Medicare: Part B Step Therapy program updates

Intravenous iron replacement therapy 

Effective for dates of service starting Feb. 1, 2023, Feraheme® (ferumoxytol injection) will move to a preferred status in the UnitedHealthcare® Medicare Advantage Part B Step Therapy program. We will no longer require prior authorization for Feraheme for Medicare and Retirement plan members.

VEGF Inhibitors class updates

As a reminder, we recently made changes to the Intravitreal Vascular Endothelial Growth Factor (VEGF) Inhibitors class, including:

• Effective Jan. 1, 2023, all Intravitreal VEGF Inhibitors except compounded Avastin® require prior authorization for all conditions, not just for neovascular (wet) age-related macular degeneration (AMD) 
• Eylea® is preferred:  
  • After compounded Avastin for AMD 
  • For all other retinal conditions (non-AMD diagnoses) 

Questions?

For questions related to the Part B Step Therapy program and the corresponding policy, call the Provider Services number on the member’s health care ID card.

For questions about prior authorizations, call 888-397-8129.

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