Topic

New Jersey

A collection of 245 issues

How to Get Tremfya (Guselkumab) Covered by UnitedHealthcare in New Jersey: Prior Authorization Guide and Appeal Process

Answer Box: Getting Tremfya Covered by UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization for Tremfya (guselkumab) with step therapy involving TNF inhibitors for psoriasis/psoriatic arthritis and documented biologic failure for IBD. Your fastest path to approval: 1. Submit complete PA documentation including diagnosis codes, disease severity assessment, TB
7 min read

How to Get Cabometyx (Cabozantinib) Covered by Cigna in New Jersey: Complete Prior Authorization and Appeals Guide

Quick Answer: Cabometyx (cabozantinib) requires prior authorization from Cigna in New Jersey, typically approved within 72 hours with complete documentation. Key requirements: FDA-approved diagnosis (RCC, HCC, or other labeled indications), documented prior therapy failures, and oncologist prescription. Submit via CoverMyMeds or Cigna provider portal. If denied, New Jersey's
6 min read

How to Get Zolgensma Covered by Cigna in New Jersey: Complete Guide to Prior Authorization, Appeals, and IHCAP External Review

Answer Box: Getting Zolgensma Covered by Cigna in New Jersey Cigna covers Zolgensma (onasemnogene abeparvovec) for children under 24 months with genetically confirmed spinal muscular atrophy (SMA) through prior authorization. The fastest path: (1) Gather genetic test results showing bi-allelic SMN1 mutations and anti-AAV9 antibody titer ≤1:50, (2) Submit
7 min read

How to Get Bylvay (odevixibat) Covered by Cigna in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Bylvay (odevixibat) Covered by Cigna in New Jersey Eligibility: Bylvay requires prior authorization from Cigna for PFIC (≥3 months) or Alagille syndrome (≥12 months) with documented moderate-to-severe pruritus and failed conventional therapies. Fastest path: Submit complete PA through Express Scripts portal with genetic testing, specialist consultation, and
5 min read

UnitedHealthcare Coverage for iLink® Corneal Cross-Linking in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Getting iLink® Covered by UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization for iLink® corneal cross-linking in New Jersey. Coverage is available for progressive keratoconus when you meet strict medical necessity criteria using FDA-approved protocols. Your fastest path to approval: Have your ophthalmologist submit a prior authorization through
5 min read