Subcutaneous Immune Globulin

Subcutaneous immune globulin is covered for FDA‑approved uses—primarily primary humoral immunodeficiencies (e.g., CVID, X‑linked/congenital agammaglobulinemia, SCID, Wiskott‑Aldrich, Hyper‑IgM, DiGeorge, IgG <250 mg/dL, IgG subclass deficiency, SAD, and other genetically confirmed PIDs) and maintenance therapy for CIDP (Hyqvia excluded for CIDP). Coverage requires specialist prescription/consultation (immunologist/allergist/ENT/pulmonologist/ID for PID; neurologist for CIDP), diagnostic/lab confirmation (low/age‑adjusted IgG and/or impaired antibody response and/or recurrent infections for PID; electrodiagnostic studies for CIDP), adult age for CIDP initiation, documentation of clinical benefit for reauthorization, and is authorized up to 12 months.

"Primary humoral immunodeficiency (general)"

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