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 |
|---|---|---|---|---|
| M5.001.016 | Lumasiran for Primary Hyperoxaluria Type 1 | May 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 2026 | The hemophilias are a group of related bleeding disorders that most commonly are inherited. inherited... | Ver |
| M5.001.018 | Nucala® (mepolizumab) | May 2026 | Mepolizumab is an interleukin-5 antagonist monoclonal antibody (igg1 kappa) for the add-on maintenance... | Ver |
| M5.001.019 | Fasenra® (benralizumab) | May 2026 | Benralizumab is an interleukin-5 antagonist monoclonal antibody (igg1 kappa) for the add-on maintenance... | Ver |
| M5.001.020 | Givosiran for Acute Hepatic Porphyria | May 2026 | Acute hepatic porphyria (ahp) is a rare disease with a prevalence of 5 to 10 cases/100,000 people in the us... | Ver |
| M5.001.021 | Biological Treatments for Refractory Myasthenia Gravis | May 2026 | Myasthenia gravis is an autoimmune neuromuscular disorder characterized by fluctuating motor weakness... | Ver |
| M5.001.022 | Ultomiris® (ravulizumab-cwvz) | May 2026 | Ravulizumab-cwvz is a complement inhibitor indicated as a treatment for adult patients, 18 years and older,... | Ver |
| M5.001.023 | Soliris (eculizumab) | Aug 2025 | Soliris is a complement inhibitor indicated for the treatment of patients with paroxysmal nocturnal... | Ver |
| M5.001.024 | Adstiladrin® (nadofaragene firadenovec-vncg) | Feb 2025 | Adstiladrin is a non-replicating adenoviral vector-based gene therapy indicated for the treatment of adult... | Ver |
| M5.001.025 | Mitotic Inhibitors | Sep 2025 | Mitotic inhibitors (paclitaxel, docetaxel, abraxane) are chemotherapy agents used in multiple solid tumors,... | Ver |
| M5.001.026 | Botulinum Toxin | Mar 2026 | ... | Ver |
| M5.001.028 | Denosumab Products and its biosimilars | May 2026 | Denosumab is a fully human monoclonal antibody against receptor activator of nuclear factor κ-β... | Ver |
| M5.001.029 | Foscarbidopa-Foslevodopa (Vyalev) | May 2026 | Parkinson’s disease is a progressive neurodegenerative condition caused by a loss of dopaminergic... | Ver |
| M7.001.001 | Laser Treatment of Wine Stains | May 2024 | Studies have generally found that laser treatment can be effective at lightening port wine stains. the... | Ver |
| MP.001.001 | Dose rounding of drugs covered under the Medical Benefit | May 2026 | ... | Ver |
| MP.001.002 | Leuprolide | May 2024 | (leuprolide acetate) – a drug that is a manufactured version of a hormone. it is a hormone-releasing... | Ver |
| MP.001.003 | Split Surgical Package | Jul 2025 | ... | Ver |
| P01.001.001 | Adakveo | Jul 2022 | Adakveo is a prescription medicine used to treat the symptoms of sickle cell disease. adakveo may be used... | Ver |
| P01.001.002 | Beovu | Jul 2022 | Beovu is a prescription medicine used to treat neovascular (wet) age-related macular degeneration (amd) and... | Ver |
| P1.001.001 | Adakveo | Sep 2025 | Adakveo® is an iv p-selectin inhibitor approved by the fda for reducing vaso-occlusive crises (voc) in... | Ver |