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.

Tabla de Políticas Médicas

ID Título Revisión Descripción Acceso
13.007.001 Maxillofacial Prosthesis Oct 2024 These are specialized and extensive prosthesis services to replace the loss of a great part of the facial and... Ver
13.008.001 Frenectomy Oct 2023 It is the surgical procedure of the extirpation, dissection or muscular liberation of the frenulum that... Ver
13.009.001 Maxillary Obturators Aug 2023 Maxillary obturators are considered a maxillofacial prosthesis. maxillary prosthetic devices are generally... Ver
13.009.002 Oral Surgical Splint, Impression And Preparation Nov 2020 The oral splints are molds manufactured by the oral and maxillofacial surgeon prior to surgery. these molds... Ver
13.009.003 Orthognathic Surgery Aug 2026 Are procedures that include surgical manipulation of the maxilla and /or the mandible to restore the correct... Ver
13.009.004 Temporomandibular Joint Disorder Mar 2026 Temporomandibular joint disorder (tmjd) refers to a group of disorders characterized by pain in the... Ver
13.010.001 Orthodontic Services Oct 2024 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 2022 Atrial fibrillation (af) is the most common type of cardiac arrhythmia. stroke associated with af is... Ver
99.001.001 Gene Therapies for Duchenne Muscular Dystrophy Apr 2026 Duchenne muscular dystrophy (dmd) is an inherited disorder that results in progressive muscle weakness and... Ver
99.999.999 List of Retired Policies Jul 2026 List of retired... Ver
M3.001.001 Therapeutic Radiopharmaceuticals for Prostate Cancer Aug 2026 ... Ver
M3.001.002 Radio 223 Injection (Xofigo) May 2025 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 2026 Viscosupplementation therapy is part of the therapy used in the treatment of osteoarthritis of the knee.... Ver
M5.001.002 Rituximab May 2026 Rituximab is a genetically engineered chimeric murine/human monoclonal igg1 kappa antibody directed against... Ver
M5.001.003 Trastuzumab – Trastuzumab Biologics Aug 2026 Trastuzumab is a monoclonal antibody, one of a group of drugs designed to attack specific cancer cells.... Ver
M5.001.005 Bevacizumab Aug 2026 Bevacizumab is a humanized monoclonal antibody directed against vascular endothelial growth factor a... Ver
M5.001.006 G-Csf Filgrastim Aug 2026 White blood cell growth factors, also known as granulocyte colony stimulating factors (g-csf), are... Ver
M5.001.007 Somatuline® Depot; Lanreotide May 2026 Somatuline® depot; lanreotide is used to treat people with acromegaly (condition in which the body... Ver
M5.001.008 Simponi ARIA® (golimumab) May 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 2026 Stelara is a human igg1κ monoclonal antibody that binds with high affinity and specificity to the p40... Ver