Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1139 issues

How Long Does It Take to Get Koselugo (Selumetinib) Approved by UnitedHealthcare in Georgia? Complete Timeline & Appeals Guide

Answer Box: Getting Koselugo Approved by UnitedHealthcare in Georgia Timeline: UnitedHealthcare/OptumRx now processes most prior authorizations in 29 seconds using automated systems when all criteria are met electronically. Manual reviews take up to 72 hours for standard requests. First step: Have your doctor submit the prior authorization through the

Denied for Dojolvi (Triheptanoin) by UnitedHealthcare in New Jersey? Complete Appeal Guide with Templates

Answer Box: UnitedHealthcare requires prior authorization for Dojolvi (triheptanoin) with molecular confirmation of long-chain fatty acid oxidation disorder (LC-FAOD) and specialist prescription. No step therapy applies. If denied, request peer-to-peer review immediately, then file internal appeal within 180 days. After exhausting internal appeals, use New Jersey's IHCAP external

How to Get Vanflyta (Quizartinib) Covered by UnitedHealthcare in Washington: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Vanflyta Covered by UnitedHealthcare in Washington Vanflyta (quizartinib) requires prior authorization from UnitedHealthcare for FLT3-ITD positive AML. Submit documentation of FLT3-ITD mutation testing, EKG showing QTc ≤450ms, and medical necessity justification through the UnitedHealthcare Provider Portal. If denied, Washington residents have strong appeal rights including external review

If Amvuttra Isn't Approved by UnitedHealthcare in New York: Formulary Alternatives & Exception Paths

Answer Box: Your Next Steps if Amvuttra is Denied If UnitedHealthcare denied Amvuttra (vutrisiran) for TTR amyloidosis in New York, you have several paths forward. First, review which formulary alternatives your plan covers—typically Onpattro, Tegsedi, or Vyndaqel depending on your condition type. Second, work with your specialist to document

How to Get Imbruvica (Ibrutinib) Covered by UnitedHealthcare in Washington: Prior Authorization, Appeals, and Templates

Answer Box: Getting Imbruvica Covered by UnitedHealthcare in Washington UnitedHealthcare requires prior authorization for Imbruvica (ibrutinib) but doesn't mandate step therapy for CLL, SLL, or Waldenström macroglobulinemia. The fastest path: (1) Submit complete PA with pathology, diagnosis, and treatment history; (2) If denied, file internal appeal within 180

Hemgenix Coverage by UnitedHealthcare in Michigan: Prior Authorization, Appeals, and Alternative Options

Answer Box: Getting Hemgenix Covered by UnitedHealthcare in Michigan UnitedHealthcare requires prior authorization for Hemgenix (etranacogene dezaparvovec) with strict eligibility criteria. To get coverage in Michigan: 1) Confirm you meet clinical requirements (50+ factor IX exposure days, no inhibitors, on current prophylaxis), 2) Submit PA through UHC Provider Portal with

Renewing Taltz (Ixekizumab) Approval with UnitedHealthcare in California: Complete Renewal Guide 2025

Answer Box: Renewing Taltz (Ixekizumab) with UnitedHealthcare in California Quick Path to Renewal: Submit your Taltz renewal request 2-4 weeks before your current authorization expires. You'll need clinical notes showing treatment response, updated diagnosis codes, and confirmation you're not using other biologics. If denied, California residents

How to Get Tagrisso (Osimertinib) Covered by UnitedHealthcare in Washington: Prior Authorization Guide & Appeal Steps

Answer Box: Getting Tagrisso Covered by UnitedHealthcare in Washington You can get Tagrisso (osimertinib) covered by UnitedHealthcare in Washington if you have EGFR-mutated non-small cell lung cancer (NSCLC) and meet prior authorization criteria. The fastest path: ensure your oncologist has documented EGFR mutation test results (exon 19 deletion or L858R)

Getting Symdeko (Tezacaftor/Ivacaftor) Covered by UnitedHealthcare in Virginia: Complete Prior Authorization Guide

Answer Box: Your Path to Symdeko Coverage in Virginia Symdeko (tezacaftor/ivacaftor) requires prior authorization from UnitedHealthcare, with specific genotype documentation and specialist requirements. The fastest path: 1) Confirm F508del mutation status via FDA-cleared testing, 2) Have your CF specialist submit UnitedHealthcare's Symdeko Prior Authorization form with complete

Myths vs. Facts: Getting Gilenya (Fingolimod) Covered by UnitedHealthcare in Ohio

Answer Box: Getting Gilenya Covered by UnitedHealthcare in Ohio The Facts: UnitedHealthcare requires prior authorization for Gilenya (fingolimod) with documented failure of two first-line MS therapies, baseline EKG, ophthalmology exam, and vaccination records. If denied, you have 60 days to appeal internally, then 180 days for Ohio's external