Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1136 issues

Myths vs. Facts: Getting Fintepla (Fenfluramine) Covered by UnitedHealthcare in Ohio - Complete Appeals Guide

Answer Box: Getting Fintepla Covered by UnitedHealthcare in Ohio Fintepla (fenfluramine) requires prior authorization from UnitedHealthcare and strict REMS program compliance. Most denials stem from missing REMS documentation or incomplete step therapy records. First step today: Ensure your prescriber has enrolled in the Fintepla REMS program and completed your baseline
5 min read

How to Get Lutathera (Lutetium Lu-177 Dotatate) Covered by UnitedHealthcare in North Carolina: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Lutathera Covered by UnitedHealthcare in North Carolina Lutathera requires prior authorization from UnitedHealthcare with strict step therapy requirements. You must show disease progression on octreotide LAR or lanreotide, plus SSTR-positive imaging (Ga-68 DOTATATE PET scan). If denied, appeals succeed in 85% of cases. Start today: Gather your
5 min read

Myths vs. Facts: Getting Kymriah (Tisagenlecleucel) Covered by UnitedHealthcare in Ohio

Answer Box: Getting Kymriah Covered by UnitedHealthcare in Ohio Yes, UnitedHealthcare covers Kymriah for FDA-approved indications, but prior authorization is required. Success depends on meeting clinical criteria, submitting complete documentation, and using certified treatment centers. First step: Have your oncologist initiate PA through the UnitedHealthcare Provider Portal with CD19+ status,
6 min read

Resources to Get Lutathera (Lutetium Lu-177 Dotatate) Approved with UnitedHealthcare in Washington: Forms, Portals & Appeals Guide

Answer Box: Getting Lutathera Covered by UnitedHealthcare in Washington Lutathera requires prior authorization from UnitedHealthcare with strict clinical criteria. The fastest path: Submit through the UnitedHealthcare Provider Portal with complete documentation including SSTR-positive imaging, GEP-NET diagnosis, and disease progression on octreotide. If denied, file internal appeals within 180 days, then
5 min read

UnitedHealthcare's Coverage Criteria for Rinvoq (upadacitinib) in North Carolina: What Counts as "Medically Necessary"?

Answer Box: Getting Rinvoq Covered by UnitedHealthcare in North Carolina UnitedHealthcare requires prior authorization for Rinvoq (upadacitinib) with mandatory step therapy—patients must fail at least one TNF inhibitor first. To get approved: 1) Have your specialist document TNF inhibitor failure/intolerance, 2) Submit PA through OptumRx with complete medical
6 min read

How to Get Hemlibra (Emicizumab) Covered by UnitedHealthcare in New York: Complete Cost-Cutting Guide

Answer Box: Getting Hemlibra Covered by UnitedHealthcare in New York Hemlibra (emicizumab) requires prior authorization from UnitedHealthcare, dispensed through specialty pharmacy (typically Optum), with commercial patients eligible for up to $15,000 annual copay assistance. Key requirements: confirmed hemophilia A diagnosis, inhibitor status documentation, and prophylaxis indication. If denied, New
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UnitedHealthcare's Coverage Criteria for Rebif in Illinois: What Counts as "Medically Necessary"?

Answer Box: Getting Rebif Covered by UnitedHealthcare in Illinois UnitedHealthcare requires prior authorization for Rebif (interferon beta-1a) with documented medical necessity including confirmed relapsing MS diagnosis, MRI evidence of disease activity, and often step therapy with preferred alternatives first. Submit complete documentation through OptumRx portal including recent MRI, relapse history,
6 min read