Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Recorded changes
83,427 on record
Recorded policy changes, newest first| Recorded | Payer | Policy | Change |
|---|
| Aug 2, 2026 | Oscar Health | Phenoxybenzamine Hydrochloride (Dibenzyline) (PG054, Ver. 7)PayerPolicy · OSCAR-PG054-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Pedmark (sodium thiosulfate) (PG133, Ver. 5)PayerPolicy · OSCAR-PG133-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Pancreatic Digestive Enzymes - pancrelipase (Brand Names: Creon; Pancreaze; Pertzye; Viokace; Zenpep) (PG027, Ver. 7)PayerPolicy · OSCAR-PG027-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Oxiconazole (Oxistat 1%) (PG100, Ver. 6)PayerPolicy · OSCAR-PG100-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Osphena (ospemifene) (PG169, Ver. 3)PayerPolicy · OSCAR-PG169-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Orladeyo (PG090, Ver. 8)PayerPolicy · OSCAR-PG090-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Orilissa (elagolix) (PG261, Ver. 2)PayerPolicy · OSCAR-PG261-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Orgovyx (relugolix) (PG089, Ver. 7)PayerPolicy · OSCAR-PG089-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Opioids (PG018, Ver. 8)PayerPolicy · OSCAR-PG018-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Omisirge (omidubicel-onlv) (PG149, Ver. 3)PayerPolicy · OSCAR-PG149-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Omega-3-acid ethyl esters (Lovaza) (PG005, Ver. 8)PayerPolicy · OSCAR-PG005-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Ohtuvayre (ensifentrine) (PG237, Ver. 3)PayerPolicy · OSCAR-PG237-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Non-Formulary Products Criteria (PG069, Ver. 8)PayerPolicy · OSCAR-PG069-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Non-Formulary Mental Health Products Criteria (PG265, Ver. 1)PayerPolicy · OSCAR-PG265-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Non-Formulary Antiretroviral Products Criteria (PG268, Ver. 1)PayerPolicy · OSCAR-PG268-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Nevanac (nepafenac) ophthalmic suspension (PG078, Ver. 7)PayerPolicy · OSCAR-PG078-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Neffy (epinephrine nasal spray) (PG243, Ver.3)PayerPolicy · OSCAR-PG243-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Myrbetriq (mirabegron) (PG181, Ver. 3)PayerPolicy · OSCAR-PG181-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Modafinil (Provigil) (PG035, Ver. 7)PayerPolicy · OSCAR-MODAFINIL-PROVIGIL-PG035-VER-7-0FCCD48CE3 | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Miebo (perfluorohexyloctane) (PG166, Ver. 3)PayerPolicy · OSCAR-PG166-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Mesalamine DR 800 mg (Asacol HD) (PG024, Ver. 8)PayerPolicy · OSCAR-PG024-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Memantine (Namenda) (PG213, Ver. 2)PayerPolicy · OSCAR-MEMANTINE-NAMENDA-PG213-VER-2-F6D49CA891 | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Medications for Cosmetic Purposes (PG080, Ver. 7)PayerPolicy · OSCAR-PG080-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Medical Necessity Prior Authorization Criteria for Formulary Products (PG076, Ver. 8)PayerPolicy · OSCAR-PG076-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Mayzent (siponimod) (PG228, Ver. 3)PayerPolicy · OSCAR-PG228-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Mavenclad (cladribine) (PG227, Ver. 3)PayerPolicy · OSCAR-PG227-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lynkuet (elinzanetant) (PG281, Ver. 1)PayerPolicy · OSCAR-PG281-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lybalvi (olanzapine/samidorphan) (PG283, Ver. 1)PayerPolicy · OSCAR-PG283-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Luxturna (voretigene neparvovec-rzyl) (CG060)PayerPolicy · OSCAR-LUXTURNA-VORETIGENE-NEPARVOVEC-RZYL-CG060-FA3E023521 | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lurasidone (Latuda) (PG057, Ver. 8)PayerPolicy · OSCAR-LURASIDONE-LATUDA-PG057-VER-8-E9E490410C | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lumryz (sodium oxybate) (PG246, Ver. 3)PayerPolicy · OSCAR-PG246-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lokelma (sodium zirconium cyclosilicate) (PG143, Ver. 4)PayerPolicy · OSCAR-PG143-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Livtencity (maribavir) (PG113, Ver. 5)PayerPolicy · OSCAR-PG113-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lidocaine topical system (PG124, Ver. 5)PayerPolicy · OSCAR-PG124-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lazcluze (lazertinib) (PG251, Ver. 3)PayerPolicy · OSCAR-PG251-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lanthanum Carbonate Chewable tablet (Fosrenol) (PG177, Ver. 3)PayerPolicy · OSCAR-PG177-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lamotrigine Orally Disintegrating Tablet (PG083, Ver. 7)PayerPolicy · OSCAR-LAMOTRIGINE-ORALLY-DISINTEGRATING-TABLET-PG08-2F3851D1CD | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Lacosamide (Vimpat) (PG056, Ver. 7)PayerPolicy · OSCAR-LACOSAMIDE-VIMPAT-PG056-VER-7-12C1B1D361 | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Kesimpta (ofatumumab) (PG225, Ver. 5)PayerPolicy · OSCAR-PG225-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Kerendia (finerenone) (PG263, Ver. 2)PayerPolicy · OSCAR-PG263-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Journavx (suzetrigine) Quantity Limit Exceptions Criteria (PG260, Ver. 2)PayerPolicy · OSCAR-PG260-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Izervay (avancincaptad pegol) (PG168, Ver. 3)PayerPolicy · OSCAR-PG168-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Ivermectin 1% Topical Cream (PG239, Ver. 2)PayerPolicy · OSCAR-PG239-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Imcivree (setmelanotide) (PG088, Ver. 7)PayerPolicy · OSCAR-PG088-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Icosapent ethyl (Vascepa) (PG125, Ver. 5)PayerPolicy · OSCAR-PG125-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Hormonal Therapy for Gender Dysphoria Zero Copay Exception-REG (PG184, Ver. 3)PayerPolicy · OSCAR-PG184-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Hemangeol (propranolol hydrochloride oral solution) (PG135, Ver. 4)PayerPolicy · OSCAR-PG135-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Glatiramer Acetate (Copaxone, Glatopa) (PG221, Ver. 4)PayerPolicy · OSCAR-PG221-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Fycompa (perampanel) (PG176, Ver. 3)PayerPolicy · OSCAR-PG176-PHARMACY | New policy |
|---|
| Aug 2, 2026 | Oscar Health | Fleqsuvy (baclofen oral suspension) (PG112, Ver. 5)PayerPolicy · OSCAR-PG112-PHARMACY | New policy |
|---|