Topic

UnitedHealthcare (UnitedHealth Group)

A collection of 1141 issues

Work With Your Doctor to Get Tremfya (Guselkumab) Approved by UnitedHealthcare in New York: Complete PA Guide

Answer Box: Getting Tremfya Covered by UnitedHealthcare in New York UnitedHealthcare requires prior authorization for Tremfya (guselkumab) and typically mandates step therapy with TNF inhibitors first. Success requires: (1) documented moderate-to-severe psoriasis with PASI/BSA scores, (2) proof of TNF inhibitor trial/failure or contraindication, and (3) negative TB screening
7 min read

How to Get Retevmo (selpercatinib) Covered by UnitedHealthcare in North Carolina: Complete Appeals Guide with Forms and Timelines

Answer Box: Getting Retevmo Covered by UnitedHealthcare in North Carolina Fastest path to approval: Submit prior authorization with FDA-approved RET fusion test results, diagnosis documentation, and prior therapy history through UnitedHealthcare's provider portal. If denied, North Carolina law provides strong step therapy exception rights (72-hour response required) and
6 min read

Get Xenpozyme (Olipudase Alfa) Covered by UnitedHealthcare in California: Complete Guide to Prior Authorization and Appeals

Quick Answer: Getting Xenpozyme Covered by UnitedHealthcare in California Xenpozyme (olipudase alfa-rpcp) requires prior authorization from UnitedHealthcare and is typically covered under the medical benefit for ASMD (Niemann-Pick disease types A/B). Key requirements: confirmed ASMD diagnosis with enzyme assay showing <10% ASM activity, genetic testing showing two pathogenic
6 min read

Resources to Get Xenpozyme (olipudase alfa-rpcp) Approved with UnitedHealthcare in Michigan: Forms, Portals & Contacts

Quick Start: Getting Xenpozyme Covered by UnitedHealthcare in Michigan Xenpozyme (olipudase alfa-rpcp) requires prior authorization from UnitedHealthcare/OptumRx for coverage approval. Your fastest path: verify your Michigan plan's specialty drug benefits, gather ASMD diagnosis documentation, and submit the PA request through the UnitedHealthcare Provider Portal or OptumRx electronic
5 min read

Renewing Uplizna (Inebilizumab) Coverage with UnitedHealthcare in Texas: 2025 Timeline & Documentation Guide

Answer Box: Renewing Uplizna Coverage in Texas UnitedHealthcare requires annual renewal for Uplizna (inebilizumab) with clinical documentation of continued benefit. Start 60-90 days before your current authorization expires. Submit via the UnitedHealthcare Provider Portal with updated clinical notes, lab results, and specialist attestation. If denied, you have 180 days to
6 min read

Getting Ilaris (Canakinumab) Covered by UnitedHealthcare in New York: Complete Prior Authorization and Appeal Guide

Answer Box: Quick Path to Ilaris Coverage in New York UnitedHealthcare requires prior authorization for Ilaris (canakinumab) in New York. Submit through a rheumatologist or immunologist with complete diagnostic documentation, lab results showing inflammation (elevated CRP, ESR, ferritin), and evidence of failed first-line therapies. If denied, you have 180 days
6 min read

Renewing Oxlumo (lumasiran) Approval with UnitedHealthcare in Ohio: Timeline, Documentation & What to Prepare

Answer Box: Renewing Oxlumo (lumasiran) with UnitedHealthcare in Ohio UnitedHealthcare requires annual renewal for Oxlumo (lumasiran) with proof of at least 30% reduction in urinary oxalate levels from baseline. Start renewal 60-90 days before expiration. Submit updated lab results, clinical notes showing continued benefit, and specialist documentation through the UnitedHealthcare
5 min read