Topic

Trikafta / Kaftrio (elexacaftor/tezacaftor/ivacaftor)

A collection of 36 issues

How to Get Trikafta Covered by Aetna CVS Health in Ohio: Complete Prior Authorization and Appeals Guide 2024

Quick Answer: Getting Trikafta Covered by Aetna CVS Health in Ohio Trikafta requires prior authorization from Aetna CVS Health in Ohio. The fastest path to approval: 1) Have your CF specialist submit a PA request with complete CFTR genotype documentation and ICD-10 diagnosis code E84.0-E84.9, 2) Ensure CVS

How to Get Trikafta Covered by UnitedHealthcare in North Carolina: Prior Authorization Guide and Appeals Process

Answer Box: Fastest Path to Trikafta Coverage UnitedHealthcare requires prior authorization for Trikafta through OptumRx specialty pharmacy. You need documented CFTR genotype testing showing F508del or another responsive mutation, plus a CF specialist's medical necessity letter. If denied, you have 180 days for internal appeals, then 120 days

How to Get Trikafta Covered by Aetna CVS Health in California: Complete Prior Authorization and Appeals Guide 2024

Answer Box: Fastest Path to Trikafta Approval Trikafta requires prior authorization from Aetna CVS Health in California. Submit CFTR genotype results showing F508del mutation, baseline liver function tests, and CF specialist attestation through Aetna's provider portal. Standard approval takes 5-10 business days. If denied, file internal appeal within

Myths vs. Facts: Getting Trikafta Covered by Cigna in Michigan - Complete 2025 Guide

Quick Answer: Trikafta Coverage by Cigna in Michigan Getting Trikafta covered by Cigna in Michigan requires prior authorization with specific documentation: CFTR genotype testing showing eligible mutations, CF specialist prescription, and clinical justification. Common myths persist about automatic coverage and simple approval processes. Reality: Success depends on complete documentation, understanding

How to Get Trikafta Covered by Aetna CVS Health in Virginia: Complete Prior Authorization and Appeals Guide 2024

Answer Box: Getting Trikafta Covered by Aetna CVS Health in Virginia Trikafta requires prior authorization from Aetna CVS Health in Virginia. Submit complete documentation including CFTR genotype testing showing F508del mutation, CF diagnosis with ICD-10 codes E84.0-E84.9, and baseline liver function tests. If denied, appeal within 180 days

How Long Does It Take to Get Trikafta Approved by Cigna in Virginia? Complete Timeline and Appeals Guide

Answer Box: Getting Trikafta Approved by Cigna in Virginia Standard Cigna prior authorization for Trikafta takes up to 5 business days in Virginia, or 2 calendar days for expedited requests. You'll need F508del mutation documentation, CF specialist prescription, and complete clinical records. If denied, you have 180 days

Getting Trikafta Covered by Blue Cross Blue Shield in California: Complete Guide to Prior Authorization and Appeals (2024)

Answer Box: Fastest Path to Trikafta Coverage Trikafta requires prior authorization from Blue Cross Blue Shield of California. You'll need CFTR genotype documentation, CF diagnosis with ICD-10 codes, and baseline liver function tests. Submit through Blue Shield's AuthAccel portal or fax the PA form. If denied,

How to Get Trikafta Covered by Humana in Illinois: Prior Authorization, Appeals & Coding Guide

Answer Box: Getting Trikafta Covered by Humana in Illinois Yes, Humana covers Trikafta (elexacaftor/tezacaftor/ivacaftor) in Illinois, but prior authorization is required. The fastest path: (1) Submit PA request via Availity.com or fax 1-888-447-3430 with complete clinical documentation including CFTR genotype, (2) If denied, file internal appeal within

How to Get Trikafta Covered by Blue Cross Blue Shield in Florida: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Trikafta Covered in Florida Trikafta requires prior authorization from Blue Cross Blue Shield plans in Florida. To get coverage: 1) Have your CF specialist submit a PA request with genetic testing showing F508del or responsive CFTR mutation, 2) Use Florida Blue's specialty pharmacy network (not

How to Get Trikafta Covered by Aetna CVS Health in Florida: Complete Prior Authorization and Appeals Guide 2025

Answer Box: Getting Trikafta Covered by Aetna CVS Health in Florida Trikafta requires prior authorization from Aetna CVS Health with CFTR genotype documentation (F508del or eligible mutation), confirmed CF diagnosis (ICD-10 E84.0), and pulmonologist prescription. Submit requests 30-60 days early via Availity portal or fax to avoid coverage gaps.