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Medicare AdvantageCoverageMedium impact

MA08.025h, Omalizumab (Xolair®)

Independence Blue Cross·Allergy & Immunology, Pulmonology, Dermatology·Pharmacy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Medicare Advantage policy MA08.025h for Omalizumab (Xolair®) has been updated effective October 1, 2025. This is a pharmacy policy change that may affect coverage criteria, prior authorization requirements, or billing procedures for this specialty asthma and chronic urticaria medication.

Action Required

Action needed
By October 1, 2025: Review updated MA08.025h policy for Omalizumab (Xolair®) at the provided URL to identify specific changes to coverage criteria, prior authorization requirements, or billing procedures. Update billing workflows and staff training accordingly for Medicare Advantage patients requiring this medication.