• Medical Policies

    Premera offers access to more than 300 medical policies online. Since we’re continually updating these pages, we encourage you to visit often. The policies are in Adobe PDF format. Individual plans use different medical policies. View individual plan medical policies and also View our HMO medical policies.

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48 results found for preventive
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https://www.premera.com/medicalpolicies/10.01.523.pdf#search=preventive
BENEFIT COVERAGE GUIDELINE - 10.01.523 Preventive Care Effective Date: Sep. 1, 2024 Last ... Introduction The health plan covers preventive services that are required by the ...
https://www.premera.com/medicalpolicies/6.01.521.pdf#search=preventive
10.01.523 Preventive Care Select a hyperlink below to be directed to that section. ... under the Affordable Care Act as a preventive benefit) o Men aged 70 and older, ...
https://www.premera.com/medicalpolicies/5.01.584.pdf#search=preventive
... necessary for the preventive treatment of migraine when all the following are met: . ... for the preventive treatment of episodic migraine when all the following are met: . ...
https://www.premera.com/medicalpolicies/10.01.535.pdf#search=preventive
This policy includes additional preventive coverage for certain high-risk conditions that ... | 2 of 6 ∞ Service Coverage Criteria Preventive services . Periodic oral evaluation . ...
https://www.premera.com/medicalpolicies/13.01.500.pdf#search=preventive
10.01.523 Preventive Care Select a hyperlink below to be directed to that section. ... RevitalVision Page | 4 of 45 ∞ Coding Note: Please see 10.01.523 Preventive Care for FDA ...
https://www.premera.com/medicalpolicies/7.01.171.pdf#search=preventive
... Some individuals may also require preventive migraine therapy. Current first-line therapy ... from migraine may also benefit from preventive migraine therapy, including those with ...
https://www.premera.com/medicalpolicies/8.03.501.pdf#search=preventive
Treatment for preventive or maintenance therapy (see Definition of Terms) . Treatment to ... Chiropractic preventive service: Treatment to prevent pain/disability, promote health, and ...
https://www.premera.com/medicalpolicies/7.01.567.pdf#search=preventive
... Reductive/ablative techniques o Direct excision Preventive surgical treatment Lymphatic ... Lymphatic Microsurgical Preventing Healing Approach (LYMPHA) is a preventive ...
https://www.premera.com/medicalpolicies/2.04.152.pdf#search=preventive
... in risk and is recommended by the US Preventive Services Task Force (USPSTF) and the ... US Preventive Services Task Force Recommendations The US Preventive Services Task Force ...
https://www.premera.com/medicalpolicies/2.04.509.pdf#search=preventive
... care that has the potential to focus on and direct preventive and diagnostic activities. ... determination), is not recommended." US Preventive Services Task Force Recommendations No ...
https://www.premera.com/medicalpolicies/2.04.507.pdf#search=preventive
... vitamin D supplements are covered as preventive care for individuals age 65 and older ... D levels as a preventive strategy (see Practice Guidelines and Position Statements). ...
https://www.premera.com/medicalpolicies/2.04.136.pdf#search=preventive
... No guidelines or statements were identified. US Preventive Services Task Force Recommendations The US Preventive Services Task Force (USPSTF) has not addressed nutritional panel ...
https://www.premera.com/medicalpolicies/5.01.503.pdf#search=preventive
... ODT (rimegepant) is being requested for the preventive treatment of episodic migraine. ... Updated existing criteria for CGRPs for acute use and preventive use. For acute use, ...
https://www.premera.com/medicalpolicies/10.01.522.pdf#search=preventive
... S0390 Routine foot care; removal and/or trimming of corns, calluses and/or nails and preventive maintenance in specific medical conditions (e.g., diabetes), per visit ICD-10 ...
https://www.premera.com/medicalpolicies/2.02.24.pdf#search=preventive
... Monitors can identify physiologic changes that precede clinical symptoms and thus allow preventive intervention. These devices operate through various mechanisms, including ...
https://www.premera.com/medicalpolicies/2.01.71.pdf#search=preventive
... The probability of developing nasal obstruction or basal or squamous cell carcinoma with rosacea is not sufficient to warrant preventive removal of rhinophymatous tissue. Page | 4 ...
https://www.premera.com/medicalpolicies/7.01.125.pdf#search=preventive
... Headache Management of cluster headache consists of abortive and preventive treatment. ... Summary of Evidence For individuals who have migraine headaches refractory to preventive ...
https://www.premera.com/medicalpolicies/8.01.61.pdf#search=preventive
... US Preventive Services Task Force Recommendations The US Preventive Services Task Force published recommendations for prostate cancer screening. 57 However, there are no ...
https://www.premera.com/medicalpolicies/10.01.526.pdf#search=preventive
... Gynecologists (ACOG) 18 and the U.S. Preventive Services Task Force (USPSTF) 19 ... Obstet Gynecol. 2017;130(3):657-659. 20. Moyer VA; U.S. Preventive Services Task Force. ...
https://www.premera.com/medicalpolicies/3.03.01.pdf#search=preventive
... include questions about ASD symptomatology. 19 US Preventive Services Task Force Recommendations The US Preventive Services Task Force (USPSTF) published recommendations ...
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