Topic

Prolastin-C (alpha1-proteinase inhibitor)

A collection of 10 issues

How to Get Prolastin-C Covered by Cigna in Virginia: Complete Prior Authorization Guide

Answer Box: Getting Prolastin-C Covered by Cigna in Virginia Prolastin-C requires prior authorization from Cigna in Virginia. To get approved, you need: (1) documented alpha1-antitrypsin deficiency with severe genotype (Pi*ZZ), (2) AAT serum level <11 mcmol/L, and (3) lung function evidence (FEV1 <65% predicted or accelerated

How to Get Prolastin-C Covered by Humana in Michigan: Prior Authorization Requirements and Appeal Process

Answer Box: Getting Prolastin-C Covered by Humana in Michigan Prolastin-C requires prior authorization from Humana and is subject to step therapy requirements. You'll likely need to try a preferred alpha1-proteinase inhibitor first (like Zemaira) before Humana approves Prolastin-C. Key requirements: confirmed Pi*ZZ genotype, FEV1 ≤65% predicted, and

How to Get Prolastin-C Approved by Humana in New York: Timeline, Appeals, and Step-by-Step Guide

Answer Box: Getting Prolastin-C Covered by Humana in New York Fastest path to approval: Submit prior authorization with documented severe AAT deficiency (Pi*ZZ genotype), failed Aralast trial, and specialist consultation. Humana must respond within 14 days for standard requests, 72 hours for expedited. If denied, file internal appeal within

Renewing Prolastin-C Coverage with Cigna in Illinois: 2025 Requirements and Appeal Options

Quick Answer: Renewing Prolastin-C with Cigna in Illinois Cigna requires annual reauthorization for Prolastin-C with specific documentation. Start your renewal 60-90 days before expiration. You'll need updated pulmonary function tests (FEV1 <65% predicted), confirmed AAT levels <11 μM, and specialist involvement. If denied, Illinois law provides

Getting Prolastin-C Covered by Blue Cross Blue Shield of Michigan: PA Requirements, Appeals, and State Protections (2024-2025)

Answer Box: How to Get Prolastin-C Covered by BCBS Michigan Blue Cross Blue Shield of Michigan requires prior authorization for Prolastin-C (alpha1-proteinase inhibitor) for commercial members, with specific criteria including confirmed alpha-1 antitrypsin deficiency, nonsmoker status, and symptomatic emphysema. Medicare Plus Blue and BCN Advantage members don't need

Do You Qualify for Prolastin-C Coverage by Blue Cross Blue Shield in New York? Decision Tree & Next Steps

Answer Box: Getting Prolastin-C Covered in New York To get Prolastin-C covered by Blue Cross Blue Shield in New York, you need: (1) Confirmed severe alpha-1 antitrypsin deficiency (Pi*ZZ genotype), (2) FEV1 between 30-65% predicted, and (3) clinical evidence of emphysema. First step today: Contact your pulmonologist to order

Getting Prolastin-C Covered by Blue Cross Blue Shield in Virginia: Complete Guide to Prior Authorization, Appeals, and State External Review

Answer Box: Prolastin-C Coverage with Blue Cross Blue Shield in Virginia Blue Cross Blue Shield Virginia requires prior authorization for Prolastin-C (alpha1-proteinase inhibitor) for alpha-1 antitrypsin deficiency. Coverage requires documented severe AATD (like Pi*ZZ genotype), clinical evidence of emphysema, and lung function tests showing moderate impairment (typically FEV1 35-60%

How to Get Prolastin-C Covered by UnitedHealthcare in Ohio: Appeals Guide with Forms and Timelines

Answer Box: Getting Prolastin-C Covered by UnitedHealthcare in Ohio UnitedHealthcare requires prior authorization for Prolastin-C (alpha1-proteinase inhibitor), with approvals typically requiring severe AAT deficiency genotype (Pi*ZZ), documented emphysema, and specific lung function criteria. If denied, you have 21 calendar days to appeal through the UnitedHealthcare Provider Portal, followed by

How to Get Prolastin-C Covered by Humana in Texas: Complete Requirements Checklist and Appeals Guide

Quick Answer: Getting Prolastin-C Covered by Humana in Texas Prolastin-C requires prior authorization from Humana with strict clinical documentation. You'll need confirmed Pi*ZZ genotype, AAT levels below 11 µM, FEV₁ between 30-65% predicted, and emphysema documentation. First step today: Have your doctor submit a prior authorization request

Do You Qualify for Prolastin-C Coverage by UnitedHealthcare in Georgia? Decision Tree & Next Steps

Answer Box: Your Path to Prolastin-C Coverage in Georgia Yes, you can get Prolastin-C covered by UnitedHealthcare in Georgia if you meet medical necessity criteria. You'll need confirmed alpha1-antitrypsin deficiency with Pi*ZZ genotype, documented emphysema, and AAT levels below 11 µM. Start by having your doctor submit