Topic

Pennsylvania

A collection of 499 issues

How to Get Hemgenix (etranacogene dezaparvovec) Covered by UnitedHealthcare in Pennsylvania: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Hemgenix Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Hemgenix (etranacogene dezaparvovec) with strict eligibility criteria including age 18+, severe/moderately severe hemophilia B, 50+ factor IX exposure days, and treatment at a hemophilia center. If denied, Pennsylvania's Independent External Review Program offers
6 min read

Work With Your Doctor to Get Tavalisse (Fostamatinib) Covered by Blue Cross Blue Shield in Pennsylvania: Complete Prior Authorization Guide

Quick Answer: Getting Tavalisse Covered in Pennsylvania To get Tavalisse (fostamatinib) covered by Blue Cross Blue Shield in Pennsylvania, you'll need prior authorization from a hematologist or oncologist documenting chronic ITP diagnosis, platelet count below 30,000/μL, and failure of first-line therapies (corticosteroids, IVIG, or TPO agonists)
6 min read

How to Get Rezlidhia (olutasidenib) Covered by UnitedHealthcare in Pennsylvania: Prior Authorization, Appeals, and Renewal Guide

Answer Box: Getting Rezlidhia (olutasidenib) covered by UnitedHealthcare in Pennsylvania requires prior authorization with IDH1 mutation testing, documented AML diagnosis, and prior therapy history. If denied, you have 180 days for internal appeals, then 4 months for Pennsylvania's external review (50% overturn rate). Start by having your oncologist
6 min read

How to Get Dupixent (Dupilumab) Covered by Cigna in Pennsylvania: Complete Guide with Forms, Appeals, and Coding

Answer Box: Getting Dupixent Covered by Cigna in Pennsylvania Cigna requires prior authorization for Dupixent (dupilumab) with specific clinical criteria including diagnosis documentation, prior treatment failures, and prescriber specialty. If denied, Pennsylvania's new Independent External Review program has overturned about 50% of appealed denials. First step: Gather your
6 min read

How to Get Voxzogo (vosoritide) Covered by UnitedHealthcare in Pennsylvania: 2025 Requirements, Appeals, and Documentation

Answer Box: Quick Path to Voxzogo Coverage UnitedHealthcare requires prior authorization for Voxzogo (vosoritide) in Pennsylvania. Your fastest path to approval: (1) Ensure prescription comes from a pediatric endocrinologist or geneticist, (2) Submit complete PA with FGFR3 genetic test results, open growth plate imaging, and baseline growth data via UnitedHealthcare
6 min read

How to Get Stelara (Ustekinumab) Covered by Blue Cross Blue Shield in Pennsylvania: Forms, Appeals, and Success Strategies

Quick Answer: Getting Stelara Covered by Blue Cross Blue Shield in Pennsylvania Blue Cross Blue Shield Pennsylvania requires prior authorization for Stelara (ustekinumab), but approval is achievable with proper documentation. Submit the Medical Injectable Specialty Drug Prior Authorization Form through your provider, including diagnosis codes, prior treatment failures, and clinical
7 min read