Topic

Florida

A collection of 477 issues

Work With Your Doctor to Get Breyanzi (Lisocabtagene Maraleucel) Approved by UnitedHealthcare in Florida: Complete Provider Collaboration Guide

Quick Answer: Getting Breyanzi Approved in Florida Breyanzi (lisocabtagene maraleucel) requires UnitedHealthcare prior authorization for relapsed/refractory large B-cell lymphoma or CLL/SLL after ≥2 prior therapies. Your oncologist must submit documentation showing progression after standard treatments, confirm CD19 positivity, and demonstrate you meet FDA labeling criteria. Treatment must occur
6 min read

How to Get Garadacimab (Andembry) Covered by Humana in Florida: Formulary Alternatives, Appeals, and Prior Authorization Guide

Answer Box: Getting Garadacimab Covered by Humana in Florida Garadacimab (Andembry) is not on Humana's 2025 formulary, requiring a formulary exception with medical necessity documentation. Your fastest path: (1) Try preferred alternatives like Haegarda or Cinryze first if medically appropriate, (2) Document failure/intolerance to alternatives, then (3)
6 min read

How to Get Enhertu (fam-trastuzumab deruxtecan-nxki) Covered by Aetna CVS Health in Florida: Complete Prior Authorization Guide and Appeals Process

Answer Box: Getting Enhertu Covered by Aetna CVS Health in Florida Enhertu (fam-trastuzumab deruxtecan-nxki) requires prior authorization from Aetna CVS Health for all FDA-approved indications. The fastest path to approval: (1) Submit Aetna's Enhertu precertification form (GR-69531 5-24) with HER2 testing results and prior therapy documentation, (2) Include
6 min read

How to Get Oxervate (Cenegermin) Covered by Blue Cross Blue Shield in Florida: Complete Prior Authorization Guide

Answer Box: Getting Oxervate Approved by Florida Blue Florida Blue requires prior authorization (PA) for Oxervate (cenegermin) with specific criteria: confirmed stage 2 or 3 neurotrophic keratitis, documented failure of preservative-free artificial tears for ≥2 weeks, and corneal sensitivity testing results. Submit PA via Availity.com or call 1-877-719-2583. First
6 min read

How to Get Carbaglu (Carglumic Acid) Covered by UnitedHealthcare in Florida: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Carbaglu Covered by UnitedHealthcare in Florida UnitedHealthcare requires prior authorization for Carbaglu (carglumic acid) with 12-month approvals for hyperammonemia due to NAGS deficiency, propionic acidemia, or methylmalonic acidemia. Key requirements include genetic testing confirmation, elevated ammonia levels, and metabolic specialist oversight. If denied, you have 180 days
5 min read

How to Get Kineret (anakinra) Covered by Aetna (CVS Health) in Florida: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Kineret (anakinra) Approved by Aetna (CVS Health) in Florida Aetna (CVS Health) requires prior authorization for Kineret (anakinra) with specific criteria: moderately to severely active rheumatoid arthritis in adults 18+, prescription from a rheumatologist, and documented failure of at least one traditional DMARD like methotrexate. Submit your
7 min read

The Requirements Checklist to Get Ofev (nintedanib) Covered by UnitedHealthcare in Florida: PA Forms, Appeals, and Success Strategies

Answer Box: Getting Ofev (nintedanib) Covered by UnitedHealthcare in Florida UnitedHealthcare requires prior authorization for Ofev (nintedanib) to treat idiopathic pulmonary fibrosis (IPF), systemic sclerosis-associated interstitial lung disease (SSc-ILD), and chronic fibrosing ILD with progressive phenotype. Initial approval lasts 12 months with documented progression evidence required. First step today: Gather
5 min read