Belatacept

Belatacept is covered for induction (when used with basiliximab induction, mycophenolate mofetil, and corticosteroids) and maintenance prophylaxis of organ rejection in adult (≥18 years) kidney transplant recipients — including conversion from calcineurin inhibitors — when prescribed by or in consultation with a transplant specialist and the patient is Epstein‑Barr virus (EBV) seropositive. It is not covered for EBV‑seronegative or pediatric (<18) patients, non‑kidney transplants, de novo use without meeting conversion criteria, or other non‑FDA/unsupported off‑label indications, and coverage is subject to FDA labeling, authoritative compendia/state rules and the member’s benefit plan (with a limited Ohio-specific compendia/peer‑review exception).

"For HCSC members residing in Ohio, coverage of any FDA‑approved drug when prescribed for a use recognized as safe and effective in one or more standard medical reference compendia adopted by the U."