Percutaneous Patent Foramen Ovale (PFO) Closure – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers percutaneous PFO closure to reduce recurrent ischemic stroke only when performed per FDA-labeled device indications and when imaging documents a cryptogenic stroke, a cardiologist and neurologist agree it was likely embolic, other causes (e.g., carotid disease, hypercoagulable states, atrial fibrillation) are excluded, the patient is aged 18–60, and required documentation is provided. The policy excludes individuals <18, ASD closure, and PFO closure for primary stroke prevention, TIA, or migraine, and coverage is contingent on member-specific benefits and submitted medical records.

"Percutaneous patent foramen ovale (PFO) closure for the prevention of recurrent ischemic stroke when used according to U."

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