Topic

Washington

A collection of 489 issues

How to Get Arikayce (Amikacin Liposome Inhalation) Covered by Cigna in Washington: Prior Authorization, Appeals, and Cost-Saving Strategies

Answer Box: Getting Arikayce Covered by Cigna in Washington Cigna requires prior authorization for Arikayce (amikacin liposome inhalation) with strict criteria: adult MAC lung disease, documented failure after ≥6 months of guideline-based multidrug therapy, and prescription by a pulmonologist or infectious disease specialist. If denied, you have 180 days to
6 min read

Getting Voydeya (Danicopan) Covered by UnitedHealthcare in Washington: Renewal Timeline, Appeals Process, and Required Documentation

Answer Box: Getting Voydeya Covered by UnitedHealthcare in Washington Voydeya (danicopan) requires prior authorization through UnitedHealthcare's OptumRx with annual renewal requirements. Start renewal 4-6 weeks early with updated labs (hemoglobin, LDH, reticulocyte count), transfusion records, and specialist documentation of ongoing benefit. If denied, Washington allows internal appeals (180
6 min read

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

Answer Box: Getting Evrysdi Covered by Blue Cross Blue Shield in Washington Blue Cross Blue Shield plans in Washington (primarily Premera and Regence) require prior authorization for Evrysdi (risdiplam) with strict medical necessity criteria. Success requires genetic confirmation of SMA, specialist prescriber, baseline motor assessments, and documentation that concurrent SMN
5 min read

How to Get Procysbi (Cysteamine Bitartrate DR) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Procysbi Covered by Cigna in Washington Procysbi (cysteamine bitartrate DR) requires prior authorization through Cigna's specialty pharmacy Accredo. Most approvals succeed when you document nephropathic cystinosis diagnosis, WBC cystine levels, and either prior cysteamine failure or medical justification for delayed-release formulation. Washington residents have strong
6 min read

How to Get Carbaglu (Carglumic Acid) Covered by Aetna CVS Health in Washington: Complete PA Guide with Appeals Process

Answer Box: Getting Carbaglu (Carglumic Acid) Covered by Aetna CVS Health in Washington Fastest path to approval: Submit prior authorization with confirmed NAGS deficiency diagnosis (genetic/enzyme testing) plus baseline elevated ammonia levels. Aetna requires 12-month PA for all FDA-approved indications. If denied, file internal appeal within 180 days, then
6 min read

Getting Lamzede (velmanase alfa-tycv) Covered by Humana in Washington: Complete PA Guide and Appeal Process

Answer Box: Your Fastest Path to Coverage Humana Medicare Advantage requires prior authorization for Lamzede (velmanase alfa-tycv) under the medical benefit. To get approved in Washington: 1. Confirm diagnosis: Submit genetic testing (MAN2B1 variants) or enzyme assay showing alpha-mannosidase deficiency 2. Document medical necessity: Specialist letter detailing non-CNS manifestations, prior
5 min read