional class II-IV symptoms, and a PAH specialist prescriber. Fastest approval path: Have your specialist submit prior authorization through UnitedHealthcare's provider portal with complete hemodynamic data and functional class

Getting Zokinvy (Lonafarnib) Covered by Cigna in Florida: Prior Authorization, Appeals, and Alternative Options

Answer Box: Getting Zokinvy Approved by Cigna in Florida Zokinvy (lonafarnib) requires prior authorization from Cigna and is typically covered on the specialty tier for FDA-approved indications (HGPS and processing-deficient progeroid laminopathies). Key requirements: genetic confirmation of LMNA mutation, patient ≥12 months old with BSA ≥0.39 m², and prescription

The Complete Requirements Checklist to Get Rezlidhia (Olutasidenib) Covered by Aetna CVS Health in Florida

Answer Box: Quick Path to Approval Rezlidhia (olutasidenib) requires prior authorization from Aetna CVS Health in Florida. To get approved: (1) Confirm your IDH1 mutation test results are documented, (2) gather records of failed prior AML therapies, and (3) have your hematologist/oncologist submit the PA request via Aetna'