Topic

Florida

A collection of 418 issues

Renewing Xembify (Immune Globulin, SC) Approval with Aetna CVS Health in Florida: Timeline, Documentation & Appeal Guide

Answer Box: Renewing Your Xembify Coverage in Florida Aetna CVS Health requires annual prior authorization renewal for Xembify (immune globulin, SC) in Florida. Start your renewal 2-3 weeks before expiration by submitting updated clinical documentation through the Aetna provider portal. Required documents include current IgG levels, infection history, and physician

Work With Your Doctor to Get Humate-P Covered by UnitedHealthcare in Florida: Prior Authorization Guide and Appeal Process

Answer Box: Getting Humate-P Covered by UnitedHealthcare in Florida Humate-P requires prior authorization from UnitedHealthcare for both hemophilia A and von Willebrand disease. For VWD, you must have severe disease OR mild/moderate VWD with documented desmopressin failure. Your doctor submits requests through the UnitedHealthcare Provider Portal or by calling

How to Get Gamifant (Emapalumab) Covered by UnitedHealthcare in Florida: Prior Authorization Guide and Appeal Process

Quick Answer: Getting Gamifant Covered in Florida Gamifant (emapalumab) requires prior authorization from UnitedHealthcare in Florida as of October 2025. The fastest path to approval: 1) Have your hematologist submit clinical documentation proving HLH diagnosis via HLH-2004 criteria, 2) Document failed conventional therapies (etoposide, steroids), and 3) Submit through the

How to Get Procysbi (Cysteamine Bitartrate DR) Covered by Blue Cross Blue Shield in Florida: 2025 Appeals Guide

Answer Box: Getting Procysbi Covered by Florida Blue Cross Blue Shield Fastest path to approval: Contact Florida Blue at 1-877-719-2583 for prior authorization. If denied, you have 180 days to file an internal appeal, followed by external review through Florida's Department of Financial Services. Florida's new

Tracleer (Bosentan) Approval with UnitedHealthcare in Florida: Answers to the Most Common Questions

Answer Box: Quick Path to Tracleer Coverage Tracleer (bosentan) requires prior authorization from UnitedHealthcare in Florida, with strict REMS program compliance. Your prescriber must be a specialist (cardiologist, pulmonologist, or rheumatologist), enroll both you and themselves in the Bosentan REMS program, and submit comprehensive PAH documentation. First step today: Confirm

How to Get Evkeeza (Evinacumab) Covered by Blue Cross Blue Shield in Florida: Complete Coding, Appeals & Authorization Guide

Quick Answer: Getting Evkeeza Covered in Florida Evkeeza (evinacumab-dgnb) requires prior authorization from Florida Blue Cross Blue Shield for homozygous familial hypercholesterolemia (HoFH). Your fastest path: 1) Confirm HoFH diagnosis with genetic testing and LDL-C ≥100 mg/dL, 2) Document failed trials of statins, ezetimibe, and PCSK9 inhibitors, 3) Submit

How to Get Evkeeza (evinacumab-dgnb) Covered by UnitedHealthcare in Florida: Prior Authorization Guide & Appeal Process

Answer Box: Getting Evkeeza Covered by UnitedHealthcare in Florida Evkeeza (evinacumab-dgnb) requires prior authorization from UnitedHealthcare in Florida. To get approved: (1) Confirm your HoFH diagnosis with genetic testing or clinical criteria, (2) Document failure/intolerance of background therapies (statins, ezetimibe, PCSK9 inhibitors), and (3) Submit through the UnitedHealthcare Provider

How to Get Jaypirca (Pirtobrutinib) Covered by Cigna in Florida: Complete Prior Authorization and Appeal Guide

Answer Box: Getting Jaypirca Covered by Cigna in Florida Jaypirca (pirtobrutinib) requires prior authorization from Cigna in Florida. Key requirements: documented failure/intolerance to prior BTK inhibitors (Imbruvica, Calquence, or Brukinsa), plus BCL-2 inhibitor for CLL/SLL patients. Submit PA through CoverMyMeds or call 1-800-882-4462. If denied, you have 65

How to Get Raxone (Idebenone) Covered by Blue Cross Blue Shield in Florida: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Raxone Covered by Florida Blue Cross Blue Shield Quick Answer: Raxone (idebenone) requires prior authorization from Florida Blue Cross Blue Shield for LHON treatment. Since it's not FDA-approved in the US, coverage depends on comprehensive medical necessity documentation including genetic LHON confirmation, failed alternatives, and

How to Get Koselugo (Selumetinib) Covered by Blue Cross Blue Shield in Florida: Complete Guide to Prior Authorization, Appeals, and Approval Success

Quick Answer: Getting Koselugo Covered by Florida Blue Cross Blue Shield Koselugo (selumetinib) is covered by Florida Blue Cross Blue Shield for pediatric patients (≥2 years) with NF1 and symptomatic, inoperable plexiform neurofibromas. Coverage requires prior authorization with specific documentation: confirmed NF1 diagnosis, baseline cardiac (LVEF) and eye exams, and