Topic

Somatuline Depot (lanreotide)

A collection of 25 issues

How to Get Somatuline Depot (Lanreotide) Covered by Blue Cross Blue Shield in Illinois: Complete Prior Authorization and Appeal Guide

Answer Box: Your Fast Track to Somatuline Depot Coverage Blue Cross Blue Shield of Illinois requires prior authorization for Somatuline Depot (lanreotide) for commercial members. The fastest path: Have your prescriber submit documentation of your FDA-approved diagnosis (acromegaly, GEP-NETs, or carcinoid syndrome), any failed octreotide trials, and supporting labs via

How to Get Somatuline Depot (Lanreotide) Covered by Humana in California: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Somatuline Depot (Lanreotide) Covered by Humana in California Fastest path: Humana requires prior authorization for Somatuline Depot, often with step therapy requiring octreotide LAR trial first. If denied, file internal appeals within 65 days, then escalate to federal Independent Review Entity (IRE) for Medicare Advantage plans or

Myths vs. Facts: Getting Somatuline Depot (lanreotide) Covered by UnitedHealthcare in Michigan

Quick Answer: Getting Somatuline Depot Covered Yes, UnitedHealthcare covers Somatuline Depot (lanreotide) in Michigan with prior authorization. Most denials stem from missing documentation or step-therapy requirements, not coverage exclusions. The fastest path: ensure your endocrinologist or oncologist documents FDA-approved indications (acromegaly, GEP-NETs, carcinoid syndrome), prior octreotide trial or contraindication, and

Work With Your Doctor to Get Somatuline Depot (Lanreotide) Approved by Aetna CVS Health in New Jersey

Answer Box: To get Somatuline Depot (lanreotide) covered by Aetna CVS Health in New Jersey, you'll need prior authorization through CVS Specialty Pharmacy with documentation of acromegaly, GEP-NET, or carcinoid syndrome diagnosis plus any required step therapy (often octreotide trial). Submit via Availity portal or fax 1-800-323-2445 with

How to Get Somatuline Depot (Lanreotide) Covered by Blue Cross Blue Shield in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Blue Cross Blue Shield plans in Washington (primarily Premera Blue Cross) require prior authorization for Somatuline Depot (lanreotide), typically demanding an octreotide trial first. Submit PA with specialist documentation, FDA-approved diagnosis (acromegaly, GEP-NETs, carcinoid syndrome), and clinical failure evidence. If denied, appeal within 180 days internally, then request

Myths vs. Facts: Getting Somatuline Depot (Lanreotide) Covered by Aetna CVS Health in California

Answer Box: Getting Somatuline Depot Covered by Aetna CVS Health in California Aetna CVS Health requires prior authorization for Somatuline Depot (lanreotide) with specific criteria for acromegaly, GEP-NETs, and carcinoid syndrome. Key requirements include elevated IGF-1 levels, endocrinologist/oncologist prescription, and often prior octreotide trial. Fastest path: Submit complete PA

Getting Somatuline Depot (Lanreotide) Covered by UnitedHealthcare in California: Complete Prior Authorization and Billing Guide

Answer Box: Your Path to Coverage Getting Somatuline Depot (lanreotide) covered by UnitedHealthcare in California requires prior authorization through OptumRx. Start with proper medical coding: ICD-10 E22.0 for acromegaly or appropriate NET codes, HCPCS J1930 (1 mg per unit), and correct NDCs. UnitedHealthcare often requires step therapy with octreotide

How Long Does It Take to Get Somatuline Depot (lanreotide) Approved by Blue Cross Blue Shield in Virginia? Complete Timeline & Appeals Guide

Answer Box: Getting Somatuline Depot (lanreotide) approved by Blue Cross Blue Shield in Virginia typically takes 5-10 business days for standard prior authorization, or 72 hours for expedited cases. Your fastest path: Have your endocrinologist/oncologist submit complete documentation including diagnosis confirmation, prior octreotide trial details, and medical necessity justification

How to Get Somatuline Depot (lanreotide) Covered by Blue Cross Blue Shield in Ohio: Prior Authorization Forms, Appeals, and Timeline Guide

Answer Box: Getting Somatuline Depot Covered in Ohio Blue Cross Blue Shield (BCBS) plans in Ohio typically require prior authorization for Somatuline Depot (lanreotide) with specific criteria for acromegaly, GEP-NETs, and carcinoid syndrome. Most plans limit coverage to one syringe per 28 days (maximum 120 mg every 4 weeks) and

How to Get Somatuline Depot (Lanreotide) Covered by Humana in New York: Prior Authorization, Appeals, and Cost Assistance Guide

Answer Box: Getting Somatuline Depot Covered by Humana in New York Fastest path to approval: Submit Humana's prior authorization form with diagnosis (acromegaly, GEP-NET, or carcinoid syndrome), prior therapy documentation, and clinical justification. Humana typically covers Somatuline Depot on specialty tier with PA required. If denied, you have