Nebraska: Coverage update for Synagis prophylaxis

Last modified: November 10, 2021

In light of the Respiratory Syncytial Virus (RSV) polymerase chain reaction (PCR) and antigen testing positivity rates consistent with RSV seasons as per American Academy of Pediatrics (AAP)-advised Infectious Diseases Society of America (IDSA) criteria, UnitedHealthcare Community Plan authorized coverage of Synagis® for clinically appropriate populations beginning Aug. 1, 2021.

How to request prior authorization for Synagis
Complete a Synagis respiratory syncytial virus (RSV) enrollment form and fax it to our Pharmacy Prior Authorization department at 866-940-7328.

Find more information on RSV trends and Synagis prophylaxis at Or call Provider Services at 866-331-2243.