Topic

Michigan

A collection of 415 issues

Work With Your Doctor to Get Blenrep (Belantamab Mafodotin) Approved by UnitedHealthcare in Michigan: Complete Provider Collaboration Guide

Answer Box: Blenrep (belantamab mafodotin) is currently only available through GSK's compassionate use program after FDA withdrawal in 2022. UnitedHealthcare requires prior authorization for specialty oncology drugs, with 85% appeal success rates through peer-to-peer review. First step: Contact your oncologist to verify eligibility for compassionate use (4+ prior
6 min read

How to Get Xywav (Ca/Mg/K/Na oxybates) Covered by Aetna CVS Health in Michigan: Complete Guide to Prior Authorization, Appeals, and External Review

Quick Answer: Getting Xywav Covered by Aetna CVS Health in Michigan Xywav (calcium/magnesium/potassium/sodium oxybates) requires prior authorization from Aetna CVS Health before dispensing. You'll need REMS enrollment, documentation of narcolepsy or idiopathic hypersomnia diagnosis, and proof of step therapy completion (modafinil/armodafinil trials). Standard decisions
6 min read

How to Get Pombiliti (cipaglucosidase alfa-atga) Covered by Humana in Michigan: Prior Authorization, Appeals, and Cost Assistance

Quick Answer: Getting Pombiliti Covered by Humana in Michigan Pombiliti (cipaglucosidase alfa-atga) typically requires prior authorization through Humana. Start by having your physician submit a prior authorization request to Humana Clinical Pharmacy Review at 1-800-555-2546, documenting late-onset Pompe disease diagnosis, lack of improvement on current enzyme replacement therapy, and medical
6 min read

Myths vs. Facts: Getting Berinert (C1-esterase inhibitor, IV) Covered by UnitedHealthcare in Michigan

Answer Box: Getting Berinert Covered by UnitedHealthcare in Michigan Eligibility: Patients with confirmed hereditary angioedema (HAE) diagnosis via C1-esterase inhibitor testing can get Berinert covered for acute attacks. Fastest path: Submit prior authorization through OptumRx with specialist prescription, documented HAE diagnosis, and attack history. First step today: Call UnitedHealthcare at
6 min read

How to Get Darzalex / Darzalex Faspro (daratumumab) Covered by Aetna in Michigan: Prior Authorization Guide and Appeals Process

Answer Box: Getting Darzalex / Darzalex Faspro Covered by Aetna in Michigan Aetna requires prior authorization for both Darzalex (IV) and Darzalex Faspro (subcutaneous) in Michigan. Submit your PA request to (866) 752-7021 or fax (888) 267-3277 with complete clinical documentation including diagnosis, prior therapy failures, and treatment plan. If denied,
5 min read