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 |
|---|---|---|---|---|---|
| P1.002.012 | Soliris (eculizumab) | Sep 22, 2025 | Sep 20, 2026 | Soliris is a complement inhibitor indicated for the treatment of patients with paroxysmal nocturnal... | Ver |
| P1.002.013 | Adstiladrin® (nadofaragene firadenovec-vncg) | Feb 20, 2025 | Feb 20, 2026 | Adstiladrin is a non-replicating adenoviral vector-based gene therapy indicated for the treatment of adult... | Ver |
| P1.002.014 | AMTAGVI (Lifileucel) | Sep 22, 2025 | Sep 20, 2026 | Amtagvi (lifileucel) is an autologous til (tumor-infiltrating lymphocyte) therapy approved by the fda in... | Ver |
| P1.002.015 | AUCATZYL (Obecabtagene autoleucel) | Sep 22, 2025 | Sep 20, 2026 | Aucatzyl is an autologous anti-cd19 car-t therapy indicated for adults with relapsed or refractory b-cell... | Ver |
| P1.002.016 | ENCELTO (Revakinagene taroretcel-lwey) | Sep 22, 2025 | Sep 20, 2026 | Encelto (revakinagene taroretcel-lwey) is a cell-based implant designed to continuously deliver recombinant... | Ver |
| P1.002.017 | KEBILIDI (Eladocagene exuparvovec-tneq) | Sep 22, 2025 | Sep 20, 2025 | Kebilidi is an adeno-associated virus (aav) vector-based gene therapy 12 indicated for the treatment of adult... | Ver |
| P1.002.018 | LANTIDRA (Donislecel) | Sep 22, 2025 | Sep 20, 2026 | Lantidra (donislecel-jujn) is an allogeneic pancreatic islet cell therapy approved by the fda in june 2023.... | Ver |
| P1.002.019 | LAVIV (Azficel-T) | Sep 02, 2025 | Sep 20, 2026 | Azficel-t is an autologous cellular product composed of fibroblasts indicated for improvement of the... | Ver |
| P1.002.021 | OMISIRGE (Omidubicel-onlv) | Sep 22, 2025 | Sep 20, 2026 | ... | Ver |
| P1.002.022 | RETHYMIC (Allogeneic processed thymus tissue – agdc) | Sep 22, 2025 | Sep 20, 2026 | Allogeneic processed thymus tissue–agdc (rethymic) was approved by the us food and drug administration... | Ver |
| P1.002.023 | RYONCIL (Remestemcel-L-rknd) | Sep 22, 2025 | Sep 20, 2026 | Remestemcel-l-rknd (ryoncil) is fda-approved for the treatment of steroid-refractory acute graftversus-host... | Ver |
| P1.002.024 | SKYSONA (Elivaldogene autotemcel) | Sep 22, 2025 | Sep 20, 2026 | Cerebral adrenoleukodystrophy (cald) is an x-linked genetic neurodegenerative disease that most severely... | Ver |
| P1.002.026 | TECELRA (Afamitresgene autoleucel) | Sep 22, 2025 | Sep 26, 2026 | Tecelra (afamitresgene autoleucel) is a melanoma-associated antigen a4 (magea4)-directed genetically modified... | Ver |
| P1.002.028 | AXTLE (pemetrxed) | Sep 22, 2025 | Sep 20, 2026 | Pemetrexed (alimta) was initially approved by the u.s. food and drug administration (fda) in february 2004... | Ver |
| P1.002.033 | Gefitinib | Sep 22, 2025 | Sep 20, 2026 | Gefitinib (iressa®) is an orally administered tyrosine kinase inhibitor (tki) of the epidermal growth... | Ver |
| PP.001.001 | Dose Rounding of Drug Covered Under The Medical Benefit | May 14, 2025 | May 20, 2026 | ... | Ver |
| PP.001.002 | Leuprolide | May 14, 2025 | May 20, 2026 | (leuprolide acetate) – a drug that is a manufactured version of a hormone. it is a hormone-releasing... | Ver |
| PP.002.002 | Discontinued Procedures/Reduced Services – Modifiers 73 & 74 | Aug 11, 2025 | Aug 20, 2026 | The term "discontinued procedure" designates a surgical or diagnostic procedure provided by a... | Ver |
| PP.002.004 | Split Surgical Package | Jun 21, 2024 | Jun 20, 2025 | ... | Ver |
