| Aetna | Wheelchairs and Power Operated Vehicles (Scooters) | 2025-12-18 |
| Aetna | Renal Sympathetic Nerve Ablation | 2025-12-18 |
| Aetna | Brachial Plexus Surgery | 2025-12-18 |
| Anthem Blue Cross | Assisted Reproductive Technology | 2025-12-18 |
| Anthem Blue Cross | Percutaneous Electrical Nerve Field Stimulation (PENFS) | 2025-12-18 |
| Medical Mutual | Cosentyx ® (secukinumab injection for subcutaneous use) | 2025-12-18 |
| Medical Mutual | Tryngolza® | 2025-12-18 |
| Medical Mutual | Tysabri (natalizumab) | 2025-12-18 |
| Medical Mutual | Voxzogo™ (vosoritide subcutaneous injection) | 2025-12-18 |
| Medical Mutual | Zilbrysq ® (zilucoplan subcutaneous injection) | 2025-12-18 |