Welcome to UnitedHealthcare Individual Exchange plans, also referred to as Individual and Family plans. These plans are offered through the Health Insurance Marketplace, or the Exchange, where individuals can research, compare, and purchase health plans.
Here, you can access a variety of resources to help you work with us as you care for members who have these state-specific plans.

Interactive guide
Access this self-paced guide for everything you need to know about our Individual Exchange plans

Quick reference guide
Get answers about working with the plans in our quick reference guide
Actions you can take in the Provider Portal
Sign in to the UnitedHealthcare Provider Portal to manage your account and complete tasks
Actions you can take in the Provider PortalVerify your participation
Check if you’re in-network for an Individual Exchange plan
Update patient information
Provide accurate patient information to help make claims processing faster
Submit a referral
Refer your patients to a specialist within minutes
Submit or check claims
Review a claim’s status or send us a new claim with ease
Check eligibility
Confirm patient eligibility and review information about their benefits
Helpful links

Guides and Resources

Policies
State-specific plan information
Find pharmacy information about clinical criteria and prior authorization forms.
Pharmacy prior authorizations and exceptions
- Alabama Clinical Criteria - Effective July 1, 2025
- Alabama Clinical Criteria - Effective June 1, 2025
- Alabama Clinical Criteria - Effective May 1, 2025
- Alabama Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Arizona Clinical Criteria - Effective July 1, 2025
- Arizona Clinical Criteria - Effective June 1, 2025
- Arizona Clinical Criteria - Effective May 1, 2025
- Arizona Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Related links
Pharmacy prior authorizations and exceptions
- Colorado Clinical Criteria - Effective July 1, 2025
- Colorado Clinical Criteria - Effective June 1, 2025
- Colorado Clinical Criteria - Effective May 1, 2025
- Colorado Prior Authorization Form for Prescription Benefits
- Colorado Prior Authorization Form for Mental Health Step Therapy Exceptions
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Related links
- 2025 Individual Exchange Plans of Colorado Quick Reference Guide
- 2024 Individual Exchange Plans of Colorado Quick Reference Guide
- Colorado Referral Requirements Quick Reference Guide
- Colorado Rocky Mountain Health Plan Out-of-Network Request Form
- Colorado Rocky Mountain Health Plan Release of Information Form
- Colorado Rocky Mountain Health Plan Release of Information Form - Spanish
- Rocky Mountain Health Plans Administers Colorado Individual Exchange Plans
- Rocky Mountain Health Plans to align with UnitedHealthcare clinical requirements
- New radiation requirements for Rocky Mountain Health Plans
- UnitedHealthcare Individual Exchange Medical and Drug Policies
Pharmacy prior authorizations and exceptions
- Florida Clinical Criteria - Effective July 1, 2025
- Florida Clinical Criteria - Effective June 1, 2025
- Florida Clinical Criteria - Effective May 1, 2025
- Florida Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Related links
Pharmacy prior authorizations and exceptions
- Georgia Clinical Criteria - Effective July 1, 2025
- Georgia Clinical Criteria - Effective June 1, 2025
- Georgia Clinical Criteria - Effective May 1, 2025
- Georgia Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Illinois Clinical Criteria - Effective July 1, 2025
- Illinois Clinical Criteria - Effective June 1, 2025
- Illinois Clinical Criteria - Effective May 1, 2025
- Illinois Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Indiana Clinical Criteria - Effective July 1, 2025
- Indiana Clinical Criteria - Effective June 1, 2025
- Indiana Clinical Criteria - Effective May 1, 2025
- Indiana Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Iowa Clinical Criteria - Effective July 1, 2025
- Iowa Clinical Criteria - Effective June 1, 2025
- Iowa Clinical Criteria - Effective May 1, 2025
- Iowa Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Kansas Clinical Criteria - Effective July 1, 2025
- Kansas Clinical Criteria - Effective June 1, 2025
- Kansas Clinical Criteria - Effective May 1, 2025
- Kansas Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Louisiana Clinical Criteria - Effective July 1, 2025
- Louisiana Clinical Criteria - Effective June 1, 2025
- Louisiana Clinical Criteria - Effective May 1, 2025
- Louisiana Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Maryland Clinical Criteria - Effective July 1, 2025
- Maryland Clinical Criteria - Effective June 1, 2025
- Maryland Clinical Criteria - Effective May 1, 2025
- Maryland Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Related links
- Maryland Health Connection administers Maryland Individual Exchange Plans
Pharmacy prior authorizations and exceptions
Related links
- UnitedHealthcare Navigate® administers Massachusetts Individual Exchange Plans
- Massachusetts Navigate Quick Reference Guide
Pharmacy prior authorizations and exceptions
- Michigan Clinical Criteria - Effective July 1, 2025
- Michigan Clinical Criteria - Effective June 1, 2025
- Michigan Clinical Criteria - Effective May 1, 2025
- Michigan Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Mississippi Clinical Criteria - Effective July 1, 2025
- Mississippi Clinical Criteria - Effective June 1, 2025
- Mississippi Clinical Criteria - Effective May 1, 2025
- Mississippi Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Missouri Clinical Criteria - Effective July 1, 2025
- Missouri Clinical Criteria - Effective June 1, 2025
- Missouri Clinical Criteria - Effective May 1, 2025
- Missouri Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Nebraska Clinical Criteria - Effective July 1, 2025
- Nebraska Clinical Criteria - Effective June 1, 2025
- Nebraska Clinical Criteria - Effective May 1, 2025
- Nebraska Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Related links
- Visit healthplanofnevada.com or sierrahealthandlife.com for plan options in Nevada
Pharmacy prior authorizations and exceptions
- New Jersey Clinical Criteria - Effective July 1, 2025
- New Jersey Clinical Criteria - Effective June 1, 2025
- New Jersey Clinical Criteria - Effective May 1, 2025
- New Jersey Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- New Mexico Clinical Criteria - Effective July 1, 2025
- New Mexico Clinical Criteria - Effective June 1, 2025
- New Mexico Clinical Criteria - Effective May 1, 2025
- New Mexico Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
Related links
Pharmacy prior authorizations and exceptions
- North Carolina Clinical Criteria - Effective July 1, 2025
- North Carolina Clinical Criteria - Effective June 1, 2025
- North Carolina Clinical Criteria - Effective May 1, 2025
- North Carolina Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Ohio Clinical Criteria - Effective July 1, 2025
- Ohio Clinical Criteria - Effective June 1, 2025
- Ohio Clinical Criteria - Effective May 1, 2025
- Ohio Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Oklahoma Clinical Criteria - Effective July 1, 2025
- Oklahoma Clinical Criteria - Effective June 1, 2025
- Oklahoma Clinical Criteria - Effective May 1, 2025
- Oklahoma Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- South Carolina Clinical Criteria - Effective July 1, 2025
- South Carolina Clinical Criteria - Effective June 1, 2025
- South Carolina Clinical Criteria - Effective May 1, 2025
- South Carolina Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Tennessee Clinical Criteria - Effective July 1, 2025
- Tennessee Clinical Criteria - Effective June 1, 2025
- Tennessee Clinical Criteria - Effective May 1, 2025
- Tennessee Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Texas Clinical Criteria - Effective July 1, 2025
- Texas Clinical Criteria - Effective June 1, 2025
- Texas Clinical Criteria - Effective May 1, 2025
- Texas Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Related links
Pharmacy prior authorizations and exceptions
- Virginia Clinical Criteria - Effective July 1, 2025
- Virginia Clinical Criteria - Effective June 1, 2025
- Virginia Clinical Criteria - Effective May 1, 2025
- Virginia Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Washington Clinical Criteria - Effective July 1, 2025
- Washington Clinical Criteria - Effective June 1, 2025
- Washington Clinical Criteria - Effective May 1, 2025
- Washington Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Related links
- Washington Healthplan Finder administers Washington Individual Exchange Plans
Pharmacy prior authorizations and exceptions
- Wisconsin Clinical Criteria - Effective July 1, 2025
- Wisconsin Clinical Criteria - Effective June 1, 2025
- Wisconsin Clinical Criteria - Effective May 1, 2025
- Wisconsin Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Pharmacy prior authorizations and exceptions
- Wyoming Clinical Criteria - Effective July 1, 2025
- Wyoming Clinical Criteria - Effective June 1, 2025
- Wyoming Clinical Criteria - Effective May 1, 2025
- Wyoming Prior Authorization Form for Prescription Benefits
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective Sept. 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective August 1, 2025
- Notice of Changes to Prior Authorization Requirements and Coverage Criteria - Effective July 1, 2025
Individual Exchange plan news
New 2025 Individual Exchange plans and prior authorization information
RMHP Individual Exchange plans to align with hospital reference lab protocol
Updates to Individual Exchange plans PDLs on Jan. 1, 2025
Get personalized news
Sign up to receive personalized UnitedHealthcare news updates by email