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Optum provides behavioral health network for UnitedHealthcare Individual and Family plans available on the Exchange

Optum Individual Exchange Plan FAQs

Beginning January 1, 2021, UnitedHealthcare expanded options for members to purchase health insurance using a Health Insurance Marketplace, otherwise known as an “Exchange.” Optum provides a behavioral health network of reliable, high quality providers, who provide affordable care, to support this business.  Optum providers who are included in this network will receive a notice regarding their participation.

Behavioral Health Prior Authorization Code List (Effective 1/1/2023):

AL Prior Authorization Requirements for UnitedHealthcare Exchange Plans

AZ Prior Authorization Requirements for UnitedHealthcare Exchange Plans

CO Prior Authorization Requirements for UnitedHealthcare Exchange Plans

FL Prior Authorization Requirements for UnitedHealthcare Exchange Plans

GA Prior Authorization Requirements for UnitedHealthcare Exchange Plans

IL Prior Authorization Requirements for UnitedHealthcare Exchange Plans

KS Prior Authorization Requirements for UnitedHealthcare Exchange Plans

LA Prior Authorization Requirements for UnitedHealthcare Exchange Plans

MD Prior Authorization Requirements for UnitedHealthcare Exchange Plans

MI Prior Authorization Requirements for UnitedHealthcare Exchange Plans

MO Prior Authorization Requirements for UnitedHealthcare Exchange Plans

MS Prior Authorization Requirements for UnitedHealthcare Exchange Plans

NC Prior Authorization Requirements for UnitedHealthcare Exchange Plans

OH Prior Authorization Requirements for UnitedHealthcare Exchange Plans

OK Prior Authorization Requirements for UnitedHealthcare Exchange Plans

TN Prior Authorization Requirements for UnitedHealthcare Exchange Plans

TX Prior Authorization Requirements for UnitedHealthcare Exchange Plans

VA Prior Authorization Requirements for UnitedHealthcare Exchange Plans

WA Prior Authorization Requirements for UnitedHealthcare Exchange Plans

WY Prior Authorization Requirments for UnitedHealthcare Exchange Plans 

Additional Information

More information and resources, including the UnitedHealthcare Administrative Guide, can be found at uhcprovider.com

Frequently Asked Questions

Click here for Optum Individual Exchange FAQs

Individual Exchange Plan QRG for 2025

Quick Reference Guide 

Platinum Providers

UM Review Required for Exchange Members