Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 116 issues

How to Get Hetlioz (Tasimelteon) Covered by UnitedHealthcare in Florida: Complete PA Guide and Appeals Process

Quick Answer: Getting Hetlioz Covered by UnitedHealthcare in Florida Hetlioz requires prior authorization from UnitedHealthcare through OptumRx. The fastest path to approval: (1) Confirm your diagnosis qualifies—Non-24-hour sleep-wake disorder in totally blind adults or Smith-Magenis syndrome sleep disturbances, (2) Document failed melatonin therapy or contraindications, and (3) Have a
5 min read

UnitedHealthcare's Coverage Criteria for Gamifant (emapalumab-lzsg) in Texas: What Counts as "Medically Necessary"?

Answer Box: Getting Gamifant Covered by UnitedHealthcare in Texas UnitedHealthcare requires prior authorization for Gamifant (emapalumab-lzsg) with strict step therapy criteria. To qualify, you must have confirmed primary HLH meeting HLH-2004 diagnostic criteria and documented failure, intolerance, or contraindication to conventional therapy (dexamethasone, etoposide, cyclosporine). Submit PA requests through the
6 min read

How to Get Tavalisse (fostamatinib) Covered by UnitedHealthcare in New Jersey: Complete Guide with Forms and Appeal Scripts

Answer Box: Getting Tavalisse Covered by UnitedHealthcare in New Jersey Fastest Path to Approval: UnitedHealthcare requires prior authorization for Tavalisse (fostamatinib) with step therapy documentation. You'll need proof of failed corticosteroids and typically a thrombopoietin receptor agonist, plus platelet counts <30,000/μL documented by a hematologist.
6 min read

How to Get Ultomiris (ravulizumab) Covered by UnitedHealthcare in Pennsylvania: Complete Guide to Prior Authorization, Appeals & Forms

Quick Answer: Getting Ultomiris Covered by UnitedHealthcare in Pennsylvania To get Ultomiris (ravulizumab) covered by UnitedHealthcare in Pennsylvania, you'll need prior authorization through OptumRx. The fastest path: 1) Have your doctor submit a PA request via the UnitedHealthcare provider portal with complete clinical documentation, 2) Include proof of
6 min read

How Long Does It Take to Get Turalio (Pexidartinib) Approved by UnitedHealthcare in Texas? Complete Timeline Guide

Answer Box: Getting Turalio Approved by UnitedHealthcare in Texas Timeline: 7-30 days for standard review, 72 hours for expedited cases. Fastest path: Complete REMS enrollment first, gather surgical consultation notes explaining why surgery isn't feasible, and submit prior authorization with comprehensive TGCT documentation through the UnitedHealthcare provider portal.
6 min read

How Long Does It Take to Get Rylaze Approved by UnitedHealthcare in New Jersey? Complete Timeline Guide

Answer Box: Getting Rylaze Approved by UnitedHealthcare in New Jersey Fastest approval path: Submit prior authorization with complete hypersensitivity documentation to E. coli asparaginase within 24-72 hours. UnitedHealthcare requires oncologist prescription, ALL/LBL diagnosis proof, and detailed allergy records. If denied, New Jersey's IHCAP external review provides binding
6 min read

How to Get Soliris (Eculizumab) Covered by UnitedHealthcare in New Jersey: Complete Guide to Prior Authorization, Appeals, and State Protections

Quick Answer: Getting Soliris Covered in New Jersey Eligibility: UnitedHealthcare requires prior authorization for Soliris (eculizumab) with strict documentation of approved conditions (PNH, aHUS, gMG, NMOSD), meningococcal vaccination records, and REMS compliance. Fastest path: Submit PA through UnitedHealthcare provider portal with complete vaccination records and specialist prescription. First step today:
6 min read

How Long Does It Take to Get Keytruda (Pembrolizumab) Approved by UnitedHealthcare in New York? Complete Timeline Guide

Answer Box: Getting Keytruda Approved by UnitedHealthcare in New York Timeline: 3-5 business days for standard review, 72 hours for expedited cases. Fastest path: Submit complete prior authorization through UnitedHealthcare Provider Portal with NCCN-aligned documentation and required biomarker testing. Start today: Contact your oncologist to gather pathology reports, biomarker results
6 min read

How to Get Dojolvi (Triheptanoin) Covered by UnitedHealthcare in Michigan: Complete PA Guide with Appeal Scripts

Answer Box: Getting Dojolvi Covered by UnitedHealthcare in Michigan Dojolvi (triheptanoin) requires prior authorization from UnitedHealthcare for long-chain fatty acid oxidation disorders (LC-FAOD). Key requirements: molecular genetic confirmation of LC-FAOD, prescription from a board-certified medical geneticist, no concurrent MCT products, and dosing ≤35% of daily calories. First step: Download the
5 min read