Topic

Washington

A collection of 54 issues

How to Get Isturisa (Osilodrostat) Covered by UnitedHealthcare in Washington: Requirements Checklist and Appeals Guide

Answer Box: Getting Isturisa Covered by UnitedHealthcare in Washington UnitedHealthcare requires prior authorization for Isturisa (osilodrostat) for adult Cushing's disease patients who aren't surgical candidates or had unsuccessful surgery. The fastest path to approval: 1) Confirm your diagnosis with elevated urinary free cortisol and endocrinologist consultation,

How to Get Revcovi (Elapegademase) Covered by Aetna (CVS Health) in Washington: Complete Appeals Guide

Answer Box: Getting Revcovi Covered by Aetna in Washington Revcovi (elapegademase) requires prior authorization from Aetna (CVS Health). To get coverage in Washington: (1) Your immunologist submits a PA request with ADA-SCID genetic confirmation and documentation of failed/contraindicated bone marrow transplant, (2) If denied, file internal appeal within 30-60

How to Get Oxlumo (Lumasiran) Covered by Humana in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Oxlumo (Lumasiran) Covered by Humana in Washington Oxlumo requires prior authorization from Humana for primary hyperoxaluria type 1 (PH1). The fastest path to approval: (1) Confirm PH1 diagnosis with genetic testing showing AGXT mutations or liver enzyme analysis, (2) Document elevated urinary oxalate levels (>0.7

How to Get Cresemba (Isavuconazole) Covered by UnitedHealthcare in Washington: Prior Authorization Guide

Answer Box: Quick Path to Cresemba Coverage UnitedHealthcare requires prior authorization for Cresemba (isavuconazole) in Washington. Your fastest path: (1) Confirm diagnosis codes B44.0 (invasive aspergillosis) or B46.x (mucormycosis), (2) Document any voriconazole contraindications or failures, and (3) Submit PA request via UnitedHealthcare Provider Portal within 180 days.

How to Get Isturisa (Osilodrostat) Covered by Aetna CVS Health in Washington: Complete Guide with Forms and Appeals

Quick Answer: Getting Isturisa (Osilodrostat) Covered by Aetna CVS Health in Washington Aetna CVS Health requires prior authorization for Isturisa (osilodrostat) in Washington. The fastest path to approval: (1) Verify your endocrinologist has documented Cushing's disease with failed/contraindicated surgery, (2) Complete Aetna's specialty medication prior

How to Get Orladeyo (Berotralstat) Covered by Humana in Washington: Timeline, Appeals & Forms

Answer Box: Getting Orladeyo Covered by Humana in Washington Orladeyo (berotralstat) is typically covered by Humana as a specialty tier drug requiring prior authorization for hereditary angioedema (HAE) prophylaxis. The fastest path to approval involves: 1) Confirming HAE diagnosis with lab results (C1-INH levels/function), 2) Submitting complete prior authorization

Renewing Zanzalintinib (XL092) Coverage with Humana in Washington: Timeline, Documentation & Appeal Steps

Answer Box: Renewing Zanzalintinib (XL092) Coverage with Humana in Washington Zanzalintinib (XL092) is an investigational drug requiring compassionate use program enrollment through Exelixis, as it's not FDA-approved. Humana typically covers investigational drugs only within clinical trials or approved compassionate use programs. To renew coverage: (1) Confirm continued eligibility

Renewing Vitrakvi (Larotrectinib) Approval with Humana in Washington: Timeline, Documentation & Appeals Guide

Answer Box: Renewing Vitrakvi Coverage with Humana in Washington Vitrakvi (larotrectinib) requires prior authorization renewal with Humana every 3-6 months. Start your renewal 30-45 days before expiration. Submit: updated clinical notes showing continued benefit, recent imaging demonstrating response/stable disease, current liver function tests, and NTRK fusion documentation. If denied,

Get Voxzogo (Vosoritide) Covered by Blue Cross Blue Shield in Washington: Complete 2025 Guide

Answer Box: Getting Voxzogo Covered in Washington Blue Cross Blue Shield Washington requires prior authorization for Voxzogo (vosoritide) in pediatric achondroplasia patients under 18 with open growth plates and confirmed FGFR3 variants. The fastest path: 1) Have your pediatric endocrinologist or geneticist gather genetic testing results and growth plate imaging,

How to Get Tepezza (Teprotumumab) Covered by Aetna CVS Health in Washington: Prior Authorization Forms, Appeal Process & Success Strategies

Answer Box: Getting Tepezza Covered by Aetna CVS Health in Washington Fastest path to approval: Your ophthalmologist submits Aetna's Tepezza Precertification Form with documented moderate-to-severe TED diagnosis and evidence of failed step therapy (prednisone, methimazole). If denied, file internal appeals within 180 days, then request external review through