Topic

New Jersey

A collection of 46 issues

How to Get Soliris (Eculizumab) Covered by Blue Cross Blue Shield in New Jersey: Complete Timeline & Appeal Guide

Answer Box: Getting Soliris Covered by BCBS in New Jersey Horizon Blue Cross Blue Shield of New Jersey requires prior authorization for Soliris (eculizumab) with approval typically taking 5-15 days for standard requests. Your fastest path: (1) Ensure meningococcal vaccination is current, (2) Have your doctor submit complete PA documentation

Getting Trikafta Renewed with Humana in New Jersey: Timeline, Documentation, and Appeals Guide

Answer Box: Renewing Trikafta with Humana in New Jersey Humana Medicare Advantage requires Trikafta (elexacaftor/tezacaftor/ivacaftor) renewal every 6-12 months with updated clinical documentation. Submit renewal requests 2-4 weeks before expiration with current liver function tests, pulmonary function data (if age ≥6), and prescriber attestation of continued benefit. If

Getting Elzonris (Tagraxofusp-erzs) Covered by Humana in New Jersey: Complete Guide to Prior Authorization and Appeals

Quick Answer: Your Path to Elzonris Coverage Getting Elzonris (tagraxofusp-erzs) covered by Humana in New Jersey requires prior authorization with specific BPDCN diagnosis documentation and capillary leak syndrome monitoring plans. Fast track: Submit PA request with CD123-positive pathology report, hematologist prescription, and CLS mitigation protocol to Humana's provider

How to Get Gilenya (Fingolimod) Covered by Cigna in New Jersey: Forms, Appeals & Step-by-Step Guide

Answer Box: Getting Gilenya (Fingolimod) Covered by Cigna in New Jersey Cigna requires prior authorization for Gilenya (fingolimod) in New Jersey. Your neurologist must submit a Cigna PA form documenting your relapsing MS diagnosis, baseline EKG and eye exam, and any failed prior therapies. Submit via CoverMyMeds, your EHR, or

Myths vs. Facts: Getting HyperHEP (Hepatitis B Immune Globulin) Covered by Aetna (CVS Health) in New Jersey

Answer Box: Getting HyperHEP Covered by Aetna (CVS Health) in New Jersey Good news: HyperHEP (hepatitis B immune globulin) is typically covered by Aetna for post-exposure prophylaxis when medically necessary. Key facts: Prior authorization isn't routinely required for emergency post-exposure use, but documentation of exposure and vaccination history

Myths vs. Facts: Getting Mepsevii (vestronidase alfa-vjbk) Covered by Aetna (CVS Health) in New Jersey

Answer Box: Getting Mepsevii Covered by Aetna in New Jersey To get Mepsevii (vestronidase alfa-vjbk) covered by Aetna (CVS Health) in New Jersey, you need: (1) confirmed MPS VII diagnosis via enzyme assay and genetic testing, (2) elevated urinary GAG levels (2-fold above normal), and (3) prescription from a metabolic