Advance Notification and Prior Authorization requirements

Health care professionals can view the following advance notification and prior authorization information or sign in to the UnitedHealthcare Provider Portal to help determine a member’s coverage.

Manage prior authorizations online

You can use the UnitedHealthcare Provider Portal to verify if a prior authorization is required. Check by member first to get the most accurate response, get a Decision ID and easily submit electronically if a prior authorization is required.

Summary of changes to advance notification and prior authorization requirements

Specialty resources

Current requirements by plan type

Choose one of the following relevant tabs to find the plan information you need.

UnitedHealthcare Medicare Advantage/Peoples Health Plans prior authorization requirements

Effective Aug. 1, 2026

Prior authorization requirements for Preferred Care Network and Preferred Care Partners of Florida

Effective Aug. 1, 2026

UnitedHealthcare Community Plan (Medicaid and long-term care)

Select your plan's state:

Individual Exchange

Effective Aug. 1, 2026

Individual Exchange behavioral health

Commercial
Medicare Advantage
Community Plan (Medicaid)
Individual Exchange

Commercial

Effective Sept. 1, 2026

Surest

Effective Sept. 1, 2026

Mid-Atlantic Health Plans

Effective Sept. 1, 2026

Oxford Health Plans

Effective Sept. 1, 2026

UnitedHealthcare Complete

Effective Aug. 1, 2026

UnitedHealthcare West

Effective Apr. 1, 2026

Neighborhood Health Partnership (NHP)

Effective Sept. 1, 2026

UnitedHealthcare of the River Valley

Effective Sept. 1, 2026

UnitedHealthcare Medicare Advantage/Peoples Health Plans prior authorization requirements

Effective Aug. 1, 2026

Prior authorization requirements for Preferred Care Network and Preferred Care Partners of Florida

Effective Aug. 1, 2026

UnitedHealthcare Community Plan (Medicaid and long-term care)

Select your plan's state:

Individual Exchange

Effective Aug. 1, 2026

Individual Exchange behavioral health

Previous requirements by plan type

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Commercial

Mid-Atlantic Health Plans

UnitedHealthcare West

UnitedHealthcare of the River Valley

Surest

Oxford Health Plans

Neighborhood Health Partnership (NHP)

UnitedHealthcare Complete

Medicare Advantage

UnitedHealthcare Medicare Advantage/ Peoples Health and Rocky Mountain Health Plans

For Rocky Mountain Individual & Plan (IFP) and Rocky Mountain Medical Advantage Prior Authorization and Advance Notification requirements prior to 3/1/25 click here

Preferred Care Network

Behavioral Health Rocky Mountain Health Plans CareAdvantage Value, CareAdvantage Enhanced

Jan. 1, 2023

Community Plan (Medicaid)

UnitedHealthcare Community Plan (Medicaid and long-term care)

Select your plan's state:

Individual Exchange

Individual Exchange behavioral health

2026

Colorado RMHP – effective Jan. 1, 2026

2025

2024

Search

Advance Notification and Prior Authorization requirements

Manage prior authorizations online

Summary of changes to advance notification and prior authorization requirements

Specialty resources

Current requirements by plan type

Commercial

Surest

Mid-Atlantic Health Plans

Oxford Health Plans

UnitedHealthcare Complete

UnitedHealthcare West

Neighborhood Health Partnership (NHP)

UnitedHealthcare of the River Valley

UnitedHealthcare Medicare Advantage/Peoples Health Plans prior authorization requirements

Prior authorization requirements for Preferred Care Network and Preferred Care Partners of Florida

UnitedHealthcare Community Plan (Medicaid and long-term care)

Individual Exchange

Individual Exchange behavioral health

Commercial

Surest

Mid-Atlantic Health Plans

Oxford Health Plans

UnitedHealthcare Complete

UnitedHealthcare West

Neighborhood Health Partnership (NHP)

UnitedHealthcare of the River Valley

UnitedHealthcare Medicare Advantage/Peoples Health Plans prior authorization requirements

Prior authorization requirements for Preferred Care Network and Preferred Care Partners of Florida

UnitedHealthcare Community Plan (Medicaid and long-term care)

Individual Exchange

Individual Exchange behavioral health

Previous requirements by plan type

Commercial

Mid-Atlantic Health Plans

UnitedHealthcare West

UnitedHealthcare of the River Valley

Surest

Oxford Health Plans

Neighborhood Health Partnership (NHP)

UnitedHealthcare Complete

UnitedHealthcare Medicare Advantage/ Peoples Health and Rocky Mountain Health Plans

Preferred Care Network

Behavioral Health Rocky Mountain Health Plans CareAdvantage Value, CareAdvantage Enhanced

UnitedHealthcare Community Plan (Medicaid and long-term care)

Individual Exchange

Individual Exchange behavioral health

Additional resources

Medicare Advantage Prior Authorization Outpatient Therapy Resources