| Ambetter Health Kentucky WellCare Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2025-08-01 |
| Ambetter Health Kentucky WellCare Clinical | Cosmetic and Reconstructive Procedures | 2025-08-01 |
| Ambetter Health Kentucky WellCare Clinical | DME and O&P Criteria | 2025-08-01 |
| Ambetter Health Kentucky WellCare Clinical | Experimental Technologies | 2025-08-01 |
| Ambetter Health Kentucky WellCare Clinical | Orthognathic Surgery | 2025-08-01 |
| Ambetter Health Kentucky WellCare Clinical | Panniculectomy | 2025-08-01 |
| Ambetter Health Kentucky WellCare Clinical | Pediatric Heart Transplant | 2025-08-01 |
| Ambetter Health Kentucky WellCare Clinical | Radiation Therapy for Skin Cancer | 2025-08-01 |
| Ambetter Health Michigan Meridian Clinical | Hematopoietic Cell Transplants for Sickle Cell Anemia and β-Thalassemia | 2025-08-01 |
| Ambetter Health Michigan Meridian Clinical | Cosmetic and Reconstructive Procedures | 2025-08-01 |