Topic

Virginia

A collection of 471 issues

How to Get Blenrep (Belantamab Mafodotin) Covered by Blue Cross Blue Shield in Virginia: Current Access Options and Appeals Guide

Answer Box: Blenrep Coverage in Virginia Blenrep (belantamab mafodotin) is not commercially available in the U.S. as of 2025 due to GSK's voluntary withdrawal in 2022 pending FDA resubmission (PDUFA target October 2025). Current access is limited to clinical trials or expanded access programs only. For Blue

How to Get Ruconest Covered by Humana in Virginia: Complete Prior Authorization Guide and Appeal Process

Quick Answer: Getting Ruconest Covered by Humana in Virginia Ruconest requires prior authorization from Humana for hereditary angioedema (HAE) treatment. Your fastest path: Have your allergist/immunologist submit a PA request through Humana's provider portal with HAE diagnosis confirmation (ICD-10 D84.1), C1-INH deficiency labs, and attack documentation.

How to Get Zokinvy (lonafarnib) Covered by Cigna in Virginia: Complete PA Guide with Appeal Templates

Answer Box: Getting Zokinvy (lonafarnib) Approved by Cigna in Virginia Cigna covers Zokinvy (lonafarnib) for HGPS and processing-deficient progeroid laminopathies through Express Scripts with prior authorization. Coverage requires patient age ≥12 months, BSA ≥0.39 m², genetic confirmation of pathogenic LMNA variant, and prescription by a geneticist or pediatric cardiologist.

How to Get Soliris (Eculizumab) Covered by Cigna in Virginia: Complete Prior Authorization Guide

Answer Box: Getting Soliris (Eculizumab) Covered by Cigna in Virginia Cigna requires prior authorization for Soliris (eculizumab) with specific diagnostic tests and vaccination requirements. The fastest path: (1) Confirm your diagnosis meets FDA criteria with required lab tests, (2) Complete meningococcal vaccinations ≥2 weeks before treatment, (3) Submit PA through

How to Get Ferriprox (Deferiprone) Covered by Humana in Virginia: Complete Guide to Prior Authorization, Appeals, and Cost Savings

Answer Box: Getting Ferriprox (Deferiprone) Covered by Humana in Virginia Ferriprox requires prior authorization from Humana and must be filled through specialty pharmacy networks. In Virginia, if denied, you have 65 days to appeal internally and 120 days for external review through the State Corporation Commission Bureau of Insurance. Three

Work With Your Doctor to Get Busulfex (Busulfan Injection) Covered by Cigna in Virginia: Complete Provider Collaboration Guide

Quick Answer: Getting Cigna to Cover Busulfex in Virginia Busulfex requires prior authorization from Cigna and is billed under the medical benefit (HCPCS code J0594). Your transplant physician must submit clinical documentation proving FDA-approved indication for CML conditioning, complete prior therapy history, and transplant candidacy. If denied, Virginia's

How to Get Jakafi (Ruxolitinib) Covered by Blue Cross Blue Shield in Virginia: Complete PA Guide & Appeal Process

Quick Answer: Getting Jakafi Covered by Blue Cross Blue Shield in Virginia Jakafi (ruxolitinib) requires prior authorization from Blue Cross Blue Shield Virginia plans, with specific documentation needed for each FDA-approved indication. Your fastest path: 1) Have your hematologist submit PA through Anthem's provider portal with complete clinical

Renewing Ruconest Approval with UnitedHealthcare in Virginia: 2025 Timeline, Documentation & Appeals Guide

Answer Box: Renewing Ruconest Coverage with UnitedHealthcare in Virginia UnitedHealthcare requires 12-month reauthorization for Ruconest with documented attack frequency over the past year. Start renewal 30-45 days before expiration. Submit attack logs, specialist notes, and current lab values through the UHC Provider Portal. If denied, appeal within 180 days, then

Get Besponsa (Inotuzumab Ozogamicin) Covered by Blue Cross Blue Shield in Virginia: Forms, Appeals & Provider Portals

Answer Box: Getting Besponsa Covered by Blue Cross Blue Shield in Virginia Besponsa (inotuzumab ozogamicin) requires prior authorization from Blue Cross Blue Shield in Virginia through their medical injectable pharmacy channel. Your fastest path to approval: (1) Verify CD22+ B-cell precursor ALL diagnosis with proper documentation, (2) Submit prior auth

Work With Your Doctor to Get Lutathera (Lutetium Lu-177 Dotatate) Approved by Humana in Virginia: Complete Provider Collaboration Guide

Answer Box: Getting Lutathera Covered by Humana in Virginia Lutathera (lutetium Lu-177 dotatate) requires prior authorization from Humana Medicare Advantage plans in Virginia, with step therapy requirements for non-preferred status. Your oncologist must document somatostatin receptor-positive imaging (Ga-68 DOTATATE PET), failed prior treatments, and medical necessity. If denied, Virginia'