Oncology Medications

Covers oncology medications and associated administration services for treatment of cancer—including metastatic, unresectable, advanced, and tumor‑agnostic (mutation‑based) indications—across covered populations. Coverage generally requires FDA approval or recognition in standard compendia or supporting peer‑reviewed literature (typically two articles), may include an initial minimum treatment period in certain states, and is subject to the member’s benefit plan, state‑specific mandates, contraindications, formulary/step‑therapy rules, and availability of biosimilars/generics.

"Drugs prescribed for the treatment of cancer must be covered even if not FDA‑approved for that indication when the drug is recognized for the covered indication in a standard reference compendium."

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