Topic

Lutathera (lutetium Lu-177 dotatate)

A collection of 35 issues

How to Get Lutathera (lutetium Lu-177 dotatate) Covered by UnitedHealthcare in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Your Fastest Path to Lutathera Coverage Lutathera requires prior authorization from UnitedHealthcare OptumRx for somatostatin receptor-positive GEP-NETs. Submit PA through the UHC Provider Portal with SSTR-positive imaging (Ga-68 DOTATATE PET), documented progression on somatostatin analogs, and NCCN guideline support. If denied, file internal appeal within 180 days, then
5 min read

How to Get Lutathera (Lutetium Lu-177 Dotatate) Covered by Cigna in Ohio: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Lutathera Covered by Cigna in Ohio Yes, Cigna covers Lutathera (lutetium Lu-177 dotatate) for somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors, but prior authorization is required. Your fastest path to approval: 1) Have your oncologist submit a PA request with SSTR-positive imaging (Ga-68 DOTATATE PET/CT), pathology confirming well-differentiated
6 min read

How to Get Lutathera Covered by Blue Cross Blue Shield in California: Complete Forms, Portal & Appeals Guide

Answer Box: Getting Lutathera Approved by Blue Cross Blue Shield California Blue Cross Blue Shield California requires prior authorization for Lutathera (lutetium Lu-177 dotatate) as a medical benefit drug for somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Submit requests via your oncologist through the AuthAccel online system or contact Evolent at
7 min read

Work With Your Doctor to Get Lutathera (Lutetium Lu-177 Dotatate) Approved by Humana in Virginia: Complete Provider Collaboration Guide

Answer Box: Getting Lutathera Covered by Humana in Virginia Lutathera (lutetium Lu-177 dotatate) requires prior authorization from Humana Medicare Advantage plans in Virginia, with step therapy requirements for non-preferred status. Your oncologist must document somatostatin receptor-positive imaging (Ga-68 DOTATATE PET), failed prior treatments, and medical necessity. If denied, Virginia'
5 min read

Work With Your Doctor to Get Lutathera Approved by Blue Cross Blue Shield in Georgia: Complete Prior Authorization Guide

Quick Answer: Blue Cross Blue Shield of Georgia (Anthem BCBS GA) requires prior authorization for Lutathera for somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. You'll need SSTR-positive imaging, documented progression on octreotide/lanreotide, and an oncologist's letter of medical necessity. If denied, Georgia allows external review within 60
7 min read

How to Get Lutathera Covered by Humana in California: Prior Authorization Forms, Appeal Process & Success Strategies

Answer Box: Getting Lutathera Covered by Humana in California Lutathera (lutetium Lu-177 dotatate) requires prior authorization from Humana and is covered under Medicare Part B as a medical benefit. Key requirements include SSTR-positive PET imaging and documented failure/progression on somatostatin analogs like octreotide or lanreotide. If denied, California residents
7 min read

How to Get Lutathera (Lutetium Lu-177 Dotatate) Covered by Blue Cross Blue Shield in North Carolina: Complete Guide with Forms and Appeals

Answer Box: Getting Lutathera Covered by Blue Cross Blue Shield in North Carolina Blue Cross Blue Shield of North Carolina covers Lutathera (lutetium Lu-177 dotatate) for somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors when medical necessity criteria are met. Fastest path to approval: Submit prior authorization with complete documentation including SSTR-positive imaging,
5 min read

How to Get Lutathera Approved by Cigna in Florida: Complete Prior Authorization & Appeals Guide

Answer Box: Getting Lutathera Covered by Cigna in Florida Cigna typically requires prior authorization for Lutathera (lutetium Lu-177 dotatate) with documented somatostatin receptor-positive imaging and prior somatostatin analog therapy failure. Fastest approval path: Your oncologist submits the PA request with DOTATATE PET/CT results, pathology confirming GEP-NET, and progression notes
6 min read