The Patient Protection and Affordable Care Act (ACA) introduced a new option for consumers to access health insurance using a Health Insurance Marketplace, also known as an Exchange. These online Marketplaces let consumers research, compare and enroll for health insurance plans.
UnitedHealthcare Exchange plan participation
In 2022, we'll offer Individual Exchange plans in 7 new states. Select your state to view the welcome kit.
The Nevada Exchange Plans are administered by Sierra. For more information on these plans, visit: Nevadahealthlink.com
The Massachusetts Exchange Plans are administered by UnitedHealthcare. For more information on these plans visit: uhcprovider.com > Massachusetts > Commercial > UnitedHealthcareNavigate. (See State specific section for MA Insurance Exchange)
The New York ExchangePlans are administered by UnitedHealthcare. For more information on these plans visit: uhcprovider.com > NewYork > Commercial > UnitedHealthcare Compass
Learn more about Individual Exchange plans in 2022
Prior Authorization: If a drug requires prior authorization, step therapy, utilization management, or an exception, providers can contact OptumRx. Please provide information on diagnosis, medication history, medical records or lab tests as needed, clinical justification, and other supporting information.
For Florida, decisions for step therapy exception requests are issued within 72 hours for urgent requests and 15 days for all other requests. Adverse determinations may be appealed within 180 days by following the directions on the denial letter.
PreCheck MyScript: Check current prescription coverage and price, including out-of-pocket prescription costs for UnitedHealthcare members at their selected pharmacy. Get information on lower-cost prescription alternatives, if available, to help save members money.