Topic

Washington

A collection of 489 issues

How to Get Sumavel DosePro Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide (2024)

Important Update: Sumavel DosePro (needle-free sumatriptan injection) was discontinued in the U.S. in 2018. While this guide covers the approval process that would apply if it were available, patients seeking injectable sumatriptan should work with their doctor to access available needle-based auto-injector alternatives through Cigna's formulary. Quick

How to Get Takhzyro (lanadelumab-flyo) Covered by Blue Cross Blue Shield in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Takhzyro Covered by Blue Cross Blue Shield in Washington To get Takhzyro (lanadelumab-flyo) approved by Blue Cross Blue Shield in Washington, you need: (1) confirmed HAE Type I or II diagnosis with C1-INH and C4 lab results, (2) documentation of failed or contraindicated alternatives like Haegarda or

How to Get Qinlock (Ripretinib) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Qinlock Covered by Cigna in Washington Qinlock (ripretinib) requires prior authorization from Cigna for fourth-line GIST treatment. You'll need documented failure of three prior kinase inhibitors (imatinib, sunitinib, regorafenib), pathology confirming GIST diagnosis, and recent imaging showing disease progression. Submit through your oncologist to Cigna&

How to Get Filsuvez (Birch Triterpenes Topical Gel) Covered by Cigna in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Filsuvez Covered by Cigna in Washington Eligibility: Cigna covers Filsuvez for dystrophic or junctional epidermolysis bullosa patients ≥6 months old with confirmed genetic diagnosis and clean wounds 10-50 cm² that are 21+ days but <9 months old. Fastest Path: Have your dermatologist submit prior authorization through

Get Alprolix Covered by Humana in Washington: Prior Authorization Guide with Appeal Templates

Quick Answer: Alprolix requires prior authorization from Humana Medicare plans. Your hematologist must submit clinical documentation showing hemophilia B diagnosis, factor IX levels ≤2%, and bleeding history. Standard approval takes 72 hours; expedited reviews take 24 hours. If denied, you have 65 days to appeal and can request Washington'

Getting Translarna (Ataluren) Covered by Blue Cross Blue Shield in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Fast Track to Translarna Coverage To get Translarna (ataluren) covered by Blue Cross Blue Shield in Washington, you need: 1. Genetic confirmation of nonsense mutation DMD via molecular testing 2. Ambulatory status documentation (6-minute walk test within 6 months) 3. Prior authorization submission through your BCBS provider portal

How Long Does It Take to Get Brensocatib (BRINSUPRI) Approved by UnitedHealthcare in Washington? Timeline & Appeal Guide

Quick Answer: Brensocatib (BRINSUPRI) Approval Timeline for UnitedHealthcare in Washington Standard timeline: 1-5 business days for prior authorization decisions once complete documentation is submitted. UnitedHealthcare requires prior authorization for Brensocatib with step therapy requirements (macrolide trial, airway clearance therapy). Expedited requests: 48-72 hours for life-threatening conditions. First step today: Gather

How to Get Myozyme (Alglucosidase Alfa) Covered by Blue Cross Blue Shield in Washington: Prior Authorization Guide and Appeal Strategies

Answer Box: Getting Myozyme Covered by Blue Cross Blue Shield in Washington Blue Cross Blue Shield (BCBS) plans in Washington require prior authorization for Myozyme (alglucosidase alfa) for Pompe disease. Success requires: (1) confirmed Pompe diagnosis with enzyme and genetic testing, (2) specialist involvement (metabolic/genetics/neurology), and (3) comprehensive

Do You Qualify for Opfolda (miglustat) Coverage by Aetna CVS Health in Washington? Decision Tree & Appeal Guide

Quick Answer: Opfolda Coverage by Aetna CVS Health in Washington Yes, you likely qualify if: You have confirmed late-onset Pompe disease (LOPD), are ≥18 years old and weigh >40 kg, have tried enzyme replacement therapy for ≥1 year without adequate improvement, and have a specialist prescribing Opfolda with Pombiliti

How to Get Opfolda (miglustat) Covered by Blue Cross Blue Shield in Washington: Prior Authorization Guide, Appeals Process, and State Protection Rights

Quick Answer: Getting Opfolda Covered by Blue Cross Blue Shield in Washington Opfolda (miglustat) requires prior authorization from Blue Cross Blue Shield in Washington. The fastest path: 1) Have your doctor submit a PA request with documentation showing you're an adult (≥40 kg) with LOPD not improving on