Topic

Humana

A collection of 1023 issues

How to Get Givlaari (givosiran) Covered by Humana in North Carolina: Complete Appeals Guide with Templates

Answer Box: Getting Givlaari (givosiran) Covered by Humana in North Carolina Humana requires prior authorization for Givlaari (givosiran) for acute hepatic porphyria. To get approved: (1) Have your specialist document ≥2 attacks in the past 6 months plus elevated ALA/PBG levels, (2) Submit PA through Humana's provider

How to Get Venclexta (venetoclax) Covered by Humana in New York: Prior Authorization, Appeals, and TLS Monitoring Guide

Answer Box: Getting Venclexta Covered by Humana in New York Venclexta (venetoclax) requires prior authorization from Humana due to its high cost (~$15,620/month) and tumor lysis syndrome (TLS) risks. Your oncologist must submit documentation including confirmed CLL/AML diagnosis, TLS monitoring plan with baseline labs, and justification if

How to Get Darzalex / Darzalex Faspro (daratumumab) Covered by Humana in Illinois: Timeline, Appeals, and Prior Authorization Guide

Answer Box: Getting Darzalex / Darzalex Faspro Approved by Humana in Illinois Humana requires prior authorization for Darzalex/Darzalex Faspro (daratumumab) for multiple myeloma, typically deciding within 7 days for standard requests or 72 hours for expedited cases. Your oncologist submits via Humana's provider portal with diagnosis, prior therapy

Takhzyro (lanadelumab-flyo) Approval with Humana in New York: Answers to the Most Common Questions

Answer Box: Getting Takhzyro Covered by Humana in New York Takhzyro (lanadelumab-flyo) requires prior authorization from Humana for hereditary angioedema (HAE) prophylaxis. You'll need confirmed HAE type I/II diagnosis with lab documentation, specialist prescriber, and evidence of prior therapy failures. If denied, New York residents can file

How to Get Sumavel DosePro (Sumatriptan Injection, Needle-Free) Covered by Humana in Pennsylvania: Complete Prior Authorization Guide

Answer Box: Getting Sumavel DosePro Covered by Humana in Pennsylvania Sumavel DosePro (needle-free sumatriptan injection) was discontinued in the U.S., but generic sumatriptan auto-injectors remain available. For Humana Medicare Advantage/Part D coverage in Pennsylvania: 1) Check if your plan requires prior authorization or step therapy through oral triptans

How to Get Givlaari (givosiran) Covered by Humana in Washington: Complete Appeals Guide with Templates

Answer Box: Quick Path to Givlaari Coverage Humana requires prior authorization for Givlaari (givosiran) in Washington. You'll need: confirmed acute hepatic porphyria (AHP) diagnosis with elevated ALA/PBG labs, ≥2 attacks in past 6 months, specialist prescriber, and documented hemin use/failure. First step today: Call Humana member

Qinlock (Ripretinib) Approval with Humana in Virginia: Answers to the Most Common Questions

Answer Box: Getting Qinlock Covered by Humana in Virginia Qinlock (ripretinib) requires prior authorization from Humana with documented failure of three prior kinase inhibitors: imatinib, sunitinib, and regorafenib. Submit PA via Humana's provider portal with complete treatment history, pathology confirming advanced GIST, and imaging showing disease progression. Standard

How to Get Emgality (galcanezumab-gnlm) Covered by Humana in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Emgality (galcanezumab-gnlm) requires prior authorization from Humana in New Jersey, but you have strong protections under state law. First step: Have your doctor submit a PA request documenting failed preventive treatments and citing New Jersey's step therapy exception requirements (P.L. 2025, c.50). If denied,

How to Get Enhertu (Fam-Trastuzumab Deruxtecan-nxki) Approved by Humana in Virginia: Timeline, Forms & Appeal Process

Answer Box: Your Path to Enhertu Coverage Getting Enhertu (fam-trastuzumab deruxtecan-nxki) covered by Humana in Virginia requires prior authorization with HER2 testing documentation and medical necessity justification. Standard decisions take 7-14 days; expedited reviews complete within 72 hours if your health is at serious risk. Start by having your oncologist

How to Get Adynovate (Antihemophilic Factor) Covered by Humana in Pennsylvania: Prior Authorization, Appeals, and Cost Assistance

Answer Box: Getting Adynovate Covered by Humana in Pennsylvania Adynovate (antihemophilic factor, PEGylated) requires prior authorization from Humana but is listed as a preferred Factor VIII product for hemophilia A treatment. For Medicare Advantage members, submit PA requests through your specialty pharmacy or hemophilia treatment center with diagnosis confirmation, factor