Topic

Xyrem (sodium oxybate)

A collection of 10 issues

How to Get Xyrem (Sodium Oxybate) Covered by Humana in New York: Complete Guide to Alternatives, Appeals & Approvals

Answer Box: Quick Path to Xyrem Coverage If Xyrem isn't initially approved by Humana in New York, you have three main options: try covered alternatives first (step therapy), request a formulary exception with medical necessity documentation, or appeal any denial through New York's external review process.

How to Get Xyrem (Sodium Oxybate) Covered by UnitedHealthcare in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Xyrem Covered by UnitedHealthcare in New York UnitedHealthcare requires prior authorization and step therapy for Xyrem (sodium oxybate) in New York. The fastest path to approval: (1) Complete REMS enrollment for both prescriber and patient at XywavXyremREMS.com, (2) Document failed trials of modafinil or armodafinil, and

Get Xyrem (Sodium Oxybate) Covered by UnitedHealthcare in Michigan: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Xyrem Covered by UnitedHealthcare in Michigan To get Xyrem (sodium oxybate) covered by UnitedHealthcare in Michigan, you'll need prior authorization through OptumRx. First, ensure REMS enrollment is complete at XywavXyremREMS.com. Then submit a prior authorization request with sleep study results, documented narcolepsy diagnosis, and

How to Get Xyrem (Sodium Oxybate) Covered by Aetna CVS Health in Ohio: Complete Timeline & Appeal Guide

Answer Box: Getting Xyrem Covered by Aetna CVS Health in Ohio Xyrem (sodium oxybate) requires prior authorization from Aetna CVS Health and REMS program enrollment before coverage. The fastest path to approval: 1. Complete REMS enrollment for both patient and prescriber at xywavxyremrems.com 2. Submit prior authorization with narcolepsy

Do You Qualify for Xyrem (Sodium Oxybate) Coverage by Humana in Georgia? Decision Tree & Next Steps

Answer Box: Your Fastest Path to Xyrem Coverage Yes, Xyrem can be covered by Humana in Georgia, but requires prior authorization. The fastest path: (1) Confirm your narcolepsy diagnosis meets clinical criteria with documented sleep studies, (2) Submit Humana's Medicare Part D PA form with medical necessity letter

Do You Qualify for Xyrem Coverage by UnitedHealthcare in Pennsylvania? Decision Tree & Next Steps

Answer Box: Your Fastest Path to Xyrem Coverage To get Xyrem (sodium oxybate) covered by UnitedHealthcare in Pennsylvania: You need a confirmed narcolepsy diagnosis with documented cataplexy, REMS program enrollment, and prior authorization showing you've tried and failed preferred alternatives like modafinil or stimulants. Start today: Have your

Myths vs. Facts: Getting Xyrem (Sodium Oxybate) Covered by UnitedHealthcare in Florida - Complete 2025 Guide

Answer Box: Getting Xyrem Covered by UnitedHealthcare in Florida Eligibility: Patients with narcolepsy (with/without cataplexy) or excessive daytime sleepiness who meet strict clinical criteria and complete mandatory REMS enrollment. Fastest approval path: 1) Ensure both prescriber and patient are REMS-enrolled, 2) Submit complete prior authorization with sleep study results

Do You Qualify for Xyrem Coverage by Humana in Pennsylvania? Decision Tree & Next Steps

Answer Box: Getting Xyrem Covered by Humana in Pennsylvania You likely qualify if you have confirmed narcolepsy with cataplexy (ICD-10: G47.411), documented sleep study results, and have tried/failed standard therapies. First step: Your prescriber must enroll in the REMS program and submit prior authorization to Humana with clinical

How to Get Xyrem (Sodium Oxybate) Covered by Humana in Florida: Complete Guide to Prior Authorization and Appeals

Quick Answer: Getting Xyrem Covered by Humana in Florida Xyrem (sodium oxybate) requires prior authorization from Humana Medicare plans in Florida. The fastest path to approval: 1) Ensure both you and your prescriber are enrolled in the FDA-mandated REMS program, 2) Have your doctor submit a prior authorization request with

Get Xyrem (Sodium Oxybate) Covered by Humana in Texas: Complete Guide to Forms, Appeals & Approvals

Quick Start: Your Path to Xyrem Coverage Xyrem (sodium oxybate) requires prior authorization from Humana Medicare Advantage plans in Texas. The fastest path to approval: have your doctor submit the Medicare Part D prior authorization form with clinical documentation to 877-486-2621, while simultaneously enrolling in the mandatory XYREM REMS program