Topic

Michigan

A collection of 447 issues

Work With Your Doctor to Get Onivyde (Irinotecan Liposome) Approved by Aetna CVS Health in Michigan

Quick Answer: Getting Aetna CVS Health to Cover Onivyde in Michigan Aetna (CVS Health) requires prior authorization for Onivyde (irinotecan liposome), but approval is achievable with proper documentation. Your doctor must submit a request at least two weeks before treatment through the Availity provider portal with complete medical records, diagnosis

How to Get Dojolvi (Triheptanoin) Covered by UnitedHealthcare in Michigan: Complete PA Guide with Appeal Scripts

Answer Box: Getting Dojolvi Covered by UnitedHealthcare in Michigan Dojolvi (triheptanoin) requires prior authorization from UnitedHealthcare for long-chain fatty acid oxidation disorders (LC-FAOD). Key requirements: molecular genetic confirmation of LC-FAOD, prescription from a board-certified medical geneticist, no concurrent MCT products, and dosing ≤35% of daily calories. First step: Download the

How to Get Tysabri (Natalizumab) Covered by UnitedHealthcare in Michigan: Appeals, Copay Programs & Prior Authorization

Quick Answer: Getting Tysabri Covered by UnitedHealthcare in Michigan UnitedHealthcare requires prior authorization for Tysabri (natalizumab) through their Provider Portal or by calling 888-397-8129. If denied, you have internal appeal rights followed by Michigan DIFS external review within 127 days. First step today: Have your doctor submit a prior authorization

Getting Hetlioz LQ (Tasimelteon) Covered by Cigna in Michigan: Complete PA Guide and Appeals Process

Answer Box: How to Get Hetlioz LQ Covered by Cigna in Michigan Fastest path to approval: Submit prior authorization with confirmed Smith-Magenis Syndrome genetic testing, documented melatonin failure, and weight-based dosing rationale. If denied, file internal appeal within 180 days, then external review with Michigan DIFS within 127 days. Start

How to Get Rezlidhia (olutasidenib) Covered by Aetna CVS Health in Michigan: Complete Prior Authorization and Appeals Guide

Answer Box: Fast Track to Rezlidhia Coverage Getting Rezlidhia (olutasidenib) covered by Aetna CVS Health in Michigan requires prior authorization with documented IDH1 mutation, hematology/oncology specialist prescription, and evidence of prior therapy failures. Start by having your oncologist submit a PA request through Aetna's provider portal with

Myths vs. Facts: Getting Koselugo (Selumetinib) Covered by Blue Cross Blue Shield in Michigan - Appeals Guide 2025

Answer Box: Getting Koselugo Covered in Michigan Eligibility: Blue Cross Blue Shield of Michigan covers Koselugo for pediatric patients (ages 2-18) with NF1 and symptomatic, inoperable plexiform neurofibromas requiring prior authorization. Fastest Path: Submit complete PA with baseline LVEF (echocardiogram), ophthalmologic exam, NF1 diagnosis confirmation, and tumor imaging showing inoperability.

How to Get Enbrel (etanercept) Covered by Cigna in Michigan: Complete Prior Authorization Guide

Answer Box: Getting Enbrel Covered by Cigna in Michigan Eligibility: Cigna covers Enbrel (etanercept) for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and plaque psoriasis with prior authorization. You must be over 18, prescribed by a rheumatologist, and have tried another biologic (excluding etanercept biosimilars). Fastest path: Your doctor submits a

If Ultomiris (Ravulizumab) Isn't Approved by UnitedHealthcare in Michigan: Formulary Alternatives & Exception Strategies

Quick Answer: Your Options When Ultomiris Is Denied If UnitedHealthcare denies Ultomiris (ravulizumab) in Michigan, you have three main paths: try a formulary alternative like Soliris (eculizumab), request a formulary exception with medical necessity documentation, or pursue a formal appeal. Your fastest option is often requesting a peer-to-peer review where

Renewing Fabrazyme (Agalsidase Beta) Approval with UnitedHealthcare in Michigan: 2025 Requirements and Timeline

Answer Box: Renewing Fabrazyme with UnitedHealthcare in Michigan Fabrazyme requires annual reauthorization with UnitedHealthcare, typically 12 months after initial approval. Start the renewal process 30 days before expiration to avoid coverage gaps. Submit updated clinical documentation showing treatment response through your provider's UnitedHealthcare portal or OptumRx system. If

How to Get Acthar Gel Covered by Cigna in Michigan: Prior Authorization, Appeals, and Formulary Alternatives Guide

Answer Box: Getting Acthar Gel Covered by Cigna in Michigan Cigna requires prior authorization and step therapy for Acthar Gel (repository corticotropin injection) in Michigan. You'll need documented failure or contraindication to preferred alternatives like prednisone or IV methylprednisolone. If denied, Michigan gives you 127 days to file