Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1112 issues

How to Get Ocrevus Covered by UnitedHealthcare in North Carolina: PA Forms, Appeals, and Approval Timeline

Answer Box: Getting Ocrevus Covered by UnitedHealthcare in North Carolina UnitedHealthcare covers Ocrevus (ocrelizumab) in North Carolina when prior authorization criteria are met: confirmed MS diagnosis (relapsing forms or primary progressive), documented treatment history, and clinical necessity. No universal step therapy requirement exists in UHC's national policy, but
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Getting Strimvelis Gene Therapy Covered by UnitedHealthcare in North Carolina: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Strimvelis Covered by UnitedHealthcare in North Carolina UnitedHealthcare requires prior authorization for Strimvelis (autologous CD34+ ADA-SCID gene therapy) as a non-formulary, international specialty treatment. Start by confirming your ADA-SCID diagnosis with genetic testing, documenting failed or contraindicated alternatives, and submitting through the UHC Provider Portal. If denied,
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Work With Your Doctor to Get Takhzyro (lanadelumab-flyo) Approved by UnitedHealthcare in Illinois: Complete Collaboration Guide

Answer Box: Your Path to Takhzyro Approval in Illinois Getting Takhzyro (lanadelumab-flyo) covered by UnitedHealthcare requires documented HAE diagnosis (Type I/II with low C1-INH levels), baseline attack frequency ≥1 per month, and prescription by an allergist/immunologist. Start today: Schedule an appointment with your specialist to review your attack
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How to Get Kanuma (Sebelipase Alfa) Covered by UnitedHealthcare in Texas: Complete Prior Authorization and Appeals Guide

Quick Answer: Getting Kanuma Approved by UnitedHealthcare in Texas Kanuma (sebelipase alfa) requires prior authorization from UnitedHealthcare/OptumRx for lysosomal acid lipase deficiency (LAL-D). Success depends on: confirmed LAL-D diagnosis (enzyme assay or genetic testing), documented disease severity (elevated liver enzymes, dyslipidemia), and evidence that supportive therapies are insufficient. First
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Renewing Chenodal (Chenodiol) Approval with UnitedHealthcare in Washington: 2025 Requirements & Timeline

Answer Box: Chenodal (Chenodiol) Renewal with UnitedHealthcare in Washington UnitedHealthcare typically requires annual prior authorization renewal for Chenodal (chenodiol) with documentation of clinical response and safety monitoring. Start your renewal 60 days before expiration. Submit through the UnitedHealthcare Provider Portal with updated imaging, liver function tests, and a progress note.
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UnitedHealthcare's Coverage Criteria for Rylaze in Georgia: What Counts as "Medically Necessary"?

Answer Box: Getting Rylaze Covered by UnitedHealthcare in Georgia UnitedHealthcare requires prior authorization for Rylaze with documented hypersensitivity to E. coli asparaginase (pegaspargase). Key requirements: confirmed ALL/LBL diagnosis, age ≥1 month, detailed reaction records, and oncologist prescription. First step today: Have your oncology team submit a PA through the
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How to Get Tepezza (Teprotumumab) Covered by UnitedHealthcare in Illinois: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Tepezza Covered by UnitedHealthcare in Illinois UnitedHealthcare requires prior authorization for Tepezza (teprotumumab, HCPCS J3241) under the medical benefit. To get approval: 1) Submit PA via UHC Provider Portal with thyroid eye disease diagnosis, Clinical Activity Score ≥3, recent thyroid labs, and documented steroid trial/contraindication. 2)
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How to Get Entresto (sacubitril/valsartan) Covered by UnitedHealthcare in California: Prior Authorization, Appeals, and Coding Guide

Answer Box: Getting Entresto Covered by UnitedHealthcare in California UnitedHealthcare requires prior authorization for Entresto (sacubitril/valsartan) in California, with approval typically taking 72 hours when proper documentation is submitted. Your fastest path: (1) Have your cardiologist submit a PA through the UHC provider portal with your heart failure diagnosis,
6 min read