Topic

Soliris (eculizumab)

A collection of 49 issues

Cigna's Coverage Criteria for Soliris (Eculizumab) in Pennsylvania: What Counts as "Medically Necessary"?

Answer Box: Getting Soliris Covered by Cigna in Pennsylvania Cigna requires prior authorization for Soliris (eculizumab) with specific diagnostic tests, meningococcal vaccinations ≥2 weeks before treatment, and prescriber REMS enrollment. For PNH, you need flow cytometry showing GPI-anchored protein deficiency; for myasthenia gravis, positive anti-AChR antibodies; for NMOSD, positive anti-AQP4
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How to Get Soliris (Eculizumab) Covered by Cigna in Illinois: Complete Prior Authorization and Appeals Guide

Answer Box: Your Fastest Path to Soliris Coverage Cigna requires prior authorization for Soliris (eculizumab) in Illinois based on FDA-approved indications with specific diagnostic testing. Submit through CoverMyMeds or provider portal with specialist evaluation, required labs (flow cytometry for PNH, anti-AChR antibodies for myasthenia gravis), meningococcal vaccination proof, and REMS
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How to Get Soliris (Eculizumab) Covered by UnitedHealthcare in Washington: Complete Guide to Prior Authorization, Appeals, and State Resources

Quick Start: Your Path to Soliris Coverage in Washington Getting Soliris (eculizumab) covered by UnitedHealthcare in Washington requires prior authorization with strict documentation. First step: Verify your plan type (commercial, Medicaid/Apple Health, or Medicare) and gather diagnosis labs, vaccination records, and prior therapy history. Submit PA through the UnitedHealthcare
6 min read

The Complete Guide to Getting Soliris (Eculizumab) Covered by Cigna in Texas: Forms, Appeals, and Success Strategies

Quick Answer: Getting Soliris (Eculizumab) Covered by Cigna in Texas Cigna requires prior authorization for Soliris using their specific CCRD form with documented FDA-approved diagnosis (PNH, aHUS, gMG, or NMOSD), meningococcal vaccination proof, and REMS enrollment. If denied, Texas residents with fully-insured plans can appeal internally (180 days) and request
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How to Get Soliris (Eculizumab) Covered by Humana in Texas: Complete Prior Authorization and Appeals Guide

Quick Answer: Soliris (eculizumab) requires prior authorization from Humana for all FDA-approved conditions (PNH, aHUS, myasthenia gravis, NMOSD). Key requirements: meningococcal vaccination ≥2 weeks before treatment, diagnostic confirmation, and step therapy documentation. Submit through CenterWell Specialty Pharmacy or fax to 877-486-2621. If denied, Texas residents have 65 days to appeal
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How to Get Soliris (eculizumab) Covered by Cigna in New Jersey: Complete Prior Authorization and Appeals Guide

Answer Box: Your Fastest Path to Soliris Coverage Cigna requires prior authorization for Soliris (eculizumab) with a 72-hour standard review (24 hours if expedited). Key requirements: confirmed diagnosis via flow cytometry (PNH) or antibody testing (gMG/NMOSD), meningococcal vaccinations ≥2 weeks before treatment, REMS enrollment, and documented prior therapy failures.
6 min read