Topic

Florida

A collection of 418 issues

How to Get Poteligeo (mogamulizumab-kpkc) Covered by Cigna in Florida: Complete Guide to Prior Authorization and Appeals

Quick Answer: Getting Poteligeo Covered by Cigna in Florida Cigna requires prior authorization for Poteligeo (mogamulizumab-kpkc) through Express Scripts/Accredo with decisions within 72 hours (24 hours if expedited). You'll need complete TNMB staging documentation, proof of mycosis fungoides or Sézary syndrome diagnosis, and evidence of prior systemic

How to Get Taltz (ixekizumab) Covered by Cigna in Florida: Prior Authorization Forms, Appeals Timeline, and Approval Strategies

Answer Box: Getting Taltz (ixekizumab) Covered by Cigna in Florida Taltz (ixekizumab) requires prior authorization from Cigna in Florida and typically mandates step therapy with a TNF inhibitor first. Your prescriber must submit a PA request via electronic portal, CoverMyMeds, or fax to 866-873-8279 with documented TNF inhibitor failure/intolerance

Get Dupixent (Dupilumab) Covered by Humana in Florida: Appeals Guide & Templates

Quick Answer: Getting Dupixent Covered by Humana in Florida Most Humana Medicare Advantage plans require prior authorization for Dupixent (dupilumab) with step therapy requirements. Your prescriber must document failed trials of lower-cost alternatives and submit detailed medical necessity documentation. If denied, you have 65 days to appeal internally, followed by

Myths vs. Facts: Getting Cometriq (Cabozantinib) Covered by Aetna (CVS Health) in Florida

Answer Box: Getting Cometriq (Cabozantinib) Covered by Aetna (CVS Health) in Florida Eligibility: Aetna covers Cometriq (cabozantinib capsules) for metastatic medullary thyroid carcinoma with prior authorization. Fastest path: Submit PA with confirmed MTC diagnosis, elevated calcitonin levels, and imaging showing metastatic disease. First step today: Verify your plan's

How to Get Oxlumo (Lumasiran) Covered by Cigna in Florida: Complete Forms, Appeals & Timeline Guide

Answer Box: To get Oxlumo (lumasiran) covered by Cigna in Florida, you need: (1) confirmed PH1 diagnosis with genetic testing showing biallelic AGXT variants, (2) elevated urinary oxalate levels, and (3) prescription from a nephrologist or urologist. Start by downloading Cigna's Oxlumo Prior Authorization Form and faxing completed

Myths vs. Facts: Getting Elevidys Gene Therapy Covered by Humana in Florida (2024 Guide)

Answer Box: Fast Track to Elevidys Coverage Elevidys requires prior authorization from Humana in Florida. The fastest path: confirm your child has genetic DMD confirmation (no exon 8/9 deletion), anti-AAVrh74 antibody titer <1:400, and get referred to an MDA-certified center like Nemours Orlando or UF Fixel Institute.

Myths vs. Facts: Getting Duopa (carbidopa/levodopa enteral) Covered by Blue Cross Blue Shield in Florida

Quick Answer: Duopa (carbidopa/levodopa enteral) requires prior authorization from Blue Cross Blue Shield Florida. Success depends on documenting advanced Parkinson's disease with ≥2 hours daily "OFF" time, failed oral therapies, and surgical candidacy for PEG-J tube placement. Submit via CoverMyMeds or call 1-877-719-2583. If denied,

Get Alprolix Covered by Cigna in Florida: Forms, Appeals & Approval Timeline

Answer Box: Getting Alprolix Covered by Cigna in Florida Cigna requires prior authorization for Alprolix (coagulation factor IX, rFIXFc; eftrenonacog alfa) in Florida. Your hematologist must submit the Clotting Factors Prior Authorization Form with diagnosis, bleeding history, and medical necessity documentation. Standard review takes 5 business days; expedited reviews complete

How to Get Arikayce Covered by Blue Cross Blue Shield in Florida: Complete Appeals Guide with Templates

Answer Box: Getting Arikayce Covered by Florida Blue Cross Blue Shield Fastest path to approval: Submit prior authorization through Florida Blue's provider portal with documented evidence of refractory MAC lung disease (≥6 months positive cultures despite multidrug therapy). If denied, file internal appeal within 180 days, then external

Myths vs. Facts: Getting Dupixent (dupilumab) Covered by Aetna CVS Health in Florida

Answer Box: The Reality of Dupixent Coverage with Aetna CVS Health in Florida Fact: Dupixent requires prior authorization through Aetna CVS Health in Florida, regardless of your doctor's prescription. Fastest path to approval: Submit complete PA documentation showing diagnosis severity, failed prior therapies (topical steroids for atopic dermatitis,