Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1139 issues

The Requirements Checklist to Get Orladeyo (berotralstat) Covered by UnitedHealthcare in Texas: Forms, Appeals, and Timeline

Answer Box: Getting Orladeyo Covered by UnitedHealthcare in Texas UnitedHealthcare requires prior authorization for Orladeyo (berotralstat) in Texas. The fastest path: (1) Confirm HAE diagnosis with C1-INH lab results, (2) Submit OptumRx PA form with complete clinical documentation, (3) Use electronic submission for 24-72 hour decisions. New users may face

Do You Qualify for Xenpozyme Coverage by UnitedHealthcare in New York? Decision Tree & Next Steps

Answer Box: Your Fastest Path to Xenpozyme Coverage Yes, you likely qualify for Xenpozyme (olipudase alfa-rpcp) coverage by UnitedHealthcare in New York if you have confirmed ASMD (Niemann-Pick disease types A/B) with enzyme deficiency <10% and genetic testing showing biallelic SMPD1 mutations. The fastest path: (1) Gather enzyme

The Requirements Checklist to Get Voydeya (Danicopan) Covered by UnitedHealthcare in Georgia: Complete Prior Authorization Guide

Answer Box: Getting Voydeya Covered by UnitedHealthcare in Georgia Eligibility: Adults with PNH experiencing extravascular hemolysis despite C5 inhibitor therapy (eculizumab/ravulizumab). Fastest path: Submit prior authorization through OptumRx with documented EVH evidence, vaccination records, and specialist attestation. Start today: Verify your plan requires PA via the UnitedHealthcare provider portal

How to Get Orkambi (Lumacaftor/Ivacaftor) Covered by UnitedHealthcare in Ohio: Prior Authorization, Appeals, and Templates

Quick Answer: To get Orkambi (lumacaftor/ivacaftor) covered by UnitedHealthcare in Ohio, you need prior authorization with genetic testing confirming F508del homozygosity, CF specialist prescription, and documented clinical necessity. If denied, file internal appeals within 180 days, then request external review through Ohio Department of Insurance. Start by gathering your

How to Get Firazyr (Icatibant) Covered by UnitedHealthcare in Florida: Complete PA and Appeals Guide

Quick Answer: Getting Firazyr Covered by UnitedHealthcare in Florida UnitedHealthcare requires prior authorization for Firazyr (icatibant) in Florida, with strict medical necessity criteria and step therapy requirements. Your fastest path to approval: Have your HAE specialist submit a PA request through OptumRx (1-800-711-4555) with documented diagnosis, prior attack history, and

Myths vs. Facts: Getting Busulfex (busulfan injection) Covered by UnitedHealthcare in Ohio

Answer Box: Getting Busulfex Covered by UnitedHealthcare in Ohio Fastest path to approval: Submit prior authorization through UnitedHealthcare's provider portal with complete conditioning regimen documentation, including CML diagnosis (ICD-10 C92.10), failed prior therapies, and transplant center pre-approval. If denied, file internal appeal within 180 days, then request

How to Get Signifor / Signifor LAR (Pasireotide) Covered by UnitedHealthcare in California: Complete Prior Authorization Guide

Answer Box: Getting Signifor Covered by UnitedHealthcare in California UnitedHealthcare requires prior authorization for Signifor (pasireotide) with board-certified endocrinologist involvement and specific biochemical documentation. For Cushing's disease, no step therapy is required—just proof of endogenous hypercortisolism and surgical ineligibility/failure. Submit requests through the UHC Provider Portal

How to Get Opfolda (miglustat) Covered by UnitedHealthcare in New York: Complete Guide with Forms & Appeal Scripts

Answer Box: Getting Opfolda Coverage in New York To get Opfolda (miglustat) covered by UnitedHealthcare in New York: You must have confirmed late-onset Pompe disease and an active UnitedHealthcare prior authorization for Pombiliti (the required combination partner). Submit both PA requests simultaneously through the UHC Provider Portal. If denied, you

How Long Does It Take to Get Enhertu Approved by UnitedHealthcare in Michigan? Timeline & Appeal Process

Answer Box: Getting Enhertu Covered by UnitedHealthcare in Michigan Timeline: UnitedHealthcare's OptumRx system can approve Enhertu in under 30 seconds through automated prior authorization if all criteria are met, or up to 30 days for manual review. First step: Have your oncologist submit the prior authorization through the

Complete Guide to Getting Sylvant (Siltuximab) Covered by UnitedHealthcare in Georgia: Requirements, Appeals, and Timeline

Answer Box: Getting Sylvant Covered by UnitedHealthcare in Georgia Fastest path to approval: UnitedHealthcare requires prior authorization for Sylvant (siltuximab) with strict HIV-negative and HHV-8-negative testing requirements. Submit complete documentation through the UnitedHealthcare Provider Portal within 1-5 days for standard approval. If denied, Georgia residents have 180 days for internal