Topic

Koselugo (selumetinib)

A collection of 33 issues

UnitedHealthcare's Coverage Criteria for Koselugo (Selumetinib) in New Jersey: What Counts as "Medically Necessary"?

Answer Box: Getting Koselugo Covered by UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization for Koselugo (selumetinib) under both medical and pharmacy benefits, with no step therapy requirements for pediatric NF1 plexiform neurofibromas. Medical necessity requires confirmed NF1 diagnosis with symptomatic, inoperable plexiform neurofibromas, baseline LVEF assessment, and ophthalmologic evaluation.
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How to Get Koselugo (selumetinib) Covered by Cigna in Pennsylvania: Prior Authorization Guide and Appeals Process

Answer Box: Getting Koselugo (selumetinib) Covered by Cigna in Pennsylvania Koselugo (selumetinib) requires prior authorization from Cigna for pediatric patients with neurofibromatosis type 1 (NF1) and symptomatic, inoperable plexiform neurofibromas. Your prescriber must document NF1 diagnosis, imaging showing inoperable plexiform neurofibromas, baseline heart function (LVEF), and eye exam results. If
6 min read

How to Get Koselugo (selumetinib) Covered by Aetna (CVS Health) in California: Complete Prior Authorization Guide with Forms and Appeals

Answer Box: Getting Koselugo (selumetinib) Covered by Aetna (CVS Health) in California Who's eligible: Pediatric patients (≥1 year) with neurofibromatosis type 1 (NF1) and symptomatic, inoperable plexiform neurofibromas. Fastest approval path: Submit prior authorization via CVS Caremark portal with complete NF1 documentation, baseline cardiac/eye exams, and surgical
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The Requirements Checklist to Get Koselugo (Selumetinib) Covered by Cigna in Michigan: Forms, Appeals, and Clinical Criteria

Answer Box: Quick Path to Koselugo Coverage Cigna requires prior authorization (PA) for Koselugo (selumetinib) in pediatric NF1 patients with symptomatic, inoperable plexiform neurofibromas. Initial approvals last 1 year with reauthorization requiring evidence of benefit. Key requirements: confirmed NF1 diagnosis (ICD-10 Q85.01), baseline LVEF evaluation, ophthalmologic exam, and MRI
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Get Koselugo (Selumetinib) Covered by Aetna CVS Health in New York: Complete Guide to Prior Authorization and Appeals

Answer Box: Quick Path to Approval Koselugo (selumetinib) requires prior authorization from Aetna CVS Health for pediatric patients ≥2 years with NF1 and symptomatic, inoperable plexiform neurofibromas. Your prescriber submits the PA with baseline LVEF (echocardiogram) and ophthalmologic evaluation results. Standard decisions take 30-45 days; expedited reviews complete within 72
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Work With Your Doctor to Get Koselugo (Selumetinib) Approved by UnitedHealthcare in Ohio: Complete Provider Collaboration Guide

Answer Box: Getting Koselugo Covered by UnitedHealthcare in Ohio Koselugo (selumetinib) requires prior authorization from UnitedHealthcare for pediatric patients ≥2 years with NF1 plexiform neurofibromas. Your doctor must submit clinical documentation proving NF1 diagnosis, inoperable symptomatic tumors, and baseline safety evaluations. If denied, you have 180 days for internal appeals,
6 min read