Topic

Oxlumo (lumasiran)

A collection of 31 issues

How to Get Oxlumo (Lumasiran) Covered by Blue Cross Blue Shield in New Jersey: Complete PA Guide with Appeals Process

Answer Box: Getting Oxlumo Covered by Blue Cross Blue Shield in New Jersey Oxlumo (lumasiran) requires prior authorization from Blue Cross Blue Shield in New Jersey for primary hyperoxaluria type 1 (PH1). Your fastest path to approval: 1. Confirm PH1 diagnosis with AGXT genetic testing or liver biopsy showing AGT

How to Get Oxlumo (lumasiran) Covered by UnitedHealthcare in Michigan: Appeals Guide with Forms and Timelines

Quick Answer: Getting Oxlumo Covered by UnitedHealthcare in Michigan Oxlumo (lumasiran) requires prior authorization from UnitedHealthcare for primary hyperoxaluria type 1 (PH1). Your fastest path: Have your nephrologist submit a comprehensive PA request with genetic PH1 confirmation, baseline urinary oxalate levels, and medical necessity documentation through the UnitedHealthcare provider portal.

Get Oxlumo (Lumasiran) Covered by Aetna CVS Health in Washington: Complete Guide with Forms and Appeals

Quick Answer: Aetna CVS Health covers Oxlumo (lumasiran) for primary hyperoxaluria type 1 (PH1) as a specialty tier medication requiring prior authorization. You'll need genetic testing confirming PH1, a specialist prescriber, and completion of Aetna's precertification form. If denied, Washington residents can appeal through internal review

How to Get Oxlumo (Lumasiran) Covered by Cigna in Michigan: Complete Prior Authorization and Appeals Guide

Quick Answer: To get Oxlumo (lumasiran) covered by Cigna in Michigan, you'll need prior authorization with confirmed PH1 diagnosis, genetic testing (AGXT), nephrologist prescription, and documented urinary oxalate levels. Submit via CoverMyMeds or Cigna portal. If denied, use Michigan's 180-day internal appeal window, then DIFS external

Get Oxlumo (Lumasiran) Covered by Aetna CVS Health in Florida: Complete Guide with Forms and Appeals

Answer Box: Get Oxlumo Covered by Aetna in Florida Yes, Aetna CVS Health covers Oxlumo (lumasiran) for primary hyperoxaluria type 1 (PH1) in Florida with prior authorization. The fastest path to approval requires: (1) confirmed PH1 diagnosis via genetic testing or liver enzyme analysis, (2) prescription from a nephrology or

How to Get Oxlumo (Lumasiran) Covered by Blue Cross Blue Shield in Ohio: Complete Appeals Guide

Answer Box: Getting Oxlumo Covered by BCBS Ohio Blue Cross Blue Shield Ohio requires prior authorization for Oxlumo (lumasiran) with strict criteria: genetic confirmation of primary hyperoxaluria type 1 (PH1), specialist prescribing, and documented urinary oxalate levels. If denied, you have 180 days for internal appeals, then external review through

How to Get Oxlumo (Lumasiran) Covered by Aetna CVS Health in California: Complete Guide with Forms and Appeals

Answer Box: Getting Oxlumo (Lumasiran) Covered by Aetna CVS Health in California Eligibility: Aetna CVS Health covers Oxlumo for primary hyperoxaluria type 1 (PH1) with confirmed AGXT gene mutation or liver enzyme deficiency. Fastest approval path: Submit the Aetna Oxlumo precertification form with genetic test results and specialist documentation. First

How Long Does It Take to Get Oxlumo (Lumasiran) Approved by Aetna CVS Health in Texas? Complete Timeline Guide

Answer Box: Oxlumo Approval Timeline with Aetna CVS Health in Texas Standard approval: 14-45 days for complete submissions; expedited/urgent: within 72 hours. Aetna processes 95% of eligible specialty drug requests within 24 hours when all documentation is complete. Key requirements: Confirmed PH1 diagnosis via AGXT genetic testing, specialist prescriber,

How to Get Oxlumo (Lumasiran) Covered by Blue Cross Blue Shield in North Carolina: Appeals, Timelines & State Protections

Quick Answer: Getting Oxlumo Covered in North Carolina Blue Cross Blue Shield of North Carolina requires prior authorization for Oxlumo (lumasiran) with specific PH1 documentation. If denied, you have strong state protections: expedited appeals within 72 hours for urgent cases, step therapy exceptions for medical necessity, and Smart NC external

How to Get Oxlumo (lumasiran) Covered by Humana in Michigan: Complete Guide with Forms and Appeal Process

Quick Answer: Getting Oxlumo (lumasiran) Covered by Humana in Michigan Oxlumo requires prior authorization from Humana Medicare Advantage plans. To get approved: (1) Confirm PH1 diagnosis with genetic testing for AGXT mutations, (2) Submit PA request through CenterWell Specialty Pharmacy with urinary oxalate levels and specialist prescription, (3) If denied,