Topic

Tepezza (teprotumumab)

A collection of 14 issues

How to Get Tepezza (Teprotumumab) Covered by Humana in Ohio: Complete Guide to Forms, Appeals & Approval

Answer Box: Getting Tepezza Covered by Humana in Ohio Tepezza (teprotumumab) requires prior authorization from Humana in Ohio for all plan types—Medicare Advantage, Medicaid (Humana Healthy Horizons), and commercial plans. The fastest path to approval: 1) Your prescriber submits a PA request via CoverMyMeds or fax to 877-486-2621 with

Myths vs. Facts: Getting Tepezza (Teprotumumab) Covered by Humana in Texas

Answer Box: Getting Tepezza Covered by Humana in Texas Tepezza (teprotumumab) coverage through Humana Medicare Advantage in Texas requires prior authorization as a Part B medical benefit. You need documentation from an ophthalmologist or endocrinologist showing moderate-to-severe thyroid eye disease (TED), failed steroid therapy, and euthyroid status within 30 days.

How to Get Tepezza (teprotumumab) Covered by Blue Cross Blue Shield in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Tepezza Covered by Blue Cross Blue Shield in Washington Fastest path: Submit prior authorization with complete TED documentation (CAS score, photos, euthyroid labs, ophthalmologist prescription). If denied, file internal appeal within plan deadlines, then request IRO external review through Washington's Office of Insurance Commissioner (1-800-562-6900)

How to Get Tepezza (teprotumumab) Covered by Cigna in Michigan: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Tepezza (teprotumumab) Covered by Cigna in Michigan Cigna requires prior authorization for Tepezza (teprotumumab) for Thyroid Eye Disease (TED). To get coverage: 1) Complete Cigna's Tepezza Prior Authorization Form with detailed TED documentation including Clinical Activity Score (CAS), 2) If denied, file internal appeal within

How to Get Tepezza (Teprotumumab) Covered by Humana in Illinois: PA Forms, Appeals, and Approval Guide

Answer Box: Getting Tepezza Covered by Humana in Illinois Tepezza (teprotumumab) requires prior authorization from Humana and is typically covered under Medicare Part B as a medical benefit, not Part D. The fastest path to approval: (1) Have your ophthalmologist or endocrinologist submit a PA request with documented thyroid eye

How to Get Tepezza (Teprotumumab) Covered by Aetna CVS Health in California: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Tepezza Covered by Aetna CVS Health in California Tepezza (teprotumumab) requires prior authorization from Aetna CVS Health for thyroid eye disease (TED). You'll need documentation of moderate-to-severe TED, specialist evaluation, and prior treatment failures. If denied, California's Independent Medical Review (IMR) has a

How to Get Tepezza (teprotumumab) Covered by UnitedHealthcare in Pennsylvania: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Tepezza Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Tepezza (teprotumumab) in Pennsylvania through OptumRx. You need: moderate-to-severe thyroid eye disease diagnosed by an ophthalmologist/endocrinologist, euthyroid status, and prior corticosteroid trial or contraindication. Submit via UHC Provider Portal or fax to 1-844-403-1027. If denied,

How to Get Tepezza (Teprotumumab) Covered by Blue Cross Blue Shield in North Carolina: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Tepezza Covered by BCBS in North Carolina Tepezza (teprotumumab) requires prior authorization from Blue Cross Blue Shield of North Carolina for thyroid eye disease coverage. Your fastest path to approval: 1) Gather comprehensive TED documentation including Clinical Activity Score (CAS ≥3), proptosis measurements, and prior therapy failures;

How to Get Tepezza (Teprotumumab) Covered by Blue Cross Blue Shield in Georgia: Complete Requirements Checklist

Answer Box: Getting Tepezza Covered by Blue Cross Blue Shield Georgia Blue Cross Blue Shield Georgia (Anthem BCBS) requires prior authorization for Tepezza (teprotumumab) for thyroid eye disease. Key requirements: active TED diagnosis, age 18+, ophthalmology/endocrinology specialist prescriber, and monitoring agreements. The fastest path: submit complete PA with clinical

How to Get Tepezza (Teprotumumab) Covered by UnitedHealthcare in Georgia: Prior Authorization Guide and Appeal Process

Answer Box: Getting Tepezza Covered by UnitedHealthcare in Georgia UnitedHealthcare requires prior authorization for Tepezza (teprotumumab) with specific criteria: moderate-to-severe thyroid eye disease diagnosed by an ophthalmologist/endocrinologist, euthyroid status, documented corticosteroid trial or contraindication, and Clinical Activity Score ≥3. Fastest path: Have your specialist submit a complete PA request