Sodium Hyaluronate – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers intra‑articular sodium hyaluronate for knee osteoarthritis (preferred: Durolane, Euflexxa, Gelsyn‑3) and excludes most other HA products and all non‑knee or cosmetic indications. Coverage requires documented knee OA with functional‑limiting pain, failure or intolerance of ≥3 months of conservative therapy (including possible steroid injection), no contraindications, FDA‑label dosing, initial one treatment course per joint for 6 months (reauthorization only after documented prior benefit, recurrent pain, and ≥6 months since the prior course), plus required clinical/imaging documentation; non‑preferred products need documented trials of or intolerance to the preferred agents.

"Intra-articular injections of sodium hyaluronate are proven and medically necessary when all of the following are met: - Diagnosis of knee osteoarthritis; and - The member has not responded adequat..."