Topic

Helixate (antihemophilic factor, rFVIII)

A collection of 40 issues

Myths vs. Facts: Getting Helixate (Antihemophilic Factor rFVIII) Covered by UnitedHealthcare in Pennsylvania

Quick Answer: Helixate Coverage by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Helixate (antihemophilic factor rFVIII) in Pennsylvania, but coverage is available for confirmed hemophilia A patients. Submit requests via the UHC Provider Portal or call OptumRx at 866-889-8054 with diagnosis documentation (ICD-10 D66), factor VIII levels, and bleeding

How to Get Helixate (rFVIII) Covered by Humana in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Fast Track to Helixate Coverage Humana requires prior authorization for Helixate (recombinant factor VIII) in New Jersey. Submit via Humana's provider portal with hemophilia A diagnosis, factor VIII levels, inhibitor testing, and bleeding history. If denied, file internal appeals within 60 days, then use New Jersey&

UnitedHealthcare's Coverage Criteria for Helixate (Antihemophilic Factor rFVIII) in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Helixate Covered by UnitedHealthcare in Texas Important Update: Helixate and related products (Kogenate FS) were discontinued in the US by 2023. UnitedHealthcare now requires prior authorization for alternative rFVIII products like Kovaltry, Jivi, or Advate for hemophilia A treatment. Fastest Path to Coverage: 1. Have your hematologist

How to Get Helixate (Antihemophilic Factor, rFVIII) Covered by Aetna CVS Health in Washington: Complete Appeals Guide

Answer Box: Fast Track to Helixate Coverage Getting Helixate (antihemophilic factor, rFVIII) covered by Aetna CVS Health in Washington requires prior authorization through CVS Caremark specialty pharmacy. Start with your hematologist submitting a complete PA request via Aetna's Availity portal including confirmed hemophilia A diagnosis, factor VIII levels,

How to Get Helixate (Antihemophilic Factor, rFVIII) Covered by Blue Cross Blue Shield of North Carolina: Complete PA Guide and Appeal Scripts

Answer Box: Getting Helixate Covered by BCBS North Carolina Blue Cross Blue Shield of North Carolina requires prior authorization for Helixate (antihemophilic factor, rFVIII) as a specialty medication. Fastest path to approval: 1) Confirm your hematologist will prescribe through BCBSNC's Hemophilia Network pharmacy, 2) Submit PA with hemophilia

How to Get Helixate (antihemophilic factor, rFVIII) Covered by Aetna CVS Health in Ohio: Complete Prior Authorization and Appeals Guide 2024

Quick Answer: Getting Helixate (antihemophilic factor, rFVIII) Covered by Aetna CVS Health in Ohio Aetna CVS Health requires prior authorization for Helixate (antihemophilic factor, rFVIII) in Ohio. Submit your PA request through your hematologist with complete hemophilia A documentation, including factor VIII levels <1% (severe) or 1-5% (moderate), bleed

Do You Qualify for Helixate Coverage by Aetna CVS Health in Illinois? Decision Tree & Next Steps

Answer Box: Getting Helixate Covered by Aetna CVS Health in Illinois Helixate (antihemophilic factor, rFVIII) requires prior authorization with Aetna CVS Health and is typically covered for confirmed hemophilia A when medically necessary. Note: Kogenate FS was discontinued in 2022-2023, so patients need alternatives like Kovaltry, Jivi, or other factor

Getting Helixate (rFVIII) Covered by Blue Cross Blue Shield in Washington: Complete Appeals Guide with State Protections

Quick Answer: Your Path to Coverage Getting Helixate (antihemophilic factor, rFVIII) covered by Blue Cross Blue Shield in Washington requires navigating prior authorization, potential step therapy, and Washington's strong external review protections. Start with a formulary exception request through your plan's pharmacy services, backed by detailed

How to Get Helixate (Antihemophilic Factor, rFVIII) Covered by Aetna CVS Health in Michigan: Complete Coverage Guide with Appeals Process

Quick Answer: Getting Helixate Covered by Aetna CVS Health in Michigan Important Update: Helixate (antihemophilic factor, rFVIII) has been discontinued by the manufacturer. Aetna CVS Health now covers alternative factor VIII products like Kovaltry, Advate, and Jivi with prior authorization. First step: Contact your hematologist to select an alternative and

How to Get Helixate (Antihemophilic Factor, rFVIII) Covered by Blue Cross Blue Shield in New York: Complete PA and Appeals Guide

Answer Box: Getting Helixate Covered in New York Helixate (antihemophilic factor, rFVIII) requires prior authorization from Blue Cross Blue Shield in New York. Submit PA requests via the Availity ICR portal or fax 1-844-493-9206. If denied, file an internal appeal within 65 days, then pursue external review through NY Department