Low-Molecular-Weight Heparins and Thrombin Inhibitors

Aetna covers low‑molecular‑weight heparins (and thrombin inhibitors) for VTE prophylaxis in specified settings — hip surgery (including replacement/hip fracture) up to 35 days post‑op; knee replacement up to 2 weeks; prevention during severely mobility‑restricting acute illness; high‑risk major thoracic surgery (malignancy or prior DVT/PE) up to 2 weeks; and abdominal‑pelvic surgery at moderate‑to‑high VTE risk for up to 2 weeks (extended to 4 weeks for high‑risk cancer surgery). LMWHs are not covered (considered experimental/investigational) for indications outside this list, including arterial thrombosis, femoral‑popliteal graft patency, improving cancer survival, and anticoagulation for hemodialysis, so use must meet the specific indication, risk status, and duration limits above.

"LMWHs considered experimental/investigational for members undergoing cerebral, ocular, or spinal surgery (intermittent pneumatic compression of the legs is indicated)."