Topic

Washington

A collection of 489 issues

How to Get Kineret (anakinra) Covered by Aetna (CVS Health) in Washington: Complete Guide with Forms, Appeals, and State Protections

Quick Answer: Getting Kineret (anakinra) Covered by Aetna (CVS Health) in Washington Eligibility: Aetna requires prior authorization for Kineret with documented failure of at least one conventional DMARD and one biologic DMARD for rheumatoid arthritis. Fastest path: Work with your rheumatologist to submit a complete prior authorization through CVS Specialty
5 min read

How to Get HyperHEP (Hepatitis B Immune Globulin) Covered by Aetna CVS Health in Washington: PA Forms, Appeals, and Approval Scripts

Quick Answer: Getting HyperHEP Covered by Aetna CVS Health in Washington Aetna CVS Health requires prior authorization for HyperHEP (hepatitis B immune globulin) in Washington, but approval is straightforward with proper documentation of post-exposure prophylaxis needs. The fastest path: (1) Have your provider call 1-866-752-7021 for expedited PA within 24-72
6 min read

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

Answer Box: Getting Jakafi (ruxolitinib) Covered by Humana in Washington Jakafi (ruxolitinib) is covered by Humana Medicare Advantage plans in Washington for FDA-approved uses, but requires prior authorization. The fastest path: have your hematologist/oncologist submit a comprehensive PA request through the Humana provider portal with diagnosis confirmation, prior therapy
6 min read

How to Get Mepsevii (vestronidase alfa-vjbk) Covered by Aetna (CVS Health) in Washington: Prior Authorization Guide and Appeals Process

Answer Box: Getting Mepsevii Covered by Aetna (CVS Health) in Washington Mepsevii (vestronidase alfa-vjbk) requires prior authorization from Aetna (CVS Health), with strict criteria including confirmed MPS VII diagnosis via enzyme assay or genetic testing, specialist prescription, and elevated urinary glycosaminoglycans. Submit the Aetna Mepsevii precertification form with complete documentation.
6 min read

How to Get Epidiolex (Cannabidiol) Covered by Humana in Washington: Prior Authorization Guide and Appeal Process

Answer Box: Getting Epidiolex Covered by Humana in Washington Epidiolex requires prior authorization from Humana for all FDA-approved seizure disorders (Lennox-Gastaut syndrome, Dravet syndrome, tuberous sclerosis complex). The fastest path to approval: 1. Confirm diagnosis with ICD-10 code and specialist consultation 2. Document failed antiseizure medications or contraindications 3. Submit
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How to Get Tysabri (Natalizumab) Covered by Blue Cross Blue Shield in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Tysabri Covered by Blue Cross Blue Shield in Washington Tysabri (natalizumab) requires prior authorization from all Blue Cross Blue Shield plans in Washington. The fastest path to approval: (1) Ensure TOUCH program enrollment for both patient and prescriber, (2) Submit comprehensive prior authorization with MRI documentation and
6 min read

How to Get Tepezza (teprotumumab) Covered by Cigna in Washington: Prior Authorization, Appeals, and Billing Guide

Quick Answer: Tepezza (teprotumumab) requires prior authorization through Cigna's Express Scripts/Accredo specialty pharmacy network. Submit clinical documentation including TED diagnosis (ICD-10: E05.00), disease severity assessment, and weight-based dosing justification. If denied, Washington residents can appeal through internal review, then external IRO review within 60 days. Start
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