Topic

New Jersey

A collection of 505 issues

How to Get Cerezyme (Imiglucerase) Approved by UnitedHealthcare in New Jersey: Complete Appeals Guide

Answer Box: Getting Cerezyme Covered by UnitedHealthcare in New Jersey Cerezyme (imiglucerase) requires prior authorization from UnitedHealthcare/OptumRx in New Jersey and may face step therapy requirements. To get coverage: 1. Submit PA request via UnitedHealthcare Provider Portal with Gaucher disease confirmation and specialist documentation 2. Request step therapy exception
6 min read

How to Get Qinlock (ripretinib) Covered by Humana in New Jersey: Prior Authorization Forms, Appeals Timeline, and Medical Necessity Requirements

Answer Box: Quick Path to Qinlock Coverage Getting Qinlock (ripretinib) covered by Humana in New Jersey requires prior authorization with documentation of failed kinase inhibitor therapy. Your oncologist must submit a PA request showing you've tried and failed imatinib, sunitinib, and regorafenib for advanced GIST. If denied, you
6 min read

How to Get Opzelura (ruxolitinib cream) Covered by Blue Cross Blue Shield in New Jersey: Complete Appeals Guide with Forms and Timelines

Quick Answer: Getting Opzelura Covered in New Jersey Opzelura (ruxolitinib cream) requires prior authorization from Blue Cross Blue Shield in New Jersey. Your fastest path to approval: Have your dermatologist document failed trials of topical corticosteroids and calcineurin inhibitors, then submit the PA request through Horizon BCBSNJ's provider
6 min read

Get Xospata (Gilteritinib) Covered by Cigna in New Jersey: Prior Authorization, Appeals, and Medical Necessity Guide

Answer Box: Fastest Path to Approval To get Xospata (gilteritinib) covered by Cigna in New Jersey: Your hematologist/oncologist must submit prior authorization with FLT3-mutation test results (FDA-approved), AML diagnosis confirmation, and documentation of relapsed/refractory status. If denied, file internal appeals within 180 days, then external review through New
6 min read

Denied for Dojolvi (Triheptanoin) by UnitedHealthcare in New Jersey? Complete Appeal Guide with Templates

Answer Box: UnitedHealthcare requires prior authorization for Dojolvi (triheptanoin) with molecular confirmation of long-chain fatty acid oxidation disorder (LC-FAOD) and specialist prescription. No step therapy applies. If denied, request peer-to-peer review immediately, then file internal appeal within 180 days. After exhausting internal appeals, use New Jersey's IHCAP external
6 min read