Topic

New Jersey

A collection of 506 issues

How to Get Evkeeza (Evinacumab-dgnb) Covered by Cigna in New Jersey: Prior Authorization, Appeals, and State Protections

Answer Box: Getting Evkeeza Covered by Cigna in New Jersey Evkeeza (evinacumab-dgnb) requires strict prior authorization from Cigna for homozygous familial hypercholesterolemia (HoFH). New Jersey law mandates 72-hour response times for non-urgent requests and 24-hour for urgent cases. First step: Have your specialist submit the Cigna PA form with genetic

How to Get Dupixent (Dupilumab) Covered by Aetna CVS Health in New Jersey: Complete Guide to Prior Authorization, Appeals, and Approval

Answer Box: Getting Dupixent Covered by Aetna CVS Health in New Jersey Dupixent (dupilumab) is covered by Aetna CVS Health for FDA-approved conditions but requires prior authorization. Success depends on documenting failed conventional therapies and meeting specific clinical criteria. Your fastest path: 1) Have your specialist submit a complete PA

How to Get Myalept (Metreleptin) Approved by Aetna CVS Health in New Jersey: Complete Coding, Appeals & IHCAP Guide

Answer Box: Getting Myalept Covered by Aetna CVS Health in New Jersey Myalept (metreleptin) requires prior authorization from Aetna CVS Health for generalized lipodystrophy only. The fastest path to approval: (1) Ensure your diagnosis is coded as E88.12 (Generalized lipodystrophy) with documented leptin deficiency, (2) Complete REMS certification before

Getting Rapivab (Peramivir) Covered by Cigna in New Jersey: Prior Authorization Guide and Appeals Process

Quick Answer: Rapivab Coverage with Cigna in New Jersey Yes, Cigna covers Rapivab (peramivir) but requires prior authorization and step therapy. You'll need documentation showing symptom onset within 48 hours, a positive flu test, and proof that oral antivirals like Tamiflu aren't suitable. If denied, New

Get Mycapssa (Octreotide Oral) Covered by Humana in New Jersey: Provider Collaboration Guide

Answer Box: Your Path to Mycapssa Coverage To get Mycapssa (oral octreotide) covered by Humana in New Jersey, you'll need prior authorization with documentation of acromegaly diagnosis and prior injectable SSA response. Your provider must submit a medical necessity letter through Humana's portal within 72 hours

Myths vs. Facts: Getting Galafold (migalastat) Covered by Aetna (CVS Health) in New Jersey

Answer Box: Getting Galafold (migalastat) Covered by Aetna (CVS Health) in New Jersey Key Facts: Aetna requires prior authorization for Galafold with documented amenable GLA variant and specialist prescription. Most denials stem from incomplete genetic documentation or missing step therapy attempts with enzyme replacement therapy. Fastest Path to Approval: 1.

How to Get Qinlock (Ripretinib) Covered by Cigna in New Jersey: Timeline, Forms & Appeal Process

Answer Box: Getting Qinlock Covered by Cigna in New Jersey Cigna requires prior authorization for Qinlock (ripretinib) in New Jersey, with approval typically taking 1-3 business days once complete documentation is submitted. Under New Jersey's 2025 regulations, Cigna must respond within 2 business days for standard requests or

How to Get Cabometyx (Cabozantinib) Covered by Humana in New Jersey: Prior Authorization, Appeals, and State Protections

Answer Box: Your Fastest Path to Coverage Cabometyx (cabozantinib) requires prior authorization under Humana Medicare Advantage plans in New Jersey. The fastest path: Have your oncologist submit a PA request through Humana's provider portal with complete clinical documentation including diagnosis, prior therapies, and imaging results. If denied, you

How to Get Vanflyta (quizartinib) Covered by Blue Cross Blue Shield in New Jersey: Complete Timeline Guide with Forms and Appeals

Answer Box: Getting Vanflyta Covered by Blue Cross Blue Shield in New Jersey Vanflyta (quizartinib) requires prior authorization with Blue Cross Blue Shield in New Jersey and is typically approved within 24-72 hours for urgent cases when complete FLT3-ITD documentation is provided. The fastest path: (1) Verify your plan covers

How to Get Cresemba (Isavuconazole) Covered by Humana in New Jersey: Renewal Guide, Forms, and Appeals Process

Answer Box: Quick Start Guide Getting Cresemba (isavuconazole) renewed with Humana in New Jersey: Submit renewal documentation 30-45 days before current authorization expires. Include updated clinical notes showing treatment response, recent liver function tests, and evidence of ongoing infection. For Medicare Advantage members, use federal appeals process (not NJ IHCAP)