Topic

Pennsylvania

A collection of 502 issues

Work With Your Doctor to Get Elelyso (taliglucerase alfa) Approved by Humana in Pennsylvania: Complete Provider Collaboration Guide

Answer Box: Get Elelyso (taliglucerase alfa) Covered by Humana in Pennsylvania Humana requires prior authorization for Elelyso (taliglucerase alfa) in Pennsylvania. Your physician must submit documentation proving confirmed Type 1 Gaucher disease diagnosis (enzyme testing + genetics), medical necessity, and consideration of formulary alternatives. If denied, you can appeal through Humana&
6 min read

How to Get Tepezza (teprotumumab) Covered by Humana in Pennsylvania: Prior Authorization Guide and Appeals Process

Answer Box: Getting Tepezza Covered by Humana in Pennsylvania Tepezza (teprotumumab) requires prior authorization from Humana for thyroid eye disease (TED) treatment. To get approved: (1) Your ophthalmologist or endocrinologist must document active, moderate-to-severe TED with Clinical Activity Score ≥3 and proptosis measurements, (2) Submit prior authorization through Humana'
6 min read

How to Get Signifor LAR (Pasireotide) Covered by Cigna in Pennsylvania: Prior Authorization Requirements and Appeals Process

Quick Answer: Getting Cigna Coverage for Signifor LAR in Pennsylvania Cigna requires prior authorization for Signifor/Signifor LAR (pasireotide) with strict medical necessity criteria. Your endocrinologist must document: confirmed acromegaly or Cushing's disease diagnosis, elevated IGF-1/UFC levels, failed surgery or ineligibility, and trial/failure of first-generation somatostatin
6 min read

How to Get Cosentyx (Secukinumab) Covered by Aetna CVS Health in Pennsylvania: Complete Guide with Forms and Appeal Scripts

Answer Box: Getting Cosentyx Covered by Aetna CVS Health in Pennsylvania Aetna CVS Health requires prior authorization for Cosentyx (secukinumab) in Pennsylvania, with step therapy requirements for most patients. Fastest path to approval: 1) Ensure TB screening is complete, 2) Document prior treatment failures (typically methotrexate or other biologics), and
5 min read

How to Get Pomalyst (Pomalidomide) Covered by UnitedHealthcare in Pennsylvania: Complete PA Guide and Appeals Process

Answer Box: Getting Pomalyst Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Pomalyst (pomalidomide) with strict step therapy requirements. To get approved, you need documented failure of at least one immunomodulatory agent (like lenalidomide), proteasome inhibitor, or anti-CD38 therapy, plus complete REMS program enrollment. First step today: Have
6 min read

How to Get Oxervate (cenegermin) Covered by Humana in Pennsylvania: Appeals Guide and Medical Necessity Templates

Quick Answer: Getting Oxervate Covered by Humana in Pennsylvania Oxervate (cenegermin) requires prior authorization from Humana for stage 2-3 neurotrophic keratitis. The fastest path: your ophthalmologist submits a medical necessity letter documenting failed conventional treatments (lubricants, bandage lenses) and confirmed corneal sensation loss. If denied, you have 65 days to
6 min read