Topic

Virginia

A collection of 406 issues

How to Get Arikayce (Amikacin Liposome Inhalation) Covered by Blue Cross Blue Shield in Virginia: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Arikayce Covered by Blue Cross Blue Shield in Virginia Arikayce (amikacin liposome inhalation) requires prior authorization from Blue Cross Blue Shield in Virginia for MAC lung disease. To get coverage, you need documented refractory MAC after 6+ months of standard multidrug therapy with persistent positive cultures. Submit
5 min read

How to Get Carbaglu (Carglumic Acid) Covered by UnitedHealthcare in Virginia: Complete PA Guide with Appeals Process

Quick Answer: Getting Carbaglu Covered by UnitedHealthcare in Virginia Yes, you can get Carbaglu (carglumic acid) covered by UnitedHealthcare in Virginia if you have confirmed NAGS deficiency. UnitedHealthcare requires prior authorization with genetic/enzyme testing, elevated ammonia levels, and specialist documentation. If denied, Virginia's external review process via
5 min read

How to Get Besponsa (Inotuzumab Ozogamicin) Covered by UnitedHealthcare in Virginia: Complete Guide to Prior Authorization, Appeals, and State Protections

Answer Box: Getting Besponsa Covered in Virginia Besponsa (inotuzumab ozogamicin) requires prior authorization from UnitedHealthcare in Virginia. Your oncologist must document CD22-positive B-cell ALL, failed prior chemotherapy, and a hepatic monitoring plan. If denied, Virginia offers strong consumer protections: you can appeal internally (180 days), then request external review through
6 min read

If Imbruvica (Ibrutinib) Isn't Approved by UnitedHealthcare in Virginia: Formulary Alternatives & Exception Paths

Answer Box: When UnitedHealthcare Denies Imbruvica in Virginia If UnitedHealthcare denies Imbruvica (ibrutinib) for CLL/SLL in Virginia, you have two main paths: try formulary-preferred alternatives like acalabrutinib (Calquence) or zanubrutinib (Brukinsa), or request an exception with documented medical necessity. UnitedHealthcare typically requires step therapy with preferred BTK inhibitors first.
5 min read