Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1143 issues

How to Get Onpattro (Patisiran) Covered by UnitedHealthcare in Illinois: Complete Guide with Appeals Process

Quick Answer: Getting Onpattro Covered by UnitedHealthcare in Illinois Yes, UnitedHealthcare covers Onpattro (patisiran) in Illinois with prior authorization for hereditary transthyretin-mediated amyloidosis polyneuropathy (hATTR-PN). The fastest path: (1) Ensure genetic testing confirms pathogenic TTR variant, (2) Get neurologist evaluation with staging (PND ≤IIIb or FAP Stage 1-2), (3) Submit
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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
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Get Hemlibra (Emicizumab-kxwh) Covered by UnitedHealthcare in Florida: Complete PA Guide, Forms & Appeal Process

Answer Box: Quick Path to Approval To get Hemlibra (emicizumab-kxwh) covered by UnitedHealthcare in Florida: Submit prior authorization through the UnitedHealthcare Provider Portal with documented hemophilia A diagnosis, inhibitor status (>5 Bethesda units if applicable), and prophylaxis indication. For patients with FVIII inhibitors, no step therapy is required. If
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Myths vs. Facts: Getting Myozyme (Alglucosidase Alfa) Covered by UnitedHealthcare in Washington

Answer Box: Getting Myozyme Covered by UnitedHealthcare in Washington Eligibility: UnitedHealthcare requires prior authorization for Myozyme (alglucosidase alfa) with confirmed Pompe disease diagnosis via enzyme testing and genetic confirmation. Fastest path: Submit PA through UnitedHealthcare provider portal with comprehensive clinical documentation including specialist referral and diagnostic testing. First step today:
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How to Get Taltz (ixekizumab) Covered by UnitedHealthcare in North Carolina: Complete Timeline and Appeals Guide

Answer Box: Getting Taltz Covered by UnitedHealthcare in North Carolina UnitedHealthcare requires prior authorization for Taltz (ixekizumab) with step therapy documentation showing failure of preferred biologics like adalimumab or etanercept. Standard approval takes 15 business days; expedited reviews complete within 72 hours. If denied, you have 180 days for internal
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How Long Does It Take to Get Filspari (sparsentan) Approved by UnitedHealthcare in Michigan? Timeline & Milestones

Answer Box: Getting Filspari Covered by UnitedHealthcare in Michigan Timeline: Standard prior authorization takes up to 15 business days; expedited review for urgent medical necessity completes within 72 hours. Pre-submission preparation (REMS enrollment, documentation) adds 1-5 days. Fastest Path: 1. Enroll in FILSPARI REMS program (prescriber and patient forms) 2.
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How to Get Helixate Covered by UnitedHealthcare in Illinois: Coverage Criteria, Appeals, and Approval Strategies

Answer Box: Getting Helixate Covered by UnitedHealthcare in Illinois Important Update: Helixate (including Helixate NexGen) has been discontinued by the manufacturer. UnitedHealthcare no longer covers these products as they're unavailable. Immediate action needed: Work with your hematologist to transition to alternative Factor VIII products like Kovaltry, Advate, or
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How to Get Isturisa (Osilodrostat) Covered by UnitedHealthcare in Florida: Complete Guide with Forms and Appeal Scripts

Answer Box: Getting Isturisa Covered by UnitedHealthcare in Florida UnitedHealthcare requires prior authorization for Isturisa (osilodrostat) in Florida for both Medicaid and Medicare Advantage plans. The fastest path to approval requires: (1) confirmed Cushing's disease diagnosis with two positive biochemical tests, (2) documentation that pituitary surgery isn'
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Crysvita (Burosumab) Approval with UnitedHealthcare in New York: Complete Guide to Prior Authorization, Appeals, and Coverage

Answer Box: Getting Crysvita Covered by UnitedHealthcare in New York UnitedHealthcare covers Crysvita (burosumab) for X-linked hypophosphatemia (XLH) and tumor-induced osteomalacia (TIO) with prior authorization in New York. Key requirements include confirmed diagnosis via genetic testing or elevated FGF23, specialist prescribing, and documented clinical need. First step today: Contact your
6 min read