Medicare AdvantageCoverageLow impact
MA08.033d, Agalsidase beta (Fabrazyme) and pegunigalsidase alfa-iwxj (Elfabrio)
Independence Blue Cross·Endocrinology, Nephrology, Cardiology +1 more·Medical Policy
Effective date
Mar 4, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA08.033d for Agalsidase beta (Fabrazyme) and pegunigalsidase alfa-iwxj (Elfabrio) has been reissued with an effective date of March 4, 2026. This policy covers enzyme replacement therapies for Fabry disease treatment under Medicare Advantage plans.
Action Required
By March 4, 2026: Billing team should review the full policy details at the provided URL to understand any changes to coverage criteria, prior authorization requirements, or billing guidelines for Fabrazyme and Elfabrio. Update billing procedures and prior authorization workflows as needed based on the complete policy content.