Topic

Washington

A collection of 489 issues

How to Get Brineura (Cerliponase Alfa) Covered by UnitedHealthcare in Washington: Complete Policy Guide and Appeals Process

Answer Box: Getting Brineura Covered by UnitedHealthcare in Washington UnitedHealthcare covers Brineura (cerliponase alfa) for pediatric CLN2 disease patients age 3+ under strict prior authorization requirements. Your fastest path: 1) Confirm CLN2 diagnosis with genetic testing, 2) Get pediatric neurologist to submit complete PA documentation via UHC provider portal, 3)

How to Get Enhertu (fam-trastuzumab deruxtecan-nxki) Covered by Humana in Washington: Appeals, Forms & Approval Timeline

Answer Box: Getting Enhertu Covered by Humana in Washington Fast track to approval: Enhertu requires prior authorization from Humana, typically placed on Specialty Tier 4. Your oncologist must submit HER2 testing results and clinical documentation through Humana's provider portal. If denied, you have 65 days to appeal and

Work With Your Doctor to Get Xospata (gilteritinib) Approved by Blue Cross Blue Shield in Washington

Quick Answer: Your Path to Xospata Approval To get Xospata (gilteritinib) covered by Blue Cross Blue Shield in Washington, you'll need: confirmed FLT3 mutation testing, documentation of relapsed/refractory AML status, and evidence of prior therapy failures. Start by scheduling a comprehensive visit with your hematologist to gather

How to Get Joenja (leniolisib) Covered by Cigna in Washington: Complete Prior Authorization Guide

Quick Answer: Getting Joenja (leniolisib) Covered by Cigna in Washington Joenja requires prior authorization from Cigna and genetic confirmation of APDS diagnosis. Submit your PA request through CoverMyMeds or MyAccredoPatients with complete genetic testing results, clinical documentation, and evidence of failed standard therapies. If denied, you have 60 days to

How to Get Hetlioz (Tasimelteon) Covered by UnitedHealthcare in Washington: PA Forms, Appeals, and Cost Guide

Answer Box: Getting Hetlioz Approved by UnitedHealthcare in Washington UnitedHealthcare requires prior authorization for Hetlioz (tasimelteon) with mandatory melatonin step therapy and specialty pharmacy dispensing through OptumRx. Coverage is limited to FDA-approved indications: Non-24-hour sleep-wake disorder in totally blind adults and Smith-Magenis syndrome sleep disturbances. Fastest approval path: 1) Get

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