CurrentUnitedHealthcarePolicy N/A

Slynd (drospirenone) prior authorization

Defines UnitedHealthcare prior authorization and medical necessity requirements for coverage of Slynd (drospirenone) as a progesterone-only oral contraceptive for females of reproductive potential.

Policy Summary

PayerUnitedHealthcare

PolicySlynd (drospirenone) prior authorization

Policy CodePolicy N/A

Change TypeRevised and clarified authorization criteria

Effective DateNov 16, 2025

Next Review DateSep 1, 2025

Key ActionObtain prior authorization and document trial/failure or contraindication/intolerance to norethindrone and norgestrel and attest patient should avoid estrogen-containing contraceptives or is breastfeeding.

SourceLink

POLICY UPDATE CHANGES

Require failure, contraindication, or intolerance to two specific progestin-only contraceptives (norethindrone and norgestrel) prior to approval.

Updated prescriber attestation statement to require instruction to avoid estrogen-containing contraceptives due to a health concern or current breastfeeding.

Authorization will be issued for 12 months.

References updated to include 2024 Selected Practice Recommendations and the June 2025 Slynd package insert.

12 monthsauthorization duration

2required prior progestin-only failures

1medication covered (Slynd)

Policy Summary

PayerUnitedHealthcare

PolicySlynd (drospirenone) prior authorization

Policy CodePolicy N/A

Change TypeRevised and clarified authorization criteria

Effective DateNov 16, 2025

Next Review DateSep 1, 2025

SourceLink

On This Page

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Coverage Criteria

Initial Therapy — Covered when ALL of the following are met:

Covered when ALL of the following are met:

Initial approval for Slynd: Medication is used for prevention of pregnancy.

Prior progestin-only trials: Patient has history of failure, contraindication, or intolerance to BOTH norethindrone (generic Ortho Micronor) AND norgestrel (Opill).

Provider attestation: Provider attests the patient has been instructed to avoid estrogen-containing contraceptives due to a health concern or the patient is currently breastfeeding.

Authorization issued for 12 months.

The policy does not provide a separate, enumerated list of coverage exclusions. Instead, it requires that estrogen-containing contraceptives be avoided when contraindicated, and this avoidance must be documented via the required prescriber attestation. No additional standalone exclusion list is specified in the policy language.

Approval of Slynd requires documentation that the medication is being used for prevention of pregnancy and that the patient has a history of failure, contraindication, or intolerance to both specified progestin-only alternatives: norethindrone (generic Ortho Micronor) and norgestrel (Opill). In addition, the provider must attest the patient has been instructed to avoid estrogen-containing contraceptives due to a health concern or is currently breastfeeding. Requests for Slynd when these step requirements are not met do not satisfy the stated coverage criteria.

Initial Therapy

Initial Therapy — Initial authorization criteria for Slynd

Initial authorization criteria for Slynd

Initial therapy: Slynd (drospirenone) is prescribed for prevention of pregnancy.

Step requirement — progestin-only trials: Documented history of failure, contraindication, or intolerance to BOTH norethindrone (generic Ortho Micronor) AND norgestrel (Opill).

Attestation: Prescriber attests the patient has been instructed to avoid estrogen-containing contraceptives for a health concern or that the patient is currently breastfeeding.

Authorization issued for 12 months.

Provider Actions and Requirements

Prior Authorization

Prior Authorization Required

Prior authorization is required for Slynd (drospirenone) for contraception. Approval is granted only when all clinical criteria are met; submit clinical documentation with the prior authorization request.

Prior authorization required for Slynd
Authorization duration: 12 months

Step Therapy

Step Therapy / Trial Requirement

Member must have a documented history of trial and failure, or documented contraindication or intolerance, to both listed progestin-only contraceptives prior to approval.

Required trials: norethindrone (generic Ortho Micronor®) and norgestrel (Opill)

Step Therapy Requirements

Step	Requirement	Notes
1	Document history of failure, contraindication, or intolerance to both norethindrone (generic Ortho Micronor) and norgestrel (Opill)	Provider must attest patient has been instructed to avoid estrogen-containing contraceptives due to a health concern or that the patient is currently breastfeeding; authorization issued for 12 months.

Continuation and Reauthorization Criteria

Continuation Therapy — reauthorization and continuation rules

Reauthorization and continuation rules

Continuation: Authorization duration is 12 months.

UnitedHealthcare may use prior claim/medication history, diagnosis codes, and/or claim logic for automated re-approval in some programs; reauthorization was removed in a prior update but current document issues 12-month authorizations.

Background

Progesterone-only contraceptives are indicated for use when estrogen-containing contraceptives are contraindicated. Slynd (drospirenone) is a progesterone-only oral contraceptive indicated to prevent pregnancy in females of reproductive potential and is considered in this policy as an alternative when estrogen-containing options are not appropriate.

Definitions

progesterone-only contraceptive — definition

DefinitionA contraceptive containing only a progestin, used when estrogen-containing contraceptives are contraindicated.

Typical useUsed to prevent pregnancy in females of reproductive potential when estrogen-containing options are contraindicated.

Drug example in policySlynd (drospirenone) is identified as a progesterone-only contraceptive in this policy.

Clinical contextProgesterone-only contraceptives are the preferred option when estrogen-containing contraceptives are contraindicated.