Apheresis – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare considers therapeutic apheresis (including plasma exchange, immunoadsorption, photopheresis, LDL apheresis and cell exchanges) medically necessary for a defined set of indications — e.g., TTP/thrombotic microangiopathy, acute inflammatory demyelinating polyneuropathy (Guillain‑Barré), acute myasthenia gravis, certain transplant desensitization/rejection scenarios, familial homozygous hypercholesterolemia/lipoprotein apheresis, hyperviscosity syndromes, acute liver failure requiring high‑volume TPE, and others — and deems it unproven/not medically necessary for many other listed conditions (e.g., ADEM, Alzheimer disease, various autoimmune/dermatologic and toxin‑related indications). Coverage is subject to the member‑specific benefit plan and applicable laws, excludes stem cell collection/harvesting, and may require medical record documentation and use of third‑party criteria (e.g., InterQual) to confirm the clinical criteria are met.

"Multiple sclerosis, acute attack, or relapse, second line therapy"