Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1066 issues

Lowering Out-of-Pocket Costs for Ruconest with UnitedHealthcare in North Carolina: Copay Cards, Appeals & Financial Assistance

Answer Box: Getting Ruconest Covered by UnitedHealthcare in North Carolina UnitedHealthcare requires prior authorization for Ruconest (C1 esterase inhibitor [recombinant]) in North Carolina, with 12-month approvals for confirmed hereditary angioedema (HAE) patients prescribed by allergists/immunologists. The fastest path: 1) Have your HAE specialist submit PA via UHC Provider Portal
6 min read

Lowering Out-of-Pocket Costs for Ilaris (Canakinumab) with UnitedHealthcare in North Carolina: Coverage, Appeals & Financial Assistance

Answer Box: Getting Ilaris Covered by UnitedHealthcare in North Carolina UnitedHealthcare requires prior authorization for Ilaris (canakinumab) under the medical benefit, with step therapy requirements for most indications. Start by having your specialist submit a PA request via the UHC provider portal with complete clinical documentation. If denied, appeal within
6 min read

Myths vs. Facts: Getting Prolastin-C Covered by UnitedHealthcare in Florida (2025 Guide)

Answer Box: Prolastin-C Coverage by UnitedHealthcare in Florida UnitedHealthcare requires prior authorization for Prolastin-C with documented severe alpha-1 antitrypsin deficiency (Pi*ZZ genotype), emphysema evidence, and step therapy trial of preferred alternatives like Aralast NP or Glassia unless contraindicated. Coverage falls under medical benefit with site-of-care preference for home infusion
6 min read

Renewing Xembify Approval with UnitedHealthcare in Pennsylvania: Timeline, Documents, and Bridge Options

Answer Box: Renewing Xembify Coverage with UnitedHealthcare in Pennsylvania Start your Xembify renewal 30 days before your current authorization expires. UnitedHealthcare typically requires updated IgG trough levels, infection history, and clinical response documentation through OptumRx for pharmacy benefit coverage. Submit via the UnitedHealthcare Provider Portal with complete medical records. If
6 min read

How to Get Opdivo (nivolumab) Covered by UnitedHealthcare in Virginia: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Opdivo (nivolumab) Covered by UnitedHealthcare in Virginia UnitedHealthcare requires prior authorization for Opdivo (nivolumab) in Virginia, with approval based on FDA-labeled indications, biomarker testing, and documented treatment failures. The fastest path: Submit a complete PA through the UHC Provider Portal with diagnosis, staging, biomarkers (PD-L1, MSI-H/dMMR
6 min read

How to Get Gamifant (Emapalumab-lzsg) Covered by UnitedHealthcare in New York: Prior Authorization, Appeals, and Medical Necessity Requirements

Quick Answer: To get Gamifant (emapalumab-lzsg) covered by UnitedHealthcare in New York, you need prior authorization showing: (1) confirmed primary HLH meeting HLH-2004 criteria, (2) failure/intolerance of conventional therapy (dexamethasone + etoposide), and (3) FDA-label dosing plan. Submit through the UnitedHealthcare Provider Portal with complete diagnostic documentation. If denied, file
5 min read

How to Get Onpattro (patisiran) Covered by UnitedHealthcare in Michigan: Complete Renewal Guide with Appeals Process

Answer Box: Getting Onpattro Covered by UnitedHealthcare in Michigan Onpattro (patisiran) requires prior authorization from UnitedHealthcare in Michigan for hereditary transthyretin-mediated amyloidosis polyneuropathy (hATTR-PN). Submit requests through the UHC Provider Portal with genetic testing, neurologist evaluation, and functional scores (mNIS+7, 6MWT, PND ≤IIIb). UnitedHealthcare must respond within 15 days
6 min read

How to Get Kesimpta (ofatumumab) Covered by UnitedHealthcare in Virginia: Appeals Guide with Forms and Timelines

Answer Box: Getting Kesimpta Covered by UnitedHealthcare in Virginia UnitedHealthcare requires prior authorization for Kesimpta (ofatumumab) with step therapy requirements in Virginia. Most denials stem from missing documentation or inadequate prior DMT failure records. Your fastest path: 1) Gather complete medical records showing relapsing MS diagnosis and prior treatment failures,
6 min read