Topic

Pennsylvania

A collection of 244 issues

Getting Kanuma (Sebelipase Alfa) Covered by Blue Cross Blue Shield in Pennsylvania: Complete Cost-Saving Guide

Answer Box: Getting Kanuma Covered in Pennsylvania Kanuma (sebelipase alfa) is typically covered by Blue Cross Blue Shield plans in Pennsylvania as a specialty drug requiring prior authorization. To get coverage: 1. Submit PA request with LAL-D diagnosis confirmation (enzyme activity test + LIPA genetic testing) 2. Use specialty pharmacy (required

Work With Your Doctor to Get HyperHEP (Hepatitis B Immune Globulin) Approved by Blue Cross Blue Shield in Pennsylvania

Answer Box: Getting HyperHEP Covered by Blue Cross Blue Shield in Pennsylvania Blue Cross Blue Shield Pennsylvania (Highmark and Independence) requires prior authorization for HyperHEP (hepatitis B immune globulin). Your fastest path to approval: work with your doctor to submit a complete prior authorization request documenting post-exposure prophylaxis need within

How Long Does It Take to Get Cresemba (Isavuconazole) Approved by Blue Cross Blue Shield in Pennsylvania? Complete Timeline & Appeals Guide

Answer Box: Quick Start Guide Getting Cresemba (isavuconazole) approved by Blue Cross Blue Shield in Pennsylvania typically takes 5-15 business days for standard prior authorization, or 72 hours for expedited urgent requests. Your fastest path: Have your infectious disease specialist submit a complete prior authorization through the BCBS provider portal

How to Get Pomalyst (pomalidomide) Covered by Aetna CVS Health in Pennsylvania: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Pomalyst Covered by Aetna CVS Health in Pennsylvania Pomalyst (pomalidomide) requires prior authorization from Aetna CVS Health in Pennsylvania. Your fastest path to approval: (1) Ensure REMS program enrollment is complete, (2) Submit PA request with documented lenalidomide and proteasome inhibitor failure, and (3) Include oncologist attestation.

The Requirements Checklist to Get Signifor LAR (Pasireotide) Covered by Blue Cross Blue Shield in Pennsylvania: Forms, Appeals, and Success Strategies

Answer Box: Getting Signifor LAR Covered by BCBS in Pennsylvania Signifor LAR (pasireotide) requires prior authorization from all Blue Cross Blue Shield plans in Pennsylvania. The fastest path to approval: (1) Verify your plan's specialty pharmacy network and current PA form, (2) Submit complete documentation including failed first-line

Oxbryta (Voxelotor) Coverage by UnitedHealthcare in Pennsylvania: 2024 FDA Withdrawal Impact and Alternative Treatments

Answer Box: Oxbryta Coverage Status Oxbryta (voxelotor) was withdrawn from the U.S. market on September 25, 2024, following FDA safety concerns. UnitedHealthcare and all insurers now universally deny coverage—no appeals process exists for a withdrawn drug. If you were taking Oxbryta, contact your sickle cell specialist immediately to

How to Get Tracleer (bosentan) Covered by Aetna CVS Health in Pennsylvania: Complete Prior Authorization Guide

Answer Box: Getting Tracleer (bosentan) Covered by Aetna CVS Health in Pennsylvania Tracleer (bosentan) is typically non-formulary on Aetna's 2025 commercial plans, requiring prior authorization and step therapy with preferred alternatives like ambrisentan or Opsumit. All patients must enroll in the mandatory REMS program before dispensing. In Pennsylvania,

Get Evkeeza (Evinacumab) Covered by UnitedHealthcare in Pennsylvania: Step-by-Step Approval Guide

Quick Answer: Getting Evkeeza Covered in Pennsylvania To get Evkeeza (evinacumab) approved by UnitedHealthcare in Pennsylvania, you need: confirmed HoFH diagnosis with LDL-C >400 mg/dL, documented failures of maximum-tolerated statins/ezetimibe/PCSK9 inhibitors, and prior authorization through the UnitedHealthcare Provider Portal. If denied, Pennsylvania's new external

How to Get Strimvelis Gene Therapy Covered by Aetna in Pennsylvania: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Strimvelis Covered by Aetna in Pennsylvania Strimvelis gene therapy for ADA-SCID requires extensive prior authorization from Aetna, including genetic confirmation, enzyme testing, and proof of no suitable bone marrow donor. Since treatment is only available in Milan, Italy, you'll need international coverage approval. Start with

How to Get Nucala (Mepolizumab) Covered by Blue Cross Blue Shield in Pennsylvania: 2024 Appeals Guide

Answer Box: Getting Nucala Covered in Pennsylvania To get Nucala (mepolizumab) covered by Blue Cross Blue Shield in Pennsylvania: Your doctor must submit a prior authorization request with blood eosinophil count ≥150 cells/µL, proof of severe eosinophilic asthma uncontrolled on high-dose ICS/LABA therapy, and exacerbation history. If denied,