Tzield® (Teplizumab-Mzwv) – Commercial Medical Benefit Drug Policyopen_in_new

UnitedHealthcare covers a one-time 14‑day course of Tzield (teplizumab‑mzwv) to delay onset of Stage 3 type 1 diabetes for patients ≥8 years with Stage 2 T1D who have ≥2 positive islet autoantibodies, dysglycemia by specified fasting/OGTT/A1C thresholds, no Stage 3 symptoms, and type 2 diabetes ruled out (age <8, prior Tzield, Stage 3 symptoms or T2D exclude coverage). Coverage requires endocrinologist prescription/consultation, FDA‑label dosing, documentation of the lab/clinical criteria, and authorization is limited to a single 14‑dose course per lifetime, subject to member plan and state/federal mandates.

"Authorization will be issued for no more than one treatment course (i."

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