How to Get Orkambi (lumacaftor/ivacaftor) Covered by Blue Cross Blue Shield in New York: Prior Authorization, Appeals, and Documentation Guide
Answer Box: Getting Orkambi Covered by BCBS in New York
Orkambi requires prior authorization from Blue Cross Blue Shield plans in New York. Key requirement: documented F508del homozygous mutation with specialist prescription. Fastest path: Have your CF specialist submit PA through the BCBS provider portal with genetic testing, clinical notes,