Topic

Virginia

A collection of 393 issues

Do You Qualify for Keppra (Levetiracetam) Coverage by Cigna in Virginia? Decision Tree & Next Steps

Answer Box: Quick Coverage Assessment Most likely to get approved: Generic levetiracetam is typically covered by Cigna without prior authorization. Brand Keppra requires medical necessity documentation showing generic failure or intolerance. First step today: Call Cigna at 1-800-997-1654 to verify your specific formulary tier and PA requirements. If denied, Virginia&

How to Get Rapivab (Peramivir) Covered by UnitedHealthcare in Virginia: Appeals Guide with Forms and Timelines

Quick Answer: Getting Rapivab Covered by UnitedHealthcare in Virginia Rapivab (peramivir) requires prior authorization from UnitedHealthcare and is often denied initially due to strict medical necessity criteria. To get coverage in Virginia: (1) Submit prior authorization through the UnitedHealthcare Provider Portal with documentation showing symptoms started within 48 hours and

Getting Opfolda (miglustat) Covered by Cigna in Virginia: Prior Authorization, Appeals & Cost Assistance

Answer Box: Getting Opfolda (miglustat) Covered by Cigna in Virginia Quick Path to Coverage: Opfolda (miglustat) requires prior authorization from Cigna and must be prescribed with Pombiliti for late-onset Pompe disease in adults ≥40 kg. Your doctor submits the PA request through CoverMyMeds or Accredo's portal, including proof

Do You Qualify for Vimizim (Elosulfase Alfa) Coverage by Aetna (CVS Health) in Virginia? Decision Tree & Next Steps

Quick Answer: Your Path to Vimizim Coverage Likely eligible if: You have confirmed MPS IVA with documented GALNS enzyme deficiency or genetic testing, plus baseline functional assessments. Fastest path: Submit prior authorization through Availity portal at least 2 weeks before treatment start. First step today: Contact your metabolic specialist to

How to Get Oxervate (Cenegermin) Covered by Cigna in Virginia: Prior Authorization Guide and Appeals Process

Answer Box: Getting Oxervate (Cenegermin) Covered by Cigna in Virginia Eligibility: Cigna covers Oxervate for stage 2 or 3 neurotrophic keratitis with prior authorization. You must be prescribed by an ophthalmologist or optometrist and have failed preservative-free artificial tears for at least 14 days. Fastest path: Submit PA request through

If Tavneos (Avacopan) Isn't Approved by Aetna (CVS Health) in Virginia: Formulary Alternatives & Exception Paths

Answer Box: Your Path Forward If Aetna (CVS Health) denies Tavneos (avacopan) for ANCA-associated vasculitis in Virginia, you have two main options: try formulary alternatives with step therapy or request a medical exception. First step today: Contact your rheumatologist or nephrologist to discuss rituximab or cyclophosphamide as alternatives while simultaneously

How to Get Gilenya (Fingolimod) Covered by Blue Cross Blue Shield in Virginia: Complete PA Guide with Forms and Appeals

Answer Box: Fast Track to Gilenya Coverage in Virginia Getting Gilenya (fingolimod) covered by Blue Cross Blue Shield in Virginia requires prior authorization in most cases. Your fastest path: 1) Verify your plan's formulary status through Anthem's provider portal, 2) Have your neurologist submit a complete

Myths vs. Facts: Getting Zokinvy (lonafarnib) Covered by Blue Cross Blue Shield in Virginia

Answer Box: Zokinvy Coverage in Virginia Getting Zokinvy (lonafarnib) covered by Blue Cross Blue Shield in Virginia requires genetic confirmation of HGPS, specialist prescription, and prior authorization. The fastest path: Have a geneticist or pediatric cardiologist submit complete documentation including genetic test results, BSA calculation (≥0.39 m²), and medical

How to Get Thiola / Thiola EC (Tiopronin) Covered by Cigna in Virginia: Complete Prior Authorization Guide

Quick Answer: Getting Thiola / Thiola EC Covered by Cigna in Virginia Cigna covers Thiola / Thiola EC (tiopronin) for cystinuria with prior authorization required. You'll need documented cystinuria diagnosis, 24-hour urine cystine levels >300-400 mg, and failed conservative treatment (hydration, diet, alkalinization). Generic tiopronin is preferred first-line; Thiola/

How to Get Givlaari (givosiran) Covered by Blue Cross Blue Shield in Virginia: Complete Appeals Guide

Answer Box: Getting Givlaari Covered in Virginia Fastest path to approval: Ensure your specialist documents at least 2 acute hepatic porphyria attacks in the past 6 months with elevated ALA/PBG levels, submit prior authorization through the BCBS Virginia provider portal with complete attack history and genetic testing results, and