Topic

North Carolina

A collection of 449 issues

How to Get Raxone (Idebenone) Covered by Blue Cross Blue Shield in North Carolina: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Raxone (Idebenone) Covered in North Carolina Raxone (idebenone) is not FDA-approved in the US and requires a formulary exception from Blue Cross Blue Shield of North Carolina. Your fastest path to approval: (1) Have your ophthalmologist submit a prior authorization request with comprehensive LHON documentation, genetic testing
6 min read

How to Get Amvuttra (vutrisiran) Covered by Humana in North Carolina: Prior Authorization, Appeals, and Cost Assistance

Quick Answer: Getting Amvuttra (vutrisiran) Covered by Humana in North Carolina Amvuttra requires prior authorization from Humana with genetic testing confirming a TTR mutation, documentation of failed step therapy (typically Wainua for polyneuropathy or tafamidis/Attruby for cardiomyopathy), and specialty pharmacy dispensing through CenterWell or approved partners. If denied, you
6 min read

How to Get Berinert (C1-Esterase Inhibitor) Covered by Blue Cross Blue Shield in North Carolina: Complete Prior Authorization Guide

Answer Box: Getting Berinert Covered by Blue Cross Blue Shield in North Carolina Blue Cross Blue Shield of North Carolina requires prior authorization for Berinert (C1-esterase inhibitor) with specific coverage criteria. The fastest path to approval: (1) Submit clinical documentation proving confirmed HAE diagnosis with lab results (low C4, abnormal
7 min read

Myths vs. Facts: Getting Hetlioz (Tasimelteon) Covered by Humana in North Carolina

Answer Box: Getting Hetlioz Covered by Humana in North Carolina Hetlioz (tasimelteon) requires prior authorization from Humana and is often non-formulary, but coverage is possible with proper documentation. Key requirements: diagnosis of Non-24-hour sleep-wake disorder (typically requiring total blindness) or Smith-Magenis syndrome, specialist evaluation with sleep logs/actigraphy, and failed
5 min read

How to Get Gattex (Teduglutide) Covered by Humana in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Gattex (Teduglutide) Covered by Humana in North Carolina Fastest Path to Approval: Humana requires prior authorization for Gattex (teduglutide) with documented short bowel syndrome and parenteral nutrition dependence. Submit through CoverMyMeds or fax 1-877-486-2621 with complete medical records, PN logs, and specialist attestation. Standard processing takes 5-14
6 min read