Topic

Orkambi (lumacaftor/ivacaftor)

A collection of 2 issues

How to Get Orkambi (lumacaftor/ivacaftor) Covered by Aetna CVS Health in Florida: Complete Approval Guide

Quick Answer: Getting Orkambi Covered by Aetna CVS Health in Florida Aetna CVS Health requires prior authorization for Orkambi (lumacaftor/ivacaftor) in Florida. Your fastest path to approval: (1) Confirm F508del homozygous mutation documentation, (2) Submit complete prior authorization via Availity provider portal with CF diagnosis and failed therapy history,

How to Get Orkambi (lumacaftor/ivacaftor) Covered by Cigna in California: Appeals Timeline and Documentation Guide

Answer Box: Getting Orkambi Covered by Cigna in California Fastest Path: Submit prior authorization with genetic test results showing F508del homozygosity, CF diagnosis documentation, and specialist prescription. If denied, file internal appeal within 180 days, then request California Independent Medical Review (IMR) through DMHC. Success rate for IMR appeals is