Oncology Medication Clinical Coverage – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers injectable oncology medications (including therapeutic radiopharmaceuticals) listed in the NCCN Drugs & Biologics Compendium with Categories of Evidence and Consensus 1, 2A, or 2B as medically necessary and excludes Category 3 recommendations, with specific preferred biosimilars/products designated (all chemotherapy agents are covered for patients <19). Non-preferred products require prior intolerance/contraindication plus physician attestation that the issue would not recur, members new to therapy must use preferred products unless criteria are met, and coverage is subject to member‑specific benefits, state/federal mandates, NCCN documentation/HCPCS coding, while CAR‑T/TIL therapies follow separate transplant criteria.

"This policy provides parameters for coverage of injectable oncology medications (including, but not limited to octreotide acetate, leuprolide acetate, leucovorin, and levoleucovorin), including the..."