Ophthalmologic Vascular Endothelial Growth Factor (VEGF) Inhibitors – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers listed intravitreal VEGF and dual VEGF/Ang‑2 inhibitors (e.g., aflibercept, ranibizumab, faricimab, and compounded bevacizumab) for specified retinal indications, while certain products (notably brolucizumab/Beovu and Buooviz) are typically excluded. Coverage requires a documented diagnosis, dosing limited to no more than 12 intravitreal injections per eye per year, documented positive clinical response for continuation, compounding pharmacies to meet USP <797>/accreditation and informed consent when using off‑label bevacizumab, and adherence to plan‑specific prior authorization/Medicare LCD rules.

"Avastin (bevacizumab): Choroidal neovascularization secondary to pathologic myopia, angioid streaks/pseudoxanthoma elasticum, or ocular histoplasmosis syndrome (OHS) Avastin (bevacizumab): Diabetic..."

Sign up to see full coverage criteria, indications, and limitations.