Topic

Soliris (eculizumab)

A collection of 49 issues

Do You Qualify for Soliris (Eculizumab) Coverage by Cigna in Florida? Decision Tree & Next Steps

Answer Box: Soliris (Eculizumab) Coverage by Cigna in Florida Cigna requires prior authorization for Soliris (eculizumab) with 72-hour standard review (24 hours expedited). Key requirements: FDA-approved diagnosis confirmation, meningococcal vaccination ≥2 weeks before treatment, REMS enrollment, and prior therapy documentation. Submit via CoverMyMeds or provider portal. If denied, internal appeals

How to Get Soliris (Eculizumab) Covered by Aetna CVS Health in Georgia: Complete Prior Authorization Guide

Quick Answer: Getting Soliris Covered by Aetna CVS Health in Georgia Aetna CVS Health requires prior authorization for Soliris (eculizumab) with diagnosis-specific criteria, mandatory meningococcal vaccination ≥2 weeks before treatment, and CVS Specialty Pharmacy dispensing. Submit the Soliris Precertification Form (GR-68742) via Availity portal or fax 1-844-268-7263. If denied, Georgia

The Requirements Checklist to Get Soliris (eculizumab) Covered by Blue Cross Blue Shield in Pennsylvania

Quick Answer: Your Path to Soliris Approval Getting Soliris (eculizumab) covered by Blue Cross Blue Shield in Pennsylvania requires meeting strict clinical criteria including confirmed diagnosis (PNH, aHUS, gMG, or NMOSD), proof of meningococcal vaccination at least 2 weeks before treatment, and documentation of failed standard therapies. Submit your prior

How to Get Soliris (Eculizumab) Covered by UnitedHealthcare in Virginia: Complete Forms, Appeals, and Contact Guide

Answer Box: Getting Soliris (Eculizumab) Covered by UnitedHealthcare in Virginia UnitedHealthcare requires prior authorization for Soliris (eculizumab) under the medical benefit (HCPCS J1299) with diagnosis-specific criteria including lab confirmation, failed prior therapies, and REMS compliance. Submit PA via UnitedHealthcare provider portal or fax to 1-844-403-1028. If denied, you have 180

Myths vs. Facts: Getting Soliris (eculizumab) Covered by Cigna in Georgia

Answer Box: Getting Soliris Covered by Cigna in Georgia A doctor's prescription does NOT guarantee Soliris (eculizumab) coverage. Cigna requires prior authorization with strict criteria: FDA-approved diagnosis confirmation (PNH, aHUS, gMG, NMOSD), meningococcal vaccination ≥2 weeks before treatment, REMS enrollment, and prior therapy documentation. If denied, Georgia law

How to Get Soliris (Eculizumab) Covered by Humana in Georgia: Complete Coding, Authorization & Appeals Guide

Quick Answer: Getting Soliris (Eculizumab) Covered by Humana in Georgia Soliris (eculizumab) requires prior authorization from Humana for all FDA-approved conditions. The fastest path: ensure meningococcal vaccination ≥2 weeks prior, gather diagnostic labs (flow cytometry for PNH, AQP4-IgG for NMOSD), and submit through CenterWell Specialty Pharmacy with proper ICD-10 coding.

How to Get Soliris (Eculizumab) Covered by Blue Cross Blue Shield of Michigan: Complete Guide with Forms, Timelines, and Appeal Scripts

Answer Box: Getting Soliris Covered by BCBS Michigan To get Soliris (eculizumab) covered by Blue Cross Blue Shield of Michigan, you'll need prior authorization through their NovoLogix system. Since July 2024, BCBS Michigan requires patients to try Empaveli (pegcetacoplan) first for most indications unless contraindicated. The fastest path:

Renewing Soliris (Eculizumab) Coverage with Blue Cross Blue Shield in North Carolina: Complete Timeline and Documentation Guide

Answer Box: Soliris (eculizumab) requires annual reauthorization with Blue Cross Blue Shield of North Carolina. Start renewal 30-60 days before expiration by gathering updated labs (LDH, hemoglobin, platelets), clinical response documentation, and current vaccination records. Submit through Blue e or your specialty pharmacy. If denied, use Smart NC external review—

How to Get Soliris (Eculizumab) Covered by Aetna CVS Health in Michigan: Complete Prior Authorization Guide

Answer Box: Getting Soliris Covered by Aetna CVS Health in Michigan Fastest path to approval: Submit prior authorization with diagnosis-specific lab values (flow cytometry for PNH, anti-AChR antibodies for myasthenia gravis), proof of meningococcal vaccination, and documentation of failed therapies. First step today: Call Aetna at (866) 752-7021 to initiate

Renewing Soliris (Eculizumab) Approval with Blue Cross Blue Shield in Florida: Complete 2025 Guide with Forms and Timelines

Answer Box: Renewing Soliris Coverage in Florida Florida Blue Cross Blue Shield requires annual Soliris (eculizumab) renewal with updated clinical documentation 30-60 days before expiration. Key requirements include: current lab results showing disease response, up-to-date meningococcal vaccination records, REMS compliance documentation, and step therapy completion records. Submit via Availity.com