Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1119 issues

How to Get Strensiq (asfotase alfa) Covered by UnitedHealthcare in Pennsylvania: Complete PA Forms, Appeals Timeline & Success Scripts

Answer Box: Getting Strensiq Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Strensiq (asfotase alfa) with strict pediatric-onset hypophosphatasia criteria. Fastest path: Submit PA through OptumRx with documented onset before age 18, genetic/biochemical confirmation, and specialist attestation. If denied, use Pennsylvania's external review program within
6 min read

How to Get Vyndaqel/Vyndamax (Tafamidis) Covered by UnitedHealthcare in New Jersey: Complete PA Guide & Appeal Forms

Answer Box: Getting Started UnitedHealthcare requires prior authorization for Vyndaqel/Vyndamax (tafamidis) in New Jersey with strict medical necessity criteria. Fastest path to approval: (1) Confirm your plan covers specialty drugs through OptumRx, (2) Have your cardiologist submit PA via UnitedHealthcare Provider Portal with complete ATTR-CM diagnostic documentation, (3) If
7 min read

Myths vs. Facts: Getting Bavencio (avelumab) Covered by UnitedHealthcare in Texas - Complete Prior Authorization Guide

Answer Box: Getting Bavencio Covered by UnitedHealthcare in Texas Eligibility: Bavencio requires prior authorization from UnitedHealthcare for metastatic Merkel cell carcinoma and maintenance urothelial carcinoma treatment. Fastest path: Submit PA through the UnitedHealthcare Provider Portal with complete pathology reports, staging studies, and treatment history. First step today: Verify your plan
5 min read

Lowering Out-of-Pocket Costs for Sumavel DosePro with UnitedHealthcare in Texas: Coverage, Copays & Patient Assistance

Quick Answer: Sumavel DosePro (needle-free sumatriptan injection) was discontinued in the U.S., so UnitedHealthcare now covers generic sumatriptan injection alternatives. Most plans require prior authorization and step therapy through oral triptans first. In Texas, you have 180 days to appeal denials internally, plus external review rights through an Independent
7 min read

How to Get Venclexta (venetoclax) Approved by UnitedHealthcare in New York: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Venclexta Approved by UnitedHealthcare in New York Fastest path to approval: Venclexta requires prior authorization from UnitedHealthcare for CLL/SLL and AML. Success depends on submitting complete documentation including diagnosis confirmation, tumor lysis syndrome (TLS) monitoring plan, and guideline-supported treatment rationale. If denied, New York patients can
6 min read

How to Get Dupixent (dupilumab) Covered by UnitedHealthcare in Georgia: Complete Coding, Appeals, and Cost Guide

Quick Answer: Getting Dupixent Covered by UnitedHealthcare in Georgia UnitedHealthcare requires prior authorization for Dupixent (dupilumab) with strict step therapy and documentation requirements. The fastest path to approval: ensure your doctor submits complete medical records showing failed conventional therapies, correct ICD-10 diagnosis codes, and recent lab values through the OptumRx
5 min read

UnitedHealthcare Coverage for Oxbryta (Voxelotor) in Washington: 2024 FDA Withdrawal and Alternative Options

Answer Box: Oxbryta Coverage Status Oxbryta (voxelotor) is no longer available and cannot be covered by UnitedHealthcare or any insurer. Pfizer voluntarily withdrew the drug in September 2024 following FDA safety review. Your fastest path forward: Work with your hematologist to transition to FDA-approved alternatives like hydroxyurea, L-glutamine, or crizanlizumab.
5 min read