Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 116 issues

How to Get Breyanzi Covered by UnitedHealthcare in California: Complete Prior Authorization Guide

Quick Answer: Getting Breyanzi Approved by UnitedHealthcare in California Breyanzi (lisocabtagene maraleucel) requires prior authorization from UnitedHealthcare before administration. To get approval: (1) Submit a complete PA request through the UnitedHealthcare Provider Portal with diagnosis documentation, prior therapy records, and REMS facility certification; (2) Allow 72 hours for standard review
7 min read

Myths vs. Facts: Getting Opsumit (Macitentan) Covered by UnitedHealthcare in Ohio

Answer Box: Getting Opsumit Covered by UnitedHealthcare in Ohio Eligibility: UnitedHealthcare requires prior authorization for Opsumit (macitentan) with documented PAH diagnosis, WHO functional class II-IV, and specialist involvement. Fastest path: Submit comprehensive PA request through UnitedHealthcare Provider Portal with complete clinical documentation. First step today: Gather PAH diagnosis confirmation, functional
5 min read

Get Firdapse (Amifampridine) Covered by UnitedHealthcare in Illinois: Complete Requirements Checklist

Answer Box: Getting Firdapse Covered by UnitedHealthcare in Illinois UnitedHealthcare requires prior authorization for Firdapse (amifampridine) to treat Lambert-Eaton myasthenic syndrome (LEMS). The fastest path to approval: (1) Confirm your neurologist has documented LEMS diagnosis with antibody testing and EMG findings, (2) Submit the UnitedHealthcare prior authorization form with clinical
6 min read

The Requirements Checklist to Get Retevmo (selpercatinib) Covered by UnitedHealthcare in Pennsylvania

Answer Box: Fast Track to Approval To get Retevmo (selpercatinib) covered by UnitedHealthcare in Pennsylvania: 1) Confirm RET fusion-positive status with FDA-approved testing (FoundationOne CDx preferred), 2) Submit prior authorization through UnitedHealthcare provider portal with complete molecular pathology reports and clinical documentation, 3) If denied, file internal appeal within 6
5 min read

Renewing Voxzogo (Vosoritide) Approval with UnitedHealthcare in Washington: 2025 Requirements & Timeline

Quick Answer: Voxzogo Renewal Requirements UnitedHealthcare requires annual reauthorization for Voxzogo (vosoritide) with documented clinical response and open epiphyses. Start renewal 60 days before expiration. Key documents: updated growth data showing improved velocity, bone age confirmation of open growth plates, and provider attestation of continued benefit. Submit through OptumRx provider
5 min read

How to Get Ibrance (Palbociclib) Covered by UnitedHealthcare in Florida: Complete PA Guide & Appeal Scripts

Quick Answer: Getting Ibrance Covered by UnitedHealthcare in Florida UnitedHealthcare requires prior authorization for Ibrance (palbociclib) in Florida through their OptumRx specialty pharmacy program. Fastest path to approval: Submit PA through the UnitedHealthcare Provider Portal's Cancer Guidance Program with documented HR+/HER2- metastatic breast cancer diagnosis and combination
6 min read

Tegsedi (Inotersen) Approval with UnitedHealthcare in Georgia: Answers to the Most Common Questions

Answer Box: Getting Tegsedi Covered by UnitedHealthcare in Georgia Yes, UnitedHealthcare covers Tegsedi (inotersen) for hereditary transthyretin-mediated (hATTR) amyloidosis with polyneuropathy in adults, but requires prior authorization. The fastest path to approval: (1) Enroll in the Tegsedi REMS program immediately, (2) Document genetic TTR mutation and prior Onpattro trial/failure,
5 min read

Do You Qualify for Enhertu Coverage by UnitedHealthcare in Georgia? Decision Tree & Next Steps

Answer Box: Your Path to Enhertu Coverage in Georgia UnitedHealthcare requires prior authorization for Enhertu (fam-trastuzumab deruxtecan) in Georgia. To qualify, you need documented HER2-positive status, appropriate diagnosis (breast, lung, or gastric cancer), and typically evidence of prior HER2-targeted therapy failure. Submit requests through the UnitedHealthcare Provider Portal with complete
5 min read