Zynteglo (betibeglogene autotemcel): Coverage Information for SelectHealth Members

Patients enrolled in SelectHealth may be eligible for coverage for Zynteglo through NYRx, the Medicaid Pharmacy Program, when certain criteria are met. SelectHealth will assist providers and members in obtaining approval for the medication through a few simple steps. 

Once the health plan receives a request from the provider for Zynteglo, our team will complete the New York State worksheet. The plan will review the necessary criteria for coverage. If the member is eligible for the medication, the plan will facilitate communication of eligibility with the state. NYRx will then work with a specialty pharmacy to dispense the medication.

For more information regarding the Zynteglo worksheet and the New York Medicaid Managed Care Plan Approval for Related Services Form Cell and Gene Therapy, please visit the following link here.