New Policy for Drug Coverage and Off-Label Drug Use Published

The World Trade Center (WTC) Health Program published new guidelines for drug coverage and off-label drug use. There are no changes to member benefits from these publications.

The new policy for drug coverage describes the WTC Health Program’s policy for determining which drugs are eligible for coverage. Additional details and the full Policy and Procedures for Coverage of Drugs is available on the policy and procedures webpage.

The new Medical Coverage Determination (MCD) for Coverage of Off-Label Drug Use of FDA-Approved Drugs outlines how and when the WTC Health Program will cover medically necessary off-label drugs. The full MCD is available in the WTC Health Program Administrative Manual – Off-Label Drug Use.