CurrentUnitedHealthcarePolicy N/A

Haegarda (C1 esterase inhibitor, human) prior authorization and medical necessity

Defines UnitedHealthcare prior authorization and medical necessity criteria for initial and renewal coverage of Haegarda for routine prophylaxis of hereditary angioedema (HAE) in eligible patients age 6 and older.

Policy Summary

PayerUnitedHealthcare

PolicyHaegarda (C1 esterase inhibitor, human) prior authorization and medical necessity

Policy CodePolicy N/A

Change TypeAnnual review — clarifications and reference updates

Effective DateJun 1, 2026

Next Review DateN/A

Key ActionObtain prior authorization with prescriber attestation and required diagnostic documentation; authorizations are issued for 12 months.

SourceLink

POLICY UPDATE CHANGES

Updated list of examples of prophylactic and acute HAE treatments and updated references (3/2026).

Diagnostic criteria for HAE with normal C1-INH levels were updated previously (3/2024) and reauthorization language was updated.

12Authorization duration (initial and reauthorization)

6+Minimum patient age for indication

1Medication covered by this policy

Medical Necessity Criteria for Haegarda

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