Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1133 issues

UnitedHealthcare's Coverage Criteria for Zokinvy (lonafarnib) in Georgia: What Counts as "Medically Necessary"?

Answer Box: Getting Zokinvy Covered by UnitedHealthcare in Georgia Zokinvy (lonafarnib) requires prior authorization from UnitedHealthcare with strict genetic and clinical criteria. To qualify, you need documented HGPS or specific progeroid laminopathy mutations, age ≥12 months, BSA ≥0.39 m², and specialist prescription. First step today: Contact your genetics specialist
5 min read

How Long Does It Take to Get Firazyr (icatibant) Approved by UnitedHealthcare in Virginia? Complete Timeline & Appeals Guide

Answer Box: Getting Firazyr Approved by UnitedHealthcare in Virginia Timeline: Standard prior authorization takes 1-7 days; expedited reviews within 72 hours for urgent cases. Requirements: Confirmed HAE diagnosis, specialist prescription (immunologist/allergist), documentation of prior therapy failures, and self-administration training records. First step: Have your HAE specialist submit a complete
5 min read

How to Get Opzelura (Ruxolitinib Cream) Covered by UnitedHealthcare in New Jersey: 2025 Step Therapy Rules and Appeal Process

Quick Answer: Getting Opzelura Covered by UnitedHealthcare in New Jersey UnitedHealthcare in New Jersey requires prior authorization for Opzelura (ruxolitinib cream) with mandatory step therapy. You must first try and fail both a topical corticosteroid and calcineurin inhibitor before approval. If denied, you have 180 days to complete UnitedHealthcare'
6 min read

How to Get Juxtapid (Lomitapide) Covered by UnitedHealthcare in California: Appeals, REMS Requirements, and Step Therapy Overrides

Answer Box: Getting Juxtapid Covered by UnitedHealthcare in California Eligibility: Juxtapid requires prior authorization from UnitedHealthcare for confirmed homozygous familial hypercholesterolemia (HoFH) with genetic testing or LDL-C ≥400 mg/dL, baseline liver function tests, and documented failure/intolerance of other lipid-lowering therapies. Fastest path: Submit prior authorization with HoFH genetic
5 min read

How to Get Advate (Octocog Alfa) Covered by UnitedHealthcare in Texas: Complete Guide to Forms, Appeals, and Approval

Answer Box: Getting Advate Covered by UnitedHealthcare in Texas UnitedHealthcare requires prior authorization for Advate (octocog alfa) in Texas, with step therapy through preferred factor VIII products first. To get approval: (1) Submit PA request through the UnitedHealthcare Provider Portal with comprehensive hemophilia A documentation, (2) Include evidence of failed/
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How to Get Thiola / Thiola EC (Tiopronin) Covered by UnitedHealthcare in Ohio: Complete PA Guide with Appeals Timeline

Quick Answer: Getting Thiola Covered by UnitedHealthcare in Ohio UnitedHealthcare requires prior authorization for Thiola/Thiola EC (tiopronin) in Ohio. The fastest path: your urologist or nephrologist submits a PA request through the UnitedHealthcare provider portal with documented cystinuria diagnosis, failed alkalinization therapy, and medical necessity letter. If denied, Ohio
6 min read

UnitedHealthcare's Coverage Criteria for Myozyme (Alglucosidase Alfa) in New York: What Counts as "Medically Necessary"?

Answer Box: Getting Myozyme Covered by UnitedHealthcare in New York To get Myozyme (alglucosidase alfa) approved by UnitedHealthcare in New York, you need: confirmed Pompe disease diagnosis (genetic testing + enzyme deficiency), specialist evaluation by a neurologist or metabolic physician, and prior authorization with comprehensive clinical documentation. If denied, New York&
6 min read

Renewing Xembify Approval with UnitedHealthcare in North Carolina: 2025 Requirements and Timeline

Answer Box: Renewing Xembify Coverage with UnitedHealthcare in North Carolina Start your Xembify renewal 60-90 days before expiration. UnitedHealthcare typically requires annual reauthorization with updated IgG levels, infection documentation, and clinical response evidence. Submit through the UnitedHealthcare Provider Portal with current labs and provider attestation. If coverage lapses, request expedited
5 min read

How to Get Firdapse (Amifampridine) Covered by UnitedHealthcare in North Carolina: Complete Guide with Appeals Process and State Protections

Answer Box: Getting Firdapse Covered in North Carolina UnitedHealthcare requires prior authorization for Firdapse (amifampridine) in North Carolina. Your fastest path to approval: (1) Have your neurologist submit a complete PA request with confirmed LEMS diagnosis (EMG showing >60% increment, P/Q-type VGCC antibodies), clinical documentation of functional impairment,
5 min read