Topic

Washington

A collection of 489 issues

How to Get Strimvelis Gene Therapy Covered by UnitedHealthcare in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Strimvelis Covered by UnitedHealthcare in Washington Strimvelis gene therapy for ADA-SCID requires prior authorization from UnitedHealthcare through OptumRx, with extensive documentation of genetic diagnosis (ICD-10 D81.31), failed standard therapies, and specialist support. Since Strimvelis isn't FDA-approved and is only available in Milan, Italy, you&
6 min read

Get Xospata (Gilteritinib) Approved by Cigna in Washington: Prior Authorization, Appeals & Alternatives

Answer Box: Getting Xospata (Gilteritinib) Covered by Cigna in Washington Eligibility: Xospata requires prior authorization from Cigna for adults with relapsed/refractory AML who have FLT3-mutated disease confirmed by an FDA-approved test. Fastest path: Have your hematologist submit clinical documentation showing FLT3 mutation positivity, prior therapy failures, and medical necessity
6 min read

Getting Pyrukynd (Mitapivat) Covered by UnitedHealthcare in Washington: Complete Prior Authorization and Appeals Guide

Quick Answer: Your Path to Pyrukynd Coverage UnitedHealthcare requires strict prior authorization for Pyrukynd (mitapivat) in Washington. You'll need genetic confirmation of pyruvate kinase deficiency (≥2 PKLR variants, ≥1 missense), baseline hemoglobin ≤10 g/dL, limited transfusion history, and hematologist oversight. If denied, Washington's external review
5 min read

How to Get Keppra (Levetiracetam) Covered by UnitedHealthcare in Washington: Complete Guide to Formulary Tiers, Prior Authorization & Appeals

Answer Box: Quick Path to Keppra Coverage Generic levetiracetam is typically covered as Tier 1 (preferred generic) without prior authorization on most UnitedHealthcare plans in Washington. Brand Keppra requires prior authorization and medical necessity documentation. If denied, you have 180 days to file internal appeals, then external review through Washington&
6 min read

Myths vs. Facts: Getting Xembify (Immune Globulin, SC) Covered by Blue Cross Blue Shield in Washington

Answer Box: Getting Xembify Covered by Blue Cross Blue Shield in Washington Eligibility: Patients with documented primary immunodeficiency (low IgG levels, recurrent infections, poor vaccine response) can get Xembify covered by BCBS plans in Washington with prior authorization. Fastest path: Submit comprehensive PA request including diagnosis, infection history, lab results,
6 min read