Eylea®, Eylea® HD (aflibercept) Injection

Coverage is limited to Eylea and Eylea HD for the listed FDA‑approved ophthalmic indications (neovascular/wet AMD, macular edema following RVO, DME, DR, ROP) and specified compendial off‑label neovascular ocular conditions and excludes other uses. Approval is for 12 months and requires administration by or under the supervision of an ophthalmologist with adherence to the specific indication‑based dosing regimens (loading and maintenance intervals) listed for Eylea and Eylea HD.

"Eylea: Neovascular (wet) age-related macular degeneration (AMD)"

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