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Medicare AdvantageCoverageMedium impact

MA08.070g, Golimumab (Simponi Aria®) Intravenous (IV) Injection

Independence Blue Cross·Rheumatology, Gastroenterology, Dermatology·Pharmacy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Medicare Advantage updated their policy for Golimumab (Simponi Aria®) intravenous injection coverage, effective October 1, 2025. This affects billing and coverage requirements for this specialty infusion medication used primarily for autoimmune conditions.

Action Required

Action needed
By October 1, 2025: Billing team must review updated Medicare Advantage coverage criteria for Golimumab (Simponi Aria®) IV injections. Update prior authorization workflows and verify current coverage requirements in billing system. Contact Medicare Advantage plans to confirm any new documentation or approval requirements for this medication.