Topic

Kalydeco (ivacaftor)

A collection of 37 issues

Getting Kalydeco (Ivacaftor) Covered by Aetna CVS Health in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Fastest Path to Kalydeco Approval in North Carolina Aetna CVS Health requires prior authorization for Kalydeco (ivacaftor) with CFTR genetic testing confirming FDA-approved mutations (like G551D), CF specialist prescription, and baseline labs. Submit via Availity portal with genetic test results, specialist notes, and pulmonary function tests. If denied,
6 min read

How to Get Kalydeco (ivacaftor) Covered by Blue Cross Blue Shield in Illinois: Prior Authorization, Appeals, and Medical Necessity Requirements

Answer Box: Getting Kalydeco Covered in Illinois Blue Cross Blue Shield of Illinois requires prior authorization for Kalydeco (ivacaftor) based on confirmed cystic fibrosis diagnosis and FDA-approved CFTR mutation. Fastest path: Have your CF specialist submit PA through MyPrime portal with genetic testing, baseline lung function, and mutation documentation. If
6 min read

Lowering Out-of-Pocket for Kalydeco (ivacaftor) with Aetna (CVS Health) in Michigan: Copay Cards, Appeals & Financial Assistance

Answer Box: Getting Kalydeco Covered in Michigan Aetna (CVS Health) covers Kalydeco (ivacaftor) as a specialty drug requiring prior authorization and CFTR genotype confirmation. Michigan patients can access up to $20,000 annual copay assistance through Vertex GPS (commercial insurance only), plus foundation grants. First step today: Have your CF
6 min read

Renewing Approval for Kalydeco (Ivacaftor) with Blue Cross Blue Shield in California: What to Prepare & When

Answer Box: Kalydeco Renewal Essentials Renew your Kalydeco (ivacaftor) authorization with Blue Cross Blue Shield of California 2-4 weeks before expiration. Submit via AuthAccel portal with updated clinic notes, liver function tests, FEV₁ data, and adherence documentation. Most renewals require proof of ongoing benefit (stable/improved lung function, reduced exacerbations)
6 min read

How to Get Kalydeco (ivacaftor) Covered by UnitedHealthcare in Washington: Complete Prior Authorization Guide with Appeals

Answer Box: Getting Kalydeco Covered by UnitedHealthcare in Washington UnitedHealthcare requires prior authorization for Kalydeco (ivacaftor) based on confirmed cystic fibrosis diagnosis and FDA-approved CFTR mutations (like G551D, R117H) without step therapy requirements. Submit via the UnitedHealthcare Provider Portal with genetic test results, CF specialist documentation, and baseline liver function
6 min read

The Requirements Checklist to Get Kalydeco (ivacaftor) Covered by UnitedHealthcare in Pennsylvania: Complete PA Guide with Forms and Appeals

Answer Box: Fast Track to Kalydeco Coverage To get Kalydeco (ivacaftor) covered by UnitedHealthcare in Pennsylvania: Submit prior authorization through OptumRx with confirmed cystic fibrosis diagnosis, FDA-cleared CFTR genetic test showing responsive mutation (like G551D or R117H), and CF specialist documentation. If denied, use Pennsylvania's Independent External Review—
5 min read