Topic

Tagrisso (osimertinib)

A collection of 12 issues

UnitedHealthcare's Coverage Criteria for Tagrisso in Ohio: What Counts as "Medically Necessary"?

Answer Box: Getting Tagrisso Covered by UnitedHealthcare in Ohio UnitedHealthcare requires prior authorization for Tagrisso (osimertinib) based on documented EGFR mutation and NSCLC diagnosis. Your fastest path to approval: 1) Gather EGFR mutation test results from FDA-approved lab, 2) Have oncologist submit PA via UnitedHealthcare Provider Portal, 3) If denied,

Do You Qualify for Tagrisso Coverage by UnitedHealthcare in Illinois? Decision Tree & Next Steps

Answer Box: Quick Path to Tagrisso Coverage in Illinois Yes, you likely qualify if you have NSCLC with EGFR mutations (exon 19 deletion, L858R, T790M, S768I, L861Q, or G719X). UnitedHealthcare requires prior authorization through OptumRx with mutation test results and treatment history. First step today: Have your oncologist submit a

Getting Tagrisso (Osimertinib) Covered by Cigna in Illinois: Complete PA Guide with Forms and Appeal Templates

Answer Box: Getting Tagrisso (Osimertinib) Covered by Cigna in Illinois Cigna requires prior authorization for Tagrisso (osimertinib) with documented EGFR mutation testing and oncology management. Illinois banned step therapy in 2025 for state-regulated plans, but ERISA plans may still require it. If denied, you have 4 months to request external

Renewing Tagrisso (Osimertinib) Coverage with Cigna in California: Essential Timeline and Documentation Guide

Answer Box: Renewing Tagrisso Coverage with Cigna Cigna requires annual renewal of prior authorization for Tagrisso (osimertinib) in California. Start the renewal process 4-6 weeks before your current authorization expires. You'll need updated EGFR mutation documentation, current oncologist assessment showing treatment benefit, and recent imaging/labs. Submit through

Myths vs. Facts: Getting Tagrisso (Osimertinib) Covered by Cigna in Georgia

Quick Answer: Tagrisso (Osimertinib) Coverage with Cigna in Georgia Fastest path to approval: Submit prior authorization with documented EGFR mutation test results and oncologist's medical necessity letter through Cigna's provider portal. If denied, file internal appeal within 180 days, then external review through Georgia Department of

Renewing Tagrisso (Osimertinib) Approval with Humana in Pennsylvania: 2025 Guide to Timing, Documentation, and Appeals

Answer Box: Renewing Your Tagrisso Coverage with Humana in Pennsylvania Tagrisso (osimertinib) renewal with Humana requires prior authorization every 6-12 months. Start the renewal process 30-45 days before your current approval expires. You'll need updated EGFR mutation testing, response assessment imaging, and a medical necessity letter from your

Myths vs. Facts: Getting Tagrisso (Osimertinib) Covered by Humana in Illinois

Answer Box: Getting Tagrisso (Osimertinib) Covered by Humana in Illinois Humana requires prior authorization for Tagrisso (osimertinib) with documented EGFR mutation testing and FDA-approved indication. If denied, you have 65 days to appeal internally, then 30 days for Illinois external review—one of the strictest deadlines nationally. First step: Have

Aetna (CVS Health) Coverage Criteria for Tagrisso (Osimertinib) in Pennsylvania: What Counts as "Medically Necessary"?

Answer Box: Getting Tagrisso (Osimertinib) Covered by Aetna (CVS Health) in Pennsylvania Aetna (CVS Health) requires prior authorization for Tagrisso with documented EGFR mutation testing (exon 19 deletion or L858R) and FDA-approved indication. Submit through CVS Caremark Specialty (1-866-814-5506) with complete clinical documentation. If denied, you have 180 days for

How to Get Tagrisso (Osimertinib) Covered by UnitedHealthcare in Washington: Prior Authorization Guide & Appeal Steps

Answer Box: Getting Tagrisso Covered by UnitedHealthcare in Washington You can get Tagrisso (osimertinib) covered by UnitedHealthcare in Washington if you have EGFR-mutated non-small cell lung cancer (NSCLC) and meet prior authorization criteria. The fastest path: ensure your oncologist has documented EGFR mutation test results (exon 19 deletion or L858R)

Myths vs. Facts: Getting Tagrisso (Osimertinib) Covered by Aetna (CVS Health) in New Jersey

Answer Box: Getting Tagrisso Covered by Aetna in New Jersey Eligibility: Tagrisso requires prior authorization from Aetna with documented EGFR mutation testing (exon 19 deletions or L858R) for metastatic or adjuvant NSCLC treatment. Fastest path: Submit PA through CVS Caremark Specialty (1-866-814-5506) with complete EGFR test results, diagnosis codes, and