Brolucizimab (Beovu®)

Beovu (brolucizumab) is covered only for FDA‑approved neovascular (wet) age‑related macular degeneration and selected compendial off‑label neovascular ophthalmic conditions (e.g., neovascular glaucoma, retinopathy of prematurity, sickle cell neovascularization, choroidal neovascularization); other uses are excluded. Coverage requires intravitreal administration by or under an ophthalmologist, documentation that the diagnosis meets the policy’s coverage criteria, adherence to dosing (6 mg monthly ×3 then 6 mg every 8–12 weeks), and is authorized for up to 12 months.

"Neovascular (Wet) Age-related Macular Degeneration (AMD) — FDA-approved indication"

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