Topic

North Carolina

A collection of 504 issues

How Long Does It Take to Get Cresemba (Isavuconazole) Approved by Cigna in North Carolina? Complete Timeline & Appeal Guide

Answer Box: Quick Start Guide Getting Cresemba (isavuconazole) approved by Cigna in North Carolina typically takes 2-5 business days with complete documentation. For invasive aspergillosis, you'll need to try voriconazole first (step therapy) unless contraindicated. If denied, North Carolina offers external review through Smart NC with 45-day standard
5 min read

How Long Does It Take to Get Xyrem (Sodium Oxybate) Approved by UnitedHealthcare in North Carolina? Complete Timeline & Appeals Guide

Quick Answer: Xyrem Approval Timeline in North Carolina Getting Xyrem (sodium oxybate) approved by UnitedHealthcare in North Carolina typically takes 1-15 business days for the prior authorization decision, plus 1-3 days for REMS enrollment. The fastest path: ensure both you and your prescriber complete REMS enrollment first, then have your
6 min read

How to Get Lutathera (Lutetium Lu-177 Dotatate) Covered by Blue Cross Blue Shield in North Carolina: Complete Guide with Forms and Appeals

Answer Box: Getting Lutathera Covered by Blue Cross Blue Shield in North Carolina Blue Cross Blue Shield of North Carolina covers Lutathera (lutetium Lu-177 dotatate) for somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors when medical necessity criteria are met. Fastest path to approval: Submit prior authorization with complete documentation including SSTR-positive imaging,
5 min read

Work With Your Doctor to Get Epidiolex (Cannabidiol) Approved by Aetna (CVS Health) in North Carolina: Forms, Appeals, and State Protections

How to Get Epidiolex (Cannabidiol) Covered by Aetna (CVS Health) in North Carolina Quick Answer: Aetna (CVS Health) covers Epidiolex for Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex with prior authorization and often step therapy. Your neurologist must document failed trials of standard antiseizure medications and submit a medical
7 min read

How to Get Myalept (Metreleptin) Covered by Cigna in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Myalept (Metreleptin) Covered by Cigna in North Carolina Fastest path to approval: Myalept requires prior authorization from Cigna with confirmed generalized lipodystrophy (ICD-10 E88.12), REMS certification, and documented metabolic complications despite standard therapy. If denied, you have 180 days for internal appeals, then 120 days for
7 min read

Work With Your Doctor to Get Hetlioz (tasimelteon) Approved by Blue Cross Blue Shield in North Carolina: Complete Guide

Answer Box: Getting Hetlioz Covered in North Carolina Eligibility: Blue Cross Blue Shield North Carolina covers Hetlioz (tasimelteon) for FDA-approved conditions (Non-24-Hour Sleep-Wake Disorder in adults, Smith-Magenis syndrome sleep disturbances) with prior authorization. Fastest path: Work with a sleep specialist to document diagnosis, failed melatonin/ramelteon trials, and functional impact.
6 min read

Work With Your Doctor to Get Abecma (idecabtagene vicleucel) Covered by Aetna (CVS Health) in North Carolina: Complete Appeals Guide

Answer Box: Getting Abecma Covered by Aetna in North Carolina Eligibility: Adults with relapsed/refractory multiple myeloma after ≥2 prior lines including an IMiD, proteasome inhibitor, and anti-CD38 antibody. Fastest path: Work with your oncologist at a certified CAR-T center to submit a comprehensive prior authorization with documented treatment failures
8 min read

Work With Your Doctor to Get Procysbi (Cysteamine Bitartrate DR) Approved by UnitedHealthcare in North Carolina

Answer Box: Your Path to Procysbi Coverage Getting Procysbi (cysteamine bitartrate DR) approved by UnitedHealthcare in North Carolina requires close collaboration with your doctor. Most plans require prior authorization and step therapy with immediate-release cysteamine first. Your fastest path: 1) Schedule a dedicated "evidence-building" visit to document nephropathic
6 min read