Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1123 issues

How to Get Berinert (C1-Esterase Inhibitor) Covered by UnitedHealthcare in Florida: Prior Authorization Guide and Appeals Process

Quick Answer: Getting Berinert Covered by UnitedHealthcare in Florida Berinert requires prior authorization from UnitedHealthcare/OptumRx in Florida. The fastest path: submit a complete PA request with HAE diagnosis documentation, prior treatment history, and medical necessity justification through the UHC Provider Portal. Standard decisions take up to 72 hours; expedited
6 min read

How to Get Zanzalintinib (XL092) Covered by UnitedHealthcare in Illinois: Appeals Guide with Forms and Timelines

Answer Box: Your Fastest Path to Coverage Getting Zanzalintinib (XL092) covered by UnitedHealthcare in Illinois requires understanding that this investigational drug is typically excluded from standard coverage. However, Illinois law provides strong appeal protections through the Health Carrier External Review Act. Your three-step approach: (1) Submit a formal prior authorization
5 min read

Work With Your Doctor to Get Lumizyme (Alglucosidase Alfa) Approved by UnitedHealthcare in Ohio: Medical Necessity Letters, Peer Reviews, and Appeals

Answer Box: Getting Lumizyme Covered by UnitedHealthcare in Ohio UnitedHealthcare requires prior authorization for all Lumizyme (alglucosidase alfa) prescriptions for Pompe disease, with potential step therapy requirements for new Medicare Advantage members. Success depends on strong physician partnership and comprehensive documentation. Your fastest path: 1) Schedule an appointment with your
7 min read

How to Get Nourianz (Istradefylline) Covered by UnitedHealthcare in Florida: Complete Guide to Prior Authorization and Appeals

Answer Box: Getting Nourianz Covered by UnitedHealthcare in Florida Nourianz (istradefylline) requires prior authorization from UnitedHealthcare OptumRx with strict step therapy requirements. To get approval in Florida: 1. Document failure/intolerance of at least two adjunctive therapy classes (amantadine, MAO-B inhibitors like rasagiline, or COMT inhibitors like entacapone) 2. Submit
6 min read

Resources to Get Busulfex (Busulfan Injection) Approved with UnitedHealthcare in Florida: Forms, Portals & Appeals Guide

Answer Box: Getting Busulfex Covered by UnitedHealthcare in Florida Busulfex (busulfan injection) requires prior authorization from UnitedHealthcare/OptumRx in Florida. Submit the General Prior Authorization form with complete clinical documentation via the UHC Provider Portal or fax to 1-844-403-1027. Standard decisions take 72 hours; urgent cases get 24-hour review. If
5 min read

Myths vs. Facts: Getting Evkeeza (evinacumab-dgnb) Covered by UnitedHealthcare in North Carolina

Answer Box Getting Evkeeza (evinacumab-dgnb) covered by UnitedHealthcare in North Carolina requires: confirmed homozygous familial hypercholesterolemia diagnosis, documented failure of statin + ezetimibe + PCSK9 inhibitor, and prior authorization through the UnitedHealthcare Provider Portal. If denied, you have 180 days to appeal internally, then can request external review through North Carolina'
5 min read

Get Cometriq (Cabozantinib) Covered by UnitedHealthcare in Pennsylvania: Complete Forms, Appeals & Contact Guide

Answer Box: Getting Cometriq Covered by UnitedHealthcare in Pennsylvania Fastest path to approval: Submit prior authorization through the UnitedHealthcare Provider Portal with oncologist documentation of progressive, metastatic medullary thyroid cancer. Required: ICD-10 diagnosis codes, pathology reports, and evidence of disease progression. Timeline: 72 hours for standard PA decisions. If denied:
5 min read