Topic

New Jersey

A collection of 505 issues

How to Get Procysbi Covered by UnitedHealthcare in New Jersey: Prior Authorization, Appeals & Step Therapy Exceptions

Answer Box: Getting Procysbi Covered by UnitedHealthcare in New Jersey UnitedHealthcare requires prior authorization for Procysbi (cysteamine bitartrate delayed-release) with step therapy typically mandating immediate-release cysteamine (Cystagon) first. To get approval in New Jersey: 1) Submit PA via UHC provider portal with nephropathic cystinosis diagnosis and WBC cystine levels, 2)
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How to Get Hemgenix (etranacogene dezaparvovec) Covered by Aetna (CVS Health) in New Jersey: Prior Authorization, Appeals, and State Protections

Answer Box: Getting Hemgenix Covered by Aetna (CVS Health) in New Jersey Aetna (CVS Health) requires prior authorization for Hemgenix (etranacogene dezaparvovec) in New Jersey. Adults with severe/moderately severe hemophilia B (Factor IX ≤2%) need: no inhibitors, current/historical prophylaxis use, and serious bleeding history. Submit the Aetna Hemgenix
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How to Get Soliris (eculizumab) Covered by Cigna in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Your Fastest Path to Soliris Coverage Cigna requires prior authorization for Soliris (eculizumab) with a 72-hour standard review (24 hours if expedited). Key requirements: confirmed diagnosis via flow cytometry (PNH) or antibody testing (gMG/NMOSD), meningococcal vaccinations ≥2 weeks before treatment, REMS enrollment, and documented prior therapy failures.
6 min read