Topic

Pennsylvania

A collection of 499 issues

How to Get Rinvoq (upadacitinib) Covered by Blue Cross Blue Shield in Pennsylvania: Complete Guide to Prior Authorization, Appeals, and State Protections

Answer Box: Getting Rinvoq Covered in Pennsylvania Blue Cross Blue Shield Pennsylvania requires prior authorization for Rinvoq (upadacitinib) with step therapy requirements. Your fastest path to approval: 1) Have your doctor submit PA documentation showing failed conventional DMARDs or TNF inhibitors, 2) Include clinical rationale and lab results, 3) Use
6 min read

How to Get Hetlioz (tasimelteon) Covered by Cigna in Pennsylvania: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Hetlioz (tasimelteon) Covered by Cigna in Pennsylvania Eligibility: Hetlioz requires prior authorization from Cigna for Non-24-Hour Sleep-Wake Disorder (adults 18+, totally blind) or Smith-Magenis syndrome (ages 3+). Fastest path: Gather sleep specialist notes, failed step therapy documentation (ramelteon + one sedative), and submit PA via Cigna provider portal.
6 min read

How to Get Fintepla (fenfluramine) Covered by Humana in Pennsylvania: Prior Authorization Requirements and Appeal Rights

Answer Box: Getting Fintepla (fenfluramine) Covered by Humana in Pennsylvania Fintepla (fenfluramine) requires prior authorization from Humana Medicare Advantage with specific documentation: confirmed Dravet syndrome or Lennox-Gastaut syndrome diagnosis, failed trials of at least two prior antiseizure medications, REMS program enrollment, and baseline echocardiogram. Submit through Humana's portal
6 min read

How to Get Koselugo (Selumetinib) Covered by Humana in Pennsylvania: Prior Authorization Forms, Appeal Scripts, and Renewal Timeline

Quick Answer: Getting Koselugo Covered by Humana in Pennsylvania Humana requires prior authorization for Koselugo (selumetinib) in Pennsylvania, typically approved for pediatric patients ≥2 years with NF1 and symptomatic, inoperable plexiform neurofibromas. Submit PA requests 30-60 days early with complete documentation: confirmed NF1 diagnosis, MRI showing plexiform neurofibromas, baseline LVEF/
6 min read