Topic

Texas

A collection of 486 issues

How Long Does It Take to Get Opfolda (miglustat) Approved by UnitedHealthcare in Texas? Complete Timeline Guide

Answer Box: Opfolda Approval Timeline in Texas Getting Opfolda (miglustat) approved by UnitedHealthcare in Texas typically takes 7-14 business days for standard review, with expedited approval possible in 24-72 hours for urgent cases. The drug requires prior authorization and must be prescribed with Pombiliti for late-onset Pompe disease in adults

Getting Cosentyx (Secukinumab) Covered by Humana in Texas: Prior Authorization Forms, Appeals, and Success Strategies

Answer Box: Your Fastest Path to Cosentyx Coverage Cosentyx (secukinumab) requires prior authorization for all Humana plans in Texas. Submit the Texas Standardized Prior Authorization Request Form via fax (1-888-447-3430) or Humana's provider portal. Include your diagnosis with ICD-10 code, prior therapy failures, PASI/BSA scores, and specialist

How to Get Rebif (Interferon Beta-1a) Covered by UnitedHealthcare in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Rebif Covered by UnitedHealthcare in Texas UnitedHealthcare requires prior authorization for Rebif (interferon beta-1a) through OptumRx, often with step therapy requirements. Fastest path: Have your neurologist submit a PA request via the UnitedHealthcare Provider Portal with complete MS documentation (diagnosis, MRI reports, relapse history). If denied, file

How to Get Tracleer (Bosentan) Covered by Cigna in Texas: Complete PA Guide and Appeals Process

Answer Box: Getting Tracleer (Bosentan) Covered by Cigna in Texas Tracleer (bosentan) requires prior authorization from Cigna and enrollment in the mandatory Bosentan REMS program. Coverage is approved for 1 year when you have WHO Group 1 PAH confirmed by right heart catheterization and are prescribed by a cardiologist or

How to Get Brineura (Cerliponase Alfa) Covered by Aetna (CVS Health) in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Brineura Covered by Aetna (CVS Health) in Texas Aetna requires prior authorization for Brineura (cerliponase alfa) in Texas with strict clinical criteria. You'll need confirmed CLN2 disease diagnosis, CLN2 Clinical Rating Scale scores ≥1 in motor and language domains, prescription by a pediatric neurologist or

How to Get Xembify (Immune Globulin, SC) Covered by Humana in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Xembify Covered by Humana in Texas Xembify (immune globulin, SC) requires prior authorization from Humana with documentation of primary immunodeficiency diagnosis, IgG levels <2 standard deviations below normal, and ≥2 serious infections annually. Submit through Humana's provider portal with complete clinical records. Standard decisions

Work With Your Doctor to Get StrataGraft Approved by Cigna in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting StrataGraft Approved by Cigna in Texas StrataGraft requires prior authorization from Cigna for adults 18+ with deep partial-thickness thermal burns when autografting is clinically indicated. Your burn specialist must submit facility-based PA documentation through Cigna's provider portal within 180 days, including burn depth assessment, wound

How to Get Uptravi (selexipag) Covered by Cigna in Texas: Prior Authorization, Appeals, and Cost Assistance

Quick Answer: Getting Uptravi (selexipag) Covered by Cigna in Texas Cigna requires prior authorization for Uptravi (selexipag) to treat WHO Group I pulmonary arterial hypertension (PAH). You'll need confirmed PAH diagnosis via right heart catheterization, functional class II-IV status, and documentation of prior therapy failures. Submit through your

Getting Bavencio (Avelumab) Covered by Blue Cross Blue Shield Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Your Path to Bavencio Coverage in Texas Blue Cross Blue Shield of Texas covers Bavencio (avelumab) with prior authorization for FDA-approved uses: metastatic Merkel cell carcinoma and maintenance urothelial carcinoma. Submit PA requests through Availity Essentials or call the number on your member ID card. If denied, you

How to Get Translarna (Ataluren) Covered by Cigna in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Translarna (Ataluren) Covered by Cigna in Texas Translarna (ataluren) requires prior authorization from Cigna/Express Scripts and is typically non-formulary, requiring a formulary exception for nonsense mutation Duchenne muscular dystrophy (DMD). The fastest path: 1) Confirm genetic testing shows nonsense mutation, 2) Have your neuromuscular specialist submit