Policies

Browse medical policies by payer and plan.

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AmeriHealth AdministratorsIndexed

amerihealth_formulary_pa.pdf

25 drugsEff. 2026-04-01Claude

Uploaded 4/5/2026, 6:13:58 PM · Indexed 4/5/2026, 6:18:14 PM

AetnaIndexed

aetna_pa_request_form.pdf

Claude

Uploaded 4/5/2026, 6:13:30 PM · Indexed 4/5/2026, 6:13:57 PM

AetnaIndexed

aetna_2026_exclusion_drug_list.pdf

27 drugsEff. 2026-04-01Claude

Uploaded 4/5/2026, 6:12:26 PM · Indexed 4/5/2026, 6:13:30 PM

AetnaIndexed

aetna_2026_drug_guide.pdf

25 drugsEff. 2026-01-01Claude

Uploaded 4/5/2026, 6:11:21 PM · Indexed 4/5/2026, 6:12:26 PM

AetnaIndexed

aetna_2025_specialty_drug_list.pdf

25 drugsEff. 2025-01-01Claude

Uploaded 4/5/2026, 6:10:30 PM · Indexed 4/5/2026, 6:11:21 PM

UnitedHealthcareIndexed

uhc_entyvio-vedolizumab.pdf

1 drugEff. 2025-07-01Claude

Uploaded 4/5/2026, 5:45:24 PM · Indexed 4/5/2026, 5:46:11 PM

UnitedHealthcareIndexed

uhc_denosumab-prolia-xgeva.pdf

3 drugsEff. 2026-04-01Claude

Uploaded 4/5/2026, 5:44:31 PM · Indexed 4/5/2026, 5:45:23 PM

UnitedHealthcareIndexed

uhc_briumvi.pdf

1 drugEff. 2026-01-01Claude

Uploaded 4/5/2026, 5:37:13 PM · Indexed 4/5/2026, 5:37:45 PM

Humana Medicare Employer PlanIndexed

humana_drug_formulary_ppo.pdf

25 drugsEff. 2025-01-01Claude

Uploaded 4/5/2026, 5:31:41 PM · Indexed 4/5/2026, 5:33:25 PM

CignaIndexed

cigna_rx_changes_2025.pdf

14 drugsEff. 2025-01-01Claude

Uploaded 4/5/2026, 5:22:34 PM · Indexed 4/5/2026, 5:24:14 PM

CignaIndexed

cigna_oncology_medications.pdf

68 drugsEff. 2026-04-01Claude

Uploaded 4/5/2026, 5:19:52 PM · Indexed 4/5/2026, 5:21:35 PM

AmeriHealth Caritas VIP Care PlusIndexed

amerihealthcaritas_2025_formulary.pdf

25 drugsEff. 2025-01-01Claude

Uploaded 4/5/2026, 5:11:53 PM · Indexed 4/5/2026, 5:17:32 PM

Unknown PayerIndexed

EmblemHealth_MPS_Denosumab_11_25_hcpcs.docx

1 drugOllama

Uploaded 4/5/2026, 5:08:49 PM · Indexed 4/5/2026, 5:09:09 PM

CignaIndexed

Cigna Rituximab Intravenous Products for Non-Oncology Indications.pdf

4 drugsEff. 02/01/2026Gemini

Uploaded 4/5/2026, 12:19:23 PM · Indexed 4/5/2026, 12:23:32 PM

Priority HealthIndexed

Priority Health 2026 MDL - Priority Health Commercial (Employer Group) and MyPriority.pdf

20 drugsEff. 2026-04-02Gemini

Uploaded 4/5/2026, 11:22:50 AM · Indexed 4/5/2026, 12:23:32 PM

Blue Cross Blue Shield of North CarolinaIndexed

BCBS NC - Corporate Medical Policy_ Preferred Injectable Oncology Program (Avastin example).pdf

20 drugsEff. 2026-01Gemini

Uploaded 4/5/2026, 11:12:14 AM · Indexed 4/5/2026, 12:23:32 PM

UnitedHealthcareIndexed

UHC Botulinum Toxins A and B – Commercial Medical Benefit Drug Policy.pdf

5 drugsEff. 2026-01-01Gemini

Uploaded 4/5/2026, 11:08:57 AM · Indexed 4/5/2026, 12:23:32 PM

Florida BlueIndexed

Florida Blue MCG Bevecizumab policy.pdf

7 drugsEff. 01/01/2026Gemini

Uploaded 4/5/2026, 11:03:04 AM · Indexed 4/5/2026, 12:23:32 PM