Topic

Michigan

A collection of 504 issues

How to Get Keppra (Levetiracetam) Covered by Cigna in Michigan: Prior Authorization, Appeals, and Cost Savings Guide

Answer Box: Getting Keppra (Levetiracetam) Covered by Cigna in Michigan Generic levetiracetam is typically covered on Cigna formularies as Tier 1 ($5-15 copay) without prior authorization. Brand Keppra requires step therapy (try generic first) and prior authorization. If denied, you have 180 days for internal appeals, then 127 days for

How to Get Dojolvi (Triheptanoin) Covered by Blue Cross Blue Shield in Michigan: PA Forms, Appeals, and Alternative Paths

Quick Answer: Getting Dojolvi Covered by BCBS Michigan Dojolvi (triheptanoin) is not listed on Blue Cross Blue Shield of Michigan's 2026 formularies, meaning it requires prior authorization or may not be covered under pharmacy benefits. Your fastest path: Have your prescriber submit a PA request via BCBS Michigan&

Get Blenrep (Belantamab Mafodotin) Covered by Blue Cross Blue Shield Michigan: Complete PA and Appeal Guide

Answer Box: Getting Blenrep Coverage in Michigan Blenrep (belantamab mafodotin) is currently withdrawn from the U.S. market but under FDA review for potential resubmission (PDUFA date October 23, 2025). Blue Cross Blue Shield of Michigan requires prior authorization for this specialty oncology drug when available, and current access is

How to Get Nourianz (istradefylline) Covered by Humana in Michigan: Complete PA Guide with Appeals Process

Answer Box: Getting Nourianz Covered by Humana in Michigan Nourianz (istradefylline) requires prior authorization from Humana Medicare plans in Michigan. Most approvals require: confirmed Parkinson's diagnosis (ICD-10 G20.A2/G20.B2), stable carbidopa/levodopa therapy for ≥1 year, and documented ≥2 hours daily OFF episodes. Submit via Humana&

Do You Qualify for Imbruvica (ibrutinib) Coverage by Blue Cross Blue Shield of Michigan? Decision Tree & Next Steps

Answer Box: Getting Imbruvica Covered by Blue Cross Blue Shield of Michigan Blue Cross Blue Shield of Michigan covers Imbruvica (ibrutinib) with prior authorization for FDA-approved indications including CLL/SLL and Waldenström macroglobulinemia. The fastest path to approval: have your oncologist submit a PA request via the BCBSM provider portal

How Long Does It Take to Get Symdeko/Symkevi Approved by UnitedHealthcare in Michigan? Complete Timeline Guide

Quick Answer: Symdeko/Symkevi Approval Timeline with UnitedHealthcare in Michigan UnitedHealthcare typically takes 5-14 business days to approve Symdeko (tezacaftor/ivacaftor) for eligible cystic fibrosis patients in Michigan, provided complete documentation is submitted. Expedited reviews are available within 24-72 hours for urgent cases. The fastest path: have your CF specialist

How to Get Enhertu (fam-trastuzumab deruxtecan-nxki) Covered by Humana in Michigan: Prior Authorization Guide and Appeals Process

Answer Box: Getting Enhertu Covered by Humana in Michigan Enhertu (fam-trastuzumab deruxtecan-nxki) requires prior authorization from Humana Medicare Advantage plans due to its high cost (~$2,440 per 100mg vial) and specialized oncology use. To get coverage in Michigan: 1. Submit prior authorization via Humana's provider portal with

Getting Cometriq (Cabozantinib) Covered by Humana in Michigan: Complete Prior Authorization and Appeals Guide

Answer Box: Fast Track to Cometriq Coverage To get Cometriq (cabozantinib) covered by Humana in Michigan: Your doctor must submit a prior authorization request through Humana's provider portal or by calling 800-555-2546, including diagnosis of metastatic medullary thyroid carcinoma, elevated calcitonin levels, and documentation that Cometriq capsules (not

How to Get Brensocatib (BRINSUPRI) Covered by UnitedHealthcare in Michigan: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting BRINSUPRI Covered in Michigan Brensocatib (BRINSUPRI) requires prior authorization through UnitedHealthcare's OptumRx with documented non-cystic fibrosis bronchiectasis, age 12+, ≥2 exacerbations yearly, and failed macrolide trial. Submit via the UnitedHealthcare Provider Portal or fax to 1-844-403-1027. If denied, you have 180 days for internal appeals,

How to Get Ferriprox (Deferiprone) Covered by Humana in Michigan: Prior Authorization Guide and Appeals Process

Answer Box: Getting Ferriprox (Deferiprone) Covered by Humana in Michigan Fastest path to approval: Submit prior authorization with documented ANC ≥1.5 x 10⁹/L, weekly monitoring plan, and evidence of transfusional iron overload (ferritin >1000 ng/mL). If denied, you have 65 days to appeal internally, then 127