Topic

Humana

A collection of 1102 issues

Getting Ilaris (Canakinumab) Covered by Humana in Ohio: Prior Authorization Guide and Appeal Process

Answer Box: Quick Path to Ilaris Coverage Ilaris (canakinumab) requires prior authorization from Humana in Ohio and is typically not on standard formularies. Fastest approval path: Have your rheumatologist submit a detailed medical necessity letter documenting failed step therapy (tocilizumab, adalimumab, or anakinra), elevated inflammatory markers, and specific diagnosis codes.

Getting Helixate (Factor VIII) Covered by Humana in Washington: Prior Authorization Guide and Appeal Process

Quick Answer: Getting Helixate Covered by Humana in Washington Helixate (recombinant Factor VIII) requires prior authorization from Humana and may face formulary challenges since related products like Kogenate FS were discontinued in the US. Your fastest path to approval: (1) Have your hematologist submit a complete prior authorization request with

Renewing Pombiliti (Cipaglucosidase Alfa) Approval with Humana in Ohio: Timeline, Documentation & Bridge Options

Answer Box: Renewing Pombiliti Coverage with Humana in Ohio Humana Medicare Advantage requires prior authorization renewal for Pombiliti (cipaglucosidase alfa) before your current approval expires. Submit renewal requests 2-4 weeks early with updated clinical documentation showing continued medical necessity and treatment response. If coverage lapses, contact Amicus ASSIST at 1-833-264-2872

Renewing Pomalyst (pomalidomide) Approval with Humana in North Carolina: Complete Timeline and Documentation Guide

Answer Box: Quick Path to Pomalyst Renewal in North Carolina Humana Medicare Advantage requires renewal documentation every 12 months for Pomalyst (pomalidomide) coverage. Start your renewal 60-90 days before expiration to avoid gaps. Required documents: updated medical necessity letter from oncologist, recent labs showing disease status, REMS compliance confirmation, and

Work With Your Doctor to Get Helixate (Antihemophilic Factor, rFVIII) Covered by Humana in Illinois: Provider Partnership Guide

Quick Answer: Getting Helixate Covered by Humana in Illinois Yes, Humana Medicare Advantage requires prior authorization for Helixate (recombinant Factor VIII) in Illinois. The fastest path to approval is working closely with your hematologist to submit comprehensive documentation through Humana's online portal or by calling 800-523-0023. Your first

The Complete Checklist to Get Krystexxa (Pegloticase) Covered by Humana in New York

Answer Box: Getting Krystexxa Covered by Humana in New York Eligibility: Patients with chronic gout refractory to allopurinol and febuxostat who have G6PD testing completed and serum uric acid >6 mg/dL. Fastest Path: Submit prior authorization through Humana's provider portal with medical necessity letter documenting failed

Do You Qualify for Blenrep (Belantamab Mafodotin) Coverage by Humana in Ohio? Decision Tree & Next Steps

Answer Box: Quick Eligibility & Action Plan Blenrep (belantamab mafodotin) was reapproved by the FDA on October 23, 2025 for relapsed/refractory multiple myeloma after ≥2 prior therapies. For Humana coverage in Ohio: (1) Confirm your diagnosis meets FDA criteria, (2) Have your oncologist submit prior authorization with clinical documentation

How to Get Tecentriq (Atezolizumab) Covered by Humana in Texas: Forms, Appeals, and Provider Contacts

Answer Box: Getting Tecentriq (Atezolizumab) Covered by Humana in Texas Tecentriq (atezolizumab) requires prior authorization from Humana Medicare Advantage plans in Texas and is subject to step therapy requirements. The fastest path to approval involves three key steps: (1) Have your oncologist call Humana at 866-461-7273 to initiate prior authorization,

How to Get Soliris (Eculizumab) Covered by Humana in California: Complete Prior Authorization Guide

Answer Box: Getting Soliris Covered by Humana in California Humana requires prior authorization for Soliris (eculizumab) in California, with strict clinical criteria based on FDA-approved indications. Your fastest path to approval: 1) Confirm your diagnosis meets FDA criteria (PNH, aHUS, gMG, or NMOSD) with supporting lab work, 2) Submit a

Myths vs. Facts: Getting Filsuvez (Birch Triterpenes Gel) Covered by Humana in North Carolina

Quick Answer: Your Path to Filsuvez Coverage Getting Filsuvez (birch triterpenes topical gel) covered by Humana in North Carolina requires prior authorization with specific epidermolysis bullosa documentation. Fast track: Submit genetic test results showing COL7A1 mutations (for dystrophic EB) or appropriate junctional EB genes, plus specialist confirmation and wound documentation.