Payer PolicyActive
Subcutaneous Implantable Naltrexone Pellets – Commercial Medical Benefit Drug Policyopen_in_new
UHC-POL-subcutaneous-implant-naltrexone-pellets
UnitedHealthcare
Effective: January 1, 2025
Updated: December 6, 2025
created · Nov 30, 2025
Policy Summary
UnitedHealthcare considers compounded subcutaneous implantable naltrexone pellets not FDA‑approved and not medically necessary (experimental/unproven) and limits their use to clinical trials. This policy excludes the FDA‑approved Vivitrol® (J2315), and actual coverage depends on the member‑specific benefit plan and applicable federal/state mandates.
Coverage Criteria Preview
Key requirements from the full policy
"No specific clinical documentation requirements (e."
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Covered Medical Codes