Individual Exchange Policies

These policies apply to UnitedHealthcare Individual Exchange plans, also referred to as Individual and Family plans. We currently offer these plans in Alabama, Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Michigan, Mississippi, Missouri, Nebraska, New Jersey (Oxford Metro), New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Virginia, Washington, Wisconsin, and Wyoming.

Reimbursement policies

• For all other states (including Massachusetts and New York), refer to our UnitedHealthcare Commercial Reimbursement Policies

Medical policies

• These medical policies also apply to Massachusetts and New York, unless otherwise indicated
• Nevada: Refer to the Health Plan of Nevada’s Medical Policies

Medical benefit drug policies

• These medical benefit drug policies also apply to Massachusetts and New York, unless otherwise indicated
• Nevada: Refer to our UnitedHealthcare Commercial Medical & Drug Policies

More UnitedHealthcare Policies and Clinical Guidelines

• Clinical Guidelines

Resources and FAQs

• Medical Records Documentation Used for Reviews