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Políticas Médicas

Las políticas médicas son documentos que definen el reconocimiento de cubierta para tecnologías, procedimientos y tratamientos. Las declaraciones de necesidad médica en las políticas, sobre si una tecnología, procedimiento, tratamiento, suplido, equipo, medicamento u otro servicio mejora el resultado en la salud de la población para la cual dicha tecnología o tratamiento fue diseñado se basan en evidencia científica, estudios clínicos y opiniones profesionales de nuestros proveedores y de las organizaciones médicas reconocidas.

Cada documento desplegado en este sitio Web se provee con propósitos informativos solamente y no es una autorización, explicación de beneficios o un contrato. El recibir beneficios está sujeto a la satisfacción de todos los términos y condiciones de la cubierta. La tecnología médica cambia constantemente y nos reservamos el derecho de revisar y actualizar nuestras políticas periódicamente.

ID Título Última Revisión Siguiente Revisión Descripción Acceso
13.010.001 Orthodontic Services Oct 24, 2024 Policy Archived The branch of dentistry that is responsible for the study, prevention, diagnosis and treatment of anomalies... Ver
7.001.168 Surgical Left Atrial Appendage Occlusion Devices for Stroke Prevention in Atrial Fibrillation Sep 07, 2022 Sep 07, 2023 Atrial fibrillation (af) is the most common type of cardiac arrhythmia. stroke associated with af is... Ver
M3.001.001 Therapeutic Radiopharmaceuticals for Prostate Cancer Aug 19, 2025 Aug 20, 2026 ... Ver
M3.001.002 Radio 223 Injection (Xofigo) May 06, 2025 May 20, 2026 Approximately 240,000 men in the united states are expected to be diagnosed with prostate cancer in 2016.... Ver
M5.001.001 Viscosupplementation Therapy For Knee May 14, 2025 May 20, 2026 Viscosupplementation therapy is part of the therapy used in the treatment of osteoarthritis of the knee.... Ver
M5.001.002 Rituximab May 14, 2025 May 20, 2026 Rituximab is a genetically engineered chimeric murine/human monoclonal igg1 kappa antibody directed against... Ver
M5.001.003 Trastuzumab – Trastuzumab Biologics Sep 25, 2025 Sep 20, 2026 Trastuzumab is a monoclonal antibody, one of a group of drugs designed to attack specific cancer cells.... Ver
M5.001.005 Bevacizumab Sep 25, 2025 May 20, 2026 Bevacizumab is a humanized monoclonal antibody directed against vascular endothelial growth factor a... Ver
M5.001.006 G-Csf Filgrastim Sep 25, 2025 May 20, 2026 White blood cell growth factors, also known as granulocyte colony stimulating factors (g-csf), are... Ver
M5.001.007 Somatuline® Depot; Lanreotide May 14, 2025 May 20, 2026 Somatuline® depot; lanreotide is used to treat people with acromegaly (condition in which the body... Ver
M5.001.008 Simponi ARIA® (golimumab) May 14, 2025 May 20, 2026 Golimumab is in a class of drugs called biologics. golimumab is a treatment for adults with moderate to... Ver
M5.001.009 Stelara® (ustekinumab) May 14, 2025 May 20, 2026 Stelara is a human igg1κ monoclonal antibody that binds with high affinity and specificity to the p40... Ver
M5.001.010 Infliximab Sep 25, 2025 May 20, 2026 Infliximab (remicade®) is a tumor necrosis factor α (tnf-α) blocking agent approved by the... Ver
M5.001.011 Erythropoiesis Stimulating Agents Sep 22, 2025 May 20, 2026 Endogenous erythropoietin is a glycoprotein hematopoietic growth factor that regulates hemoglobin levels in... Ver
M5.001.012 Vascular Endothelial Growth Factor Inhibitors for the Treatment of Ophthalmological Diseases Sep 25, 2025 Sep 20, 2026 Vascular endothelial growth factor has been implicated in the pathogenesis of a variety of ocular vascular... Ver
M5.001.013 Ruconest May 14, 2025 May 20, 2026 C-1 esterase inhibitor protein is one of nine complement proteins found in the blood that works with the... Ver
M5.001.014 Immune Globulin May 14, 2025 May 20, 2026 Immune globulin (also referred to as gamma globulin or immunoglobulin) is a therapeutic compound prepared... Ver
M5.001.015 Treatment of Hereditary Transthyretin-Mediated Amyloidosis in Adult Patients May 14, 2025 May 20, 2026 Hereditary transthyretin-mediated amyloidosis (hattr) is a rare, progressive, and fatal autosomal dominant... Ver
M5.001.016 Lumasiran for Primary Hyperoxaluria Type 1 May 14, 2025 May 20, 2026 Primary hyperoxalurias are a group of rare genetic diseases. there are 3 subtypes each resulting in the... Ver
M5.001.017 Hemophilia Antihemophilic Factor May 14, 2025 May 20, 2026 The hemophilias are a group of related bleeding disorders that most commonly are inherited. inherited... Ver
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