Topic

Washington

A collection of 489 issues

How to Get Opzelura (ruxolitinib cream) Covered by UnitedHealthcare in Washington: Complete Appeals Guide with Forms and Timelines

Getting Opzelura (ruxolitinib cream) covered by UnitedHealthcare in Washington requires prior authorization with documented failure of topical steroids and calcineurin inhibitors. Submit the OptumRx prior authorization form through the provider portal with clinical documentation. If denied, you have 180 days for internal appeals and can request external review through Washington&

Do You Qualify for Ofev (nintedanib) Coverage by Aetna (CVS Health) in Washington? Decision Tree & Next Steps

Answer Box: Your Path to Ofev (nintedanib) Coverage If you have IPF, SSc-ILD, or progressive fibrosing ILD diagnosed by a pulmonologist with HRCT evidence, you likely qualify for Ofev coverage by Aetna (CVS Health). Required: pulmonologist prescription, HRCT showing fibrosis, recent PFTs (FVC ≥50% predicted, DLCO ≥30%), and baseline liver

Getting Blenrep (Belantamab Mafodotin) Covered by Aetna (CVS Health) in Washington: Complete Access Guide for Current and Future Approval

Answer Box: Current Blenrep Access Through Aetna in Washington Blenrep (belantamab mafodotin) is not commercially available through standard Aetna coverage due to its 2022 FDA withdrawal, with re-approval anticipated October 2025. Current access requires clinical trial enrollment or GSK expanded access programs. Washington residents denied coverage can appeal through Aetna&

Work With Your Doctor to Get Prolastin-C Approved by Cigna in Washington: Provider Collaboration Guide

Answer Box: Your Path to Prolastin-C Coverage Cigna covers Prolastin-C for alpha-1 antitrypsin deficiency with prior authorization requiring: age ≥18, AAT levels <80 mg/dL, lung disease evidence (FEV1 <80% predicted), non-smoking status, and pulmonologist involvement. First step: Schedule a visit with your doctor to document these criteria

How to Get Abecma (Idecabtagene Vicleucel) Covered by UnitedHealthcare in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Abecma Covered by UnitedHealthcare in Washington UnitedHealthcare requires prior authorization for Abecma (idecabtagene vicleucel) under their CAR-T therapy transplant guidelines. Eligibility requires ≥2 prior lines including an IMiD, proteasome inhibitor, and anti-CD38 antibody, plus treatment at a UHC-designated center. First step: Submit PA via UHC Provider Portal

How to Get Helixate (Antihemophilic Factor, rFVIII) Covered by Aetna CVS Health in Washington: Complete Appeals Guide

Answer Box: Fast Track to Helixate Coverage Getting Helixate (antihemophilic factor, rFVIII) covered by Aetna CVS Health in Washington requires prior authorization through CVS Caremark specialty pharmacy. Start with your hematologist submitting a complete PA request via Aetna's Availity portal including confirmed hemophilia A diagnosis, factor VIII levels,

Get Revlimid (lenalidomide) Covered by UnitedHealthcare in Washington: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Revlimid Covered by UnitedHealthcare in Washington Revlimid (lenalidomide) requires prior authorization from UnitedHealthcare in Washington. The fastest path to approval: 1) Ensure your prescriber is REMS-certified and has all clinical documentation ready, 2) Submit the UnitedHealthcare Revlimid PA notification form through their provider portal with complete diagnosis

How to Get Arikayce (Amikacin Liposome Inhalation) Covered by Aetna CVS Health in Washington: Prior Authorization Forms, Appeals, and Timelines

Answer Box: Getting Arikayce Covered by Aetna CVS Health in Washington Arikayce (amikacin liposome inhalation) requires prior authorization from Aetna CVS Health for refractory MAC lung disease. You need 6+ months of failed multidrug therapy, positive MAC cultures, and specialist involvement. Submit via Availity portal with medical necessity letter, culture

Work With Your Doctor to Get Cystadane (Betaine Anhydrous) Approved by Blue Cross Blue Shield in Washington: Complete Provider Collaboration Guide

Answer Box: Getting Cystadane Covered Through Provider Partnership Blue Cross Blue Shield requires prior authorization for Cystadane with genetic confirmation, vitamin therapy trials, and specialist involvement. Success depends on strong provider collaboration: gather genetic testing results and homocysteine labs (>100 μmol/L), document failed vitamin B6/B12/folate trials,

Myths vs. Facts: Getting iLink® Corneal Cross-Linking Covered by Blue Cross Blue Shield in Washington

Answer Box: iLink® Coverage by Blue Cross Blue Shield in Washington Regence Blue Cross Blue Shield and Premera Blue Cross in Washington cover FDA-approved iLink® corneal cross-linking for progressive keratoconus with prior authorization. The fastest path to approval requires documenting disease progression (≥1.0 diopter Kmax increase over 6-12 months)