Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 128 issues

How to Get Evkeeza (Evinacumab) Covered by UnitedHealthcare in Michigan: Prior Authorization, Appeals, and State Protections

Quick Answer: Getting Evkeeza Covered by UnitedHealthcare in Michigan Evkeeza (evinacumab) requires prior authorization from UnitedHealthcare through OptumRx, typically with step therapy requirements. For homozygous familial hypercholesterolemia (HoFH) patients in Michigan, the fastest path involves: 1) Having your specialist submit a PA request with genetic confirmation and documented failures of

How Long Does It Take to Get Krystexxa (Pegloticase) Approved by UnitedHealthcare in Florida? Complete Timeline Guide

Answer Box: Getting Krystexxa Approved by UnitedHealthcare in Florida Standard timeline: 15 days for prior authorization decision, 7 days for appeals. UnitedHealthcare requires prior authorization for Krystexxa (pegloticase) through OptumRx, with strict requirements including G6PD testing, documented failure of standard gout medications, and rheumatology specialist prescribing. First step today: Have

Renewing Qalsody (Tofersen) Approval with UnitedHealthcare in Virginia: Complete Guide to Documentation, Timelines, and Appeals

Answer Box: Renewing Your Qalsody Coverage Getting your Qalsody (tofersen) renewed with UnitedHealthcare in Virginia requires starting 6-8 weeks before your current approval expires. You'll need updated ALSFRS-R scores, neurofilament light chain (NfL) levels showing continued benefit, and documentation of SOD1 mutation status. Submit through the UnitedHealthcare provider

How to Get Abecma (idecabtagene vicleucel) Approved by UnitedHealthcare in Michigan: Timeline, Appeals, and Forms

Answer Box: Getting Abecma Covered by UnitedHealthcare in Michigan UnitedHealthcare requires prior authorization for Abecma (idecabtagene vicleucel) CAR-T therapy. The fastest path: Submit PA through the UHCprovider.com portal with complete documentation showing relapsed/refractory multiple myeloma after ≥2 prior lines (including IMiD, proteasome inhibitor, and anti-CD38 agent). If denied,

Renewing Vanflyta (Quizartinib) Coverage with UnitedHealthcare in Illinois: Timeline, Documentation & Appeal Process

Quick Answer: Renewing Vanflyta Coverage with UnitedHealthcare in Illinois UnitedHealthcare requires 12-month renewals for Vanflyta (quizartinib) with documentation showing no disease progression. Start renewal 30-60 days before expiration. Submit: updated labs, imaging, clinical notes proving treatment response, and EKG/QTc monitoring records through the UHC Provider Portal. If denied, file

How to Get Arikayce Covered by UnitedHealthcare in Florida: Prior Authorization, Appeals, and Step Therapy Exceptions

Answer Box: Getting Arikayce Covered by UnitedHealthcare in Florida UnitedHealthcare requires prior authorization for Arikayce (amikacin liposome inhalation) in Florida with strict medical necessity criteria. To get approved: 1. Document 6+ months of failed multidrug MAC therapy with persistent positive cultures 2. Submit OptumRx prior authorization via professionals.optumrx.com

How to Get Rapivab (Peramivir) Covered by UnitedHealthcare in Washington: Prior Authorization, Appeals & Cost Strategies

Quick Answer: Getting Rapivab Covered by UnitedHealthcare in Washington Rapivab (peramivir) requires prior authorization from UnitedHealthcare through OptumRx. Your fastest path to approval: 1) Have your provider document why oral antivirals like Tamiflu won't work and that symptoms started within 48 hours, 2) Submit the PA request through

How to Get Isturisa (Osilodrostat) Covered by UnitedHealthcare in Ohio: Complete Prior Authorization Guide

Answer Box: Getting Isturisa Covered by UnitedHealthcare in Ohio Fastest path to approval: UnitedHealthcare requires prior authorization for Isturisa (osilodrostat) with documented Cushing's disease and proof that surgery isn't an option or wasn't curative. No step therapy is required if these criteria are met.