September 01, 2022

Individual Exchange: New prior authorization codes

We’re making changes to the prior authorization list for Individual Exchange benefit plans, also referred to as Individual and Family plans.

Starting Dec. 1, 2022, we’re updating the prior authorization list for the following states, where we currently offer Individual Exchange plans: 

  • Alabama
  • Arizona
  • Florida
  • Georgia
  • Illinois
  • Louisiana
  • Maryland

Starting Jan. 1, 2023, we’ll offer Individual Exchange plans in the following states:*

  • Kansas
  • Mississippi
  • Missouri
  • Ohio
  • Michigan
  • North Carolina
  • Oklahoma
  • Tennessee
  • Texas
  • Virginia
  • Washington  

See the prior authorization codes

Prior authorization requirements
Prior authorization requests for Individual Exchange plan members must be submitted electronically, unless otherwise allowed by law.  

New to the Prior Authorization and Notification tool?
The Prior Authorization and Notification tool on the UnitedHealthcare Provider Portal enables you to:

  • Check prior authorization requirements
  • Submit a request
  • Check the status of an existing request

Resources
You can find more information at UHCprovider.com/exchanges, including training and state-specific requirements.

Questions?

  • Call Provider Services at 888-478-4760.
*These states are pending regulatory approval.
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