Topic

New Jersey

A collection of 504 issues

How to Get Breyanzi (lisocabtagene maraleucel) Covered by Cigna in New Jersey: Prior Authorization, Appeals, and Medical Necessity Requirements

Answer Box: Getting Breyanzi Covered by Cigna in New Jersey Cigna covers Breyanzi (lisocabtagene maraleucel) for FDA-approved indications with prior authorization required. Key eligibility: adults with relapsed/refractory large B-cell lymphoma after ≥2 prior lines, or CLL/SLL after ≥2 lines including BTK and BCL-2 inhibitors. Fastest path to approval:
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Oxbryta (Voxelotor) Coverage by UnitedHealthcare in New Jersey: 2024 FDA Withdrawal Impact and Alternative Treatment Options

Answer Box: Oxbryta Coverage Status in New Jersey Oxbryta (voxelotor) is no longer available through UnitedHealthcare or any insurer as of September 2024 due to FDA safety concerns. If you're currently taking Oxbryta, contact your hematologist immediately to transition to approved alternatives like hydroxyurea, L-glutamine (Endari), or crizanlizumab
5 min read

How to Get Pemazyre (pemigatinib) Covered by Blue Cross Blue Shield in New Jersey: Prior Authorization Guide & Appeal Process

Quick Answer: Getting Pemazyre Covered in New Jersey Pemazyre (pemigatinib) requires prior authorization from Blue Cross Blue Shield in New Jersey for cholangiocarcinoma with FGFR2 fusion or myeloid/lymphoid neoplasms with FGFR1 rearrangement. Submit PA with FGFR testing results, oncologist attestation, and prior therapy documentation. If denied, file internal appeals
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How to Get Filsuvez (Birch Triterpenes Topical Gel) Covered by UnitedHealthcare in New Jersey: Complete Prior Authorization Guide with Forms and Appeals

Answer Box: Getting Filsuvez Covered by UnitedHealthcare in New Jersey Who's eligible: Patients 6+ months with dystrophic or junctional epidermolysis bullosa (confirmed by genetic testing) who have qualifying wounds (10-50 cm², present 3+ weeks). Fastest path: Submit UnitedHealthcare's Filsuvez prior authorization form with genetic test results,
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How to Get Amvuttra (Vutrisiran) Covered by Aetna CVS Health in New Jersey: Prior Authorization Guide and Appeal Process

Answer Box: Fast Track to Amvuttra Coverage Aetna CVS Health requires prior authorization for Amvuttra (vutrisiran) in New Jersey with step therapy after Onpattro unless contraindicated. Submit PA with confirmed hATTR-PN or ATTR-CM diagnosis, genetic testing (TTR mutation), specialist evaluation, and documented failure/intolerance to preferred alternatives. Appeals follow a
5 min read

UnitedHealthcare's Coverage Criteria for Koselugo (Selumetinib) in New Jersey: What Counts as "Medically Necessary"?

Answer Box: Getting Koselugo Covered by UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization for Koselugo (selumetinib) under both medical and pharmacy benefits, with no step therapy requirements for pediatric NF1 plexiform neurofibromas. Medical necessity requires confirmed NF1 diagnosis with symptomatic, inoperable plexiform neurofibromas, baseline LVEF assessment, and ophthalmologic evaluation.
5 min read