Topic

Kalydeco (ivacaftor)

A collection of 32 issues

How to Get Kalydeco (ivacaftor) Covered by Humana in Florida: Complete Appeals Guide with Forms and Timelines

Quick Answer: Getting Kalydeco Covered by Humana in Florida Kalydeco (ivacaftor) requires prior authorization from Humana and is typically placed on Tier 5 (Specialty) with higher cost-sharing. Your cystic fibrosis specialist must submit genetic testing results confirming a responsive CFTR mutation (like G551D or R117H), clinical documentation, and a medical

How to Get Kalydeco (ivacaftor) Covered by Blue Cross Blue Shield in Washington: Costs, Appeals, and Financial Assistance

Quick Answer: Getting Kalydeco (ivacaftor) Covered in Washington Blue Cross Blue Shield (BCBS) plans in Washington require prior authorization for Kalydeco (ivacaftor) with documented CFTR mutation testing. Most plans place it on specialty tiers (Tier 5-6) with costs ranging from $3,500-$8,950 monthly depending on your coverage. First

How to Get Kalydeco (ivacaftor) Covered by Humana in Ohio: Complete Guide with Appeals Process and Forms

Quick Answer: Getting Kalydeco (ivacaftor) Covered by Humana in Ohio Kalydeco requires prior authorization from Humana in Ohio. You need genetic test results showing a responsive CFTR mutation (like G551D or R117H), a prescription from a CF specialist, and complete clinical documentation. The fastest path: 1) Gather your genetic testing

Getting Kalydeco (Ivacaftor) Covered by Cigna in Michigan: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Kalydeco (Ivacaftor) Covered by Cigna in Michigan Eligibility: Patients with cystic fibrosis and documented FDA-approved CFTR mutations responsive to ivacaftor can get Kalydeco covered by Cigna with proper documentation. Fastest Path: 1) Gather CFTR genotype test results and CF diagnosis documentation, 2) Have your CF specialist submit

How Long Does It Take to Get Kalydeco (ivacaftor) Approved by UnitedHealthcare in New York? Complete Timeline & Appeals Guide

Answer Box: Getting Kalydeco Approved by UnitedHealthcare in New York Timeline: 3-14 days for initial decision. UnitedHealthcare must respond to Kalydeco prior authorization requests within 3 business days (non-urgent) or 24 hours (urgent) under New York state law. Most approvals happen within 5-7 days when complete documentation is submitted. Required:

How to Get Kalydeco (Ivacaftor) Covered by Humana in Michigan: Complete Appeals Guide with Forms and Timelines

Quick Answer: Getting Kalydeco Covered by Humana in Michigan Kalydeco (ivacaftor) requires prior authorization from Humana and costs approximately $369,255 annually without coverage. To get approved: (1) Submit PA request with CFTR genetic testing showing responsive mutation (G551D, R117H, etc.), (2) Include specialist documentation from CF center, (3) If

How to Get Kalydeco (ivacaftor) Covered by Blue Cross Blue Shield in Pennsylvania: Complete Appeals Guide with Forms and Timelines

Quick Answer: Getting Kalydeco Covered by Blue Cross Blue Shield in Pennsylvania Kalydeco (ivacaftor) requires prior authorization from Blue Cross Blue Shield plans in Pennsylvania. Key requirements: confirmed cystic fibrosis diagnosis, CFTR genetic testing showing a responsive mutation (like G551D or R117H), and prescription by a CF specialist. If denied,

How to Get Kalydeco (ivacaftor) Covered by Horizon Blue Cross Blue Shield New Jersey: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Kalydeco Covered in New Jersey Horizon Blue Cross Blue Shield of New Jersey requires prior authorization for Kalydeco (ivacaftor). The fastest path to approval: 1) Confirm your CFTR mutation testing shows an FDA-approved responsive mutation, 2) Have your CF specialist submit the PA request through Horizon'

How to Get Kalydeco (ivacaftor) Covered by Aetna CVS Health in Florida: Complete Guide to Forms, Appeals, and Copay Assistance

Quick Answer: Getting Kalydeco (ivacaftor) Covered by Aetna CVS Health in Florida Kalydeco requires prior authorization from Aetna CVS Health with documented cystic fibrosis diagnosis and FDA-responsive CFTR mutation testing. Your prescriber must submit clinical documentation through CVS Specialty Pharmacy, not retail locations. If denied, Florida residents have 180 days

How to Get Kalydeco (ivacaftor) Covered by Cigna in Virginia: Complete Prior Authorization Guide

Quick Answer: Getting Kalydeco (ivacaftor) Covered by Cigna in Virginia To get Kalydeco approved by Cigna in Virginia, you need: (1) documented CFTR mutation testing showing an eligible variant (not homozygous F508del), (2) cystic fibrosis diagnosis with ICD-10 code E84.0, and (3) prior authorization submission through Cigna's