Topic

Prolastin-C (alpha1-proteinase inhibitor)

A collection of 25 issues

How to Get Prolastin-C Covered by Cigna in New Jersey: Appeals, Forms & Alternative Options

Quick Answer: Getting Prolastin-C Covered by Cigna in New Jersey Eligibility: Adults with severe alpha-1 antitrypsin deficiency (serum level <11 mcM/<80 mg/dL) and emphysema. Fastest path: Submit prior authorization with pulmonologist's medical necessity letter including genotype, lung function tests, and smoking cessation documentation. First

How to Get Prolastin-C Covered by Aetna CVS Health in Virginia: Appeal Process, Forms & Timelines

Answer Box: Getting Prolastin-C Covered by Aetna CVS Health in Virginia Prolastin-C is non-formulary for most Aetna commercial plans but may be covered for Medicare members with prior authorization. Your fastest path: 1) Check if you qualify for preferred alternatives (Aralast NP, Glassia), 2) Submit a formulary exception request with

How Long Does It Take to Get Prolastin-C Approved by UnitedHealthcare in New York? Complete Timeline & Appeals Guide

Answer Box: Getting Prolastin-C Approved by UnitedHealthcare in New York Timeline: Standard prior authorization decisions take 72 hours; expedited requests get 24-hour turnaround. Requirements: Pi*ZZ genotype confirmation, lung function tests showing impairment, and often trial/failure of preferred alternatives (Aralast NP, Glassia, Zemaira). First step: Gather complete documentation and

How to Get Prolastin-C Covered by Humana Medicare in Washington: Complete Guide with Forms and Appeal Scripts

Answer Box: Quick Path to Prolastin-C Coverage Getting Prolastin-C covered by Humana Medicare in Washington requires prior authorization and may involve step therapy. Here's your fastest path: 1. Confirm eligibility: Pi*ZZ genotype, FEV1 documentation, and emphysema diagnosis 2. Submit complete PA: Include AAT levels <11 µM,

Complete Guide to Getting Prolastin-C Covered by Aetna in Pennsylvania: Prior Authorization, Appeals, and Success Strategies

Answer Box: Getting Prolastin-C Covered by Aetna in Pennsylvania Yes, Aetna requires prior authorization for Prolastin-C in Pennsylvania. Success requires documented alpha-1 antitrypsin deficiency (Pi*ZZ genotype), serum AAT levels <80 mg/dL, evidence of emphysema, and FEV1 between 25-80% of predicted. Fastest path to approval: 1. Gather genetic

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