Topic

Tagrisso (osimertinib)

A collection of 25 issues

If Tagrisso (Osimertinib) Isn't Approved by Blue Cross Blue Shield in Michigan: Formulary Alternatives & Exception Paths

Answer Box: Getting Tagrisso Alternatives or Exceptions with BCBS Michigan If BCBS Michigan denies Tagrisso (osimertinib), you have three main paths: try formulary alternatives like erlotinib or gefitinib with prior authorization, request a formulary exception for Tagrisso with medical necessity documentation, or appeal the denial through Michigan's external
5 min read

Getting Tagrisso (Osimertinib) Covered by Blue Cross Blue Shield in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Tagrisso Covered by BCBS North Carolina Fastest Path: Tagrisso (osimertinib) requires prior authorization from Blue Cross Blue Shield of North Carolina for EGFR-mutant NSCLC. Your oncologist must document EGFR mutation testing (exon 19 deletion or L858R), disease staging, and any prior TKI failures. Submit PA via CoverMyMeds
6 min read

UnitedHealthcare's Coverage Criteria for Tagrisso (osimertinib) in Pennsylvania: What Counts as "Medically Necessary"?

Answer Box: Getting Tagrisso Covered by UnitedHealthcare in Pennsylvania To get Tagrisso (osimertinib) covered by UnitedHealthcare in Pennsylvania, you need: documented EGFR mutation (exon 19 deletion or L858R), confirmed NSCLC diagnosis, and prior authorization approval. Submit through the UHC Provider Portal with pathology reports and staging documentation. If denied, Pennsylvania&
5 min read

How to Get Tagrisso (osimertinib) Covered by Blue Cross Blue Shield in California: Prior Authorization Forms, Appeal Process & Success Strategies

Answer Box: Getting Tagrisso Covered in California Blue Cross Blue Shield plans in California require prior authorization for Tagrisso (osimertinib) with documented EGFR mutations in NSCLC. Submit electronically via CoverMyMeds or the plan's provider portal with pathology reports showing EGFR testing results. If denied, file an internal appeal
6 min read

How to Get Tagrisso (Osimertinib) Covered by Aetna CVS Health in Michigan: Prior Authorization Forms, Appeals, and State Rights

Answer Box: Getting Tagrisso Covered by Aetna CVS Health in Michigan Fastest path to approval: Submit prior authorization with documented EGFR mutation test results, specific NSCLC diagnosis/stage, and prescriber attestation that Tagrisso meets FDA labeling criteria. Aetna typically requires 30-45 days for standard decisions, 72 hours for urgent oncology
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Getting Tagrisso (Osimertinib) Covered by Cigna in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Quick Path to Approval Cigna requires prior authorization for Tagrisso (osimertinib) with documented EGFR mutation testing and oncologist prescribing. Fastest approval path: Submit PA through Express Scripts/Accredo with EGFR mutation results, pathology report, and medical necessity letter. If denied, file internal appeal within 180 days, then request
6 min read