01/20/2025

United Healthcare

United Healthcare Managed Care Committee Member

Shelby Jensen, CHONC - Newland Medical Associates

Medical Policy Update

• UnitedHealthcare Commercial 
• UnitedHealthcare Medicare Advantage 

Reimbursement Policy Updates

• UnitedHealthcare Commercial 
• UnitedHealthcare Medicare Advantage 

Pharmacy and Clinical Updates

• Clinical Program Drug Step Therapy – Commercial and Individual Exchange plans, also referred to as UnitedHealthcare Individual & Family ACA Marketplace plans 

Prescription Drugs

• Q1 2025 preferred drug list updates 
• Prescription Drug List - Effective January 1, 2025 
• Browse Medicare Part D prescription drug plans 
• Alternative medications coverage for all plans  
• Specialty medication program updates for UnitedHealthcare Commercial, Community Plan, Medicare Advantage and Individual & Family Plans

Others

• 2025 UnitedHealthcare Care Provider Administrative Guide for Commercial, Individual Exchange, and Medicare Advantage 
• Medicare Advantage: Updates to prior authorization requirement for outpatient therapy and chiropractic services