Topic

Humana

A collection of 1100 issues

How to Get Prolastin-C Covered by Humana in Florida: Appeals, Timelines, and Renewal Guide

Answer Box: Getting Prolastin-C Covered by Humana in Florida Eligibility: Prolastin-C requires prior authorization from Humana with documented severe alpha-1 antitrypsin deficiency (typically Pi*ZZ genotype), emphysema, and failure of preferred agent Aralast. Fastest path: Submit complete PA request with genotype results, pulmonary function tests, and specialist letter through Humana&
6 min read

Renewing Alecensa (alectinib) Coverage with Humana in New York: Annual Requirements, Timeline, and Appeals Process

Answer Box: Renewing Your Alecensa Coverage Humana Medicare Advantage requires annual prior authorization renewal for Alecensa (alectinib) with updated clinical documentation. Start the renewal process 60 days before your current approval expires. Submit: updated ALK-positive test results, recent imaging showing stable disease or response (RECIST criteria), current lab values (CBC,
6 min read

How to Get Idelvion (albutrepenonacog alfa) Covered by Humana in North Carolina: Prior Authorization, Appeals, and Medical Necessity Guide

Answer Box: Getting Idelvion Covered by Humana in North Carolina Idelvion requires prior authorization from Humana Medicare Advantage plans in North Carolina. You'll need confirmed hemophilia B diagnosis (Factor IX <40%), documented step therapy attempts with standard products, and clinical justification for extended half-life therapy. Start today:
5 min read

How to Get Enbrel (Etanercept) Covered by Humana in Pennsylvania: Prior Authorization, Appeals & Medical Necessity Guide

Answer Box: Getting Enbrel Covered by Humana in Pennsylvania Humana requires prior authorization for Enbrel (etanercept) in Pennsylvania, with step therapy protocols favoring biosimilars first. To get coverage: (1) Have your rheumatologist/dermatologist submit a prior authorization request with complete medical necessity documentation, including TB screening and failed therapy history,
6 min read

How to Get Trikafta (Elexacaftor/Tezacaftor/Ivacaftor) Covered by Humana in Georgia: Prior Authorization, Appeals, and Alternative Options

Quick Answer: Getting Trikafta Covered by Humana in Georgia Trikafta requires prior authorization from Humana with CFTR genotype documentation, specialist prescription, and baseline labs. Most denials stem from missing mutation testing or incomplete clinical records. If denied, you have 65 days to appeal through Medicare's federal process, not
6 min read