Topic

Washington

A collection of 488 issues

How to Get Vanflyta (Quizartinib) Covered by Cigna in Washington: Complete Prior Authorization & Appeals Guide

Answer Box: Getting Vanflyta (Quizartinib) Covered by Cigna in Washington Cigna requires prior authorization for Vanflyta (quizartinib) in FLT3-ITD-positive AML patients ≥18 years old with confirmed mutation via FDA-approved testing. Submit comprehensive documentation including baseline ECG showing QTc <450ms, REMS enrollment proof, and oncologist's medical necessity letter.
5 min read

How to Get Photrexa (Riboflavin) Covered by Blue Cross Blue Shield in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Photrexa Covered by Blue Cross Blue Shield in Washington Blue Cross Blue Shield plans in Washington (Premera Blue Cross and Regence BlueShield) require prior authorization for Photrexa (riboflavin ophthalmic solution) used in epithelium-off corneal cross-linking for progressive keratoconus. To get approval: (1) Document keratoconus progression with serial
6 min read

How Long Does It Take to Get Krystexxa (Pegloticase) Approved by Aetna (CVS Health) in Washington? Complete Timeline & Appeal Guide

Answer Box: Getting Krystexxa Approved by Aetna (CVS Health) in Washington Timeline: Standard prior authorization takes 24-72 hours with complete documentation; expedited reviews for urgent cases complete within 24 hours. Requirements: Age 18+, documented failure of conventional gout therapy (allopurinol/febuxostat), serum uric acid ≤6 mg/dL response, G6PD testing,
6 min read

How to Get Strensiq (asfotase alfa) Covered by Humana in Washington: Prior Authorization Guide with Appeals Process

Answer Box: Getting Strensiq (asfotase alfa) Covered by Humana in Washington Strensiq (asfotase alfa) requires prior authorization from Humana and is likely non-formulary for most Medicare Advantage plans in Washington. Your fastest path: (1) Have your prescriber submit a formulary exception request with medical necessity documentation to Humana Clinical Pharmacy
6 min read

How to Get Epidiolex (Cannabidiol) Covered by Blue Cross Blue Shield in Washington: Complete 2025 Guide

Quick Answer: Getting Epidiolex Covered in Washington Epidiolex (cannabidiol) requires prior authorization from Blue Cross Blue Shield plans in Washington, including Premera and Regence. You'll need confirmed diagnosis of Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex seizures, plus documented failure of at least 2 generic anti-seizure medications.
6 min read

Galafold (Migalastat) Approval with UnitedHealthcare in Washington: Answers to the Most Common Questions

Answer Box: Getting Galafold Covered by UnitedHealthcare in Washington UnitedHealthcare requires prior authorization for Galafold (migalastat) with proof of Fabry disease diagnosis and an amenable GLA variant confirmed by in vitro assay. Initial approval lasts 12 months; reauthorization requires documented positive clinical response. If denied, Washington residents can appeal through
5 min read

How to Get Firdapse (amifampridine) Covered by Blue Cross Blue Shield in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Firdapse Covered by Blue Cross Blue Shield in Washington Firdapse (amifampridine) requires prior authorization from Blue Cross Blue Shield plans in Washington for Lambert-Eaton myasthenic syndrome (LEMS). To get approval: (1) Ensure confirmed LEMS diagnosis with EMG and anti-VGCC antibodies by a neuromuscular specialist, (2) Submit PA
6 min read