Topic

North Carolina

A collection of 504 issues

Getting Blenrep (Belantamab Mafodotin) Covered by Humana in North Carolina: PA Requirements, Appeals, and Alternative Options

Answer Box: Fast Track to Blenrep Coverage Blenrep (belantamab mafodotin) received FDA approval on October 23, 2025, for relapsed/refractory multiple myeloma after 2+ prior therapies. Humana Medicare typically covers FDA-approved oncology drugs but requires prior authorization. Your fastest path: 1) Have your oncologist submit Humana's "Request

How to Get Qinlock (ripretinib) Covered by Aetna (CVS Health) in North Carolina: Complete Prior Authorization and Appeal Guide

Quick Answer: To get Qinlock (ripretinib) covered by Aetna (CVS Health) in North Carolina, you'll need prior authorization showing failure of at least three kinase inhibitors (imatinib, sunitinib, regorafenib) for advanced GIST. Submit requests via Aetna's provider portal or call 1-866-814-5506. Standard decisions take 30 days;

Oxbryta (Voxelotor) Coverage with Humana in North Carolina: What You Need to Know After FDA Withdrawal

Answer Box: Oxbryta (Voxelotor) Coverage Status Oxbryta (voxelotor) is no longer available in the United States. Pfizer voluntarily withdrew the medication from all global markets on September 25-26, 2024, following FDA safety alerts. Humana and other insurers now deny all claims due to loss of FDA approval. If you'

Getting Onivyde (Irinotecan Liposome) Covered by Blue Cross Blue Shield of North Carolina: Complete PA Guide and Appeals Process

Answer Box: Quick Path to Onivyde Coverage Blue Cross Blue Shield of North Carolina requires prior authorization for Onivyde (irinotecan liposome), typically approved for FDA-indicated NALIRIFOX regimen in first-line metastatic pancreatic cancer. Your oncologist submits PA documentation including confirmed diagnosis, performance status, and treatment rationale. If denied, file internal appeal

Myths vs. Facts: Getting Rezlidhia (olutasidenib) Covered by Aetna (CVS Health) in North Carolina

Answer Box: Fast Path to Rezlidhia Coverage in North Carolina Rezlidhia (olutasidenib) requires prior authorization from Aetna (CVS Health) for adults ≥18 with confirmed relapsed/refractory IDH1-mutated AML. Submit complete documentation including FDA-approved IDH1 mutation test results, treatment history, and oncologist prescription via CVS Caremark (1-855-344-0930) or Aetna provider portal.

How Long Does It Take to Get Palynziq (pegvaliase-pqpz) Approved by Blue Cross Blue Shield in North Carolina? Complete Timeline and Appeals Guide

Answer Box: Getting Palynziq Approved in North Carolina Blue Cross Blue Shield of North Carolina requires prior authorization for Palynziq (pegvaliase-pqpz) with a 15-business-day review timeline (72 hours expedited). The medication is non-formulary and typically requires trying sapropterin (generic Kuvan) first. Key steps: 1) Verify REMS program enrollment, 2) Submit

How to Get Palynziq (pegvaliase-pqpz) Covered by Humana in North Carolina: PA Requirements, Appeals, and State Resources

Answer Box: Getting Palynziq Covered by Humana in North Carolina Humana requires prior authorization for Palynziq (pegvaliase-pqpz), typically placed on the highest specialty tier. To get coverage in North Carolina: (1) Submit PA through Humana's provider portal with confirmed PKU diagnosis, blood phenylalanine >600 µmol/L, and

How to Get Bylvay (odevixibat) Covered by Cigna in North Carolina: Forms, Appeals, and State Protections

Answer Box: Getting Bylvay (odevixibat) Covered by Cigna in North Carolina Cigna requires prior authorization for Bylvay (odevixibat) with strict criteria: confirmed PFIC (≥3 months) or Alagille syndrome (≥12 months) diagnosis, failed trials of ursodiol and pruritus medications, and specialist prescription. First step: Have your hepatologist submit PA through Cigna&

How to Get Qinlock (ripretinib) Covered by Blue Cross Blue Shield of North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Qinlock Covered by Blue Cross Blue Shield of North Carolina Qinlock (ripretinib) requires prior authorization from Blue Cross Blue Shield of North Carolina for fourth-line GIST treatment after three prior kinase inhibitors (imatinib, sunitinib, regorafenib). Most approvals take 15 business days through specialty pharmacy networks. If denied,

How to Get Voxzogo (Vosoritide) Covered by Humana in North Carolina: Complete PA Guide and Appeal Process

Answer Box: Getting Voxzogo Covered by Humana in North Carolina Humana requires prior authorization for Voxzogo (vosoritide) with genetic confirmation of achondroplasia, open growth plates, and pediatric specialist prescription. Standard approval takes 72 hours; if denied, North Carolina residents have strong appeal rights through Smart NC external review. Your first