Aboveallislove
Super Moderator
This is Fl, but I think it came federally and thus would apply to all state Medicaid program (but not positive).
http://ahca.myflorida.com/medicaid/Prescribed_Drug/drug_criteria_pdf/Orkambi_Criteria.pdf
Note they are saying between 40-90% FEV, but that IS NOT a label criteria and the FDA label actually says those under 40% FEV should have extra doctor supervision, so for those outside the parameters on Medicaid, it might mean a fight/appeal, which alone might leave you exhausted and breathless for FEVs.
http://ahca.myflorida.com/medicaid/Prescribed_Drug/drug_criteria_pdf/Orkambi_Criteria.pdf
Note they are saying between 40-90% FEV, but that IS NOT a label criteria and the FDA label actually says those under 40% FEV should have extra doctor supervision, so for those outside the parameters on Medicaid, it might mean a fight/appeal, which alone might leave you exhausted and breathless for FEVs.