• 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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467 results found for policy
https://www.premera.com/medicalpolicies/5.01.646.pdf#search=policy
PHARMACY POLICY - 5.01.646 SGLT2 Inhibitors Effective Date: Jul. 1, 2025 Last Revised: ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.656.pdf#search=policy
PHARMACY POLICY - 5.01.656 Drug Quantity Management Effective Date: Oct. 1, 2025 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/7.01.142.pdf#search=policy
MEDICAL POLICY - 7.01.142 Surgery for Groin Pain in Athletes BCBSA Ref. Policy: 7.01.142 Effective Date: May 1, 2025 Last Revised: Apr. 7, 2025 Replaces: N/A RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/2.04.509.pdf#search=policy
MEDICAL POLICY - 2.04.509 Cardiovascular Risk Panels BCBSA Ref. Policy: 2.04.65 Effective Date: Dec. 1, 2025 Last Revised: Nov. 10, 2025 RELATED MEDICAL POLICIES: None Select a ...
https://www.premera.com/medicalpolicies/2.04.520.pdf#search=policy
MEDICAL POLICY - 2.04.520 Laboratory Testing Investigational Services BCBSA Ref. Policy: 2.04.159 Effective Date: Jan. 1, 2025 Last Revised: Nov. 1, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/5.01.545.pdf#search=policy
PHARMACY POLICY - 5.01.545 Pharmacologic Treatment of Benign Prostatic Hyperplasia ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.562.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.562 Imlygic (talimogene laherparepvec) Effective Date: ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.570.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.570 Pharmacologic Treatment of Duchenne Muscular Dystrophy BCBSA Ref. Policy: 5.01.27 & 5.01.46 Effective Date: Dec. 1, 2025* Last Revised: Nov. ...
https://www.premera.com/medicalpolicies/5.01.576.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.576 Drugs for Rare Diseases BCBSA Ref. Policy: 5.01.37 and 5.01.40 Effective Date: Nov. 1, 2025 Last Revised: Oct. 14, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/5.01.581.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.581 Pharmacologic Treatment of Hemophilia BCBSA Ref. Policy: 8.01.65 Effective Date: Oct. 1, 2025 Last Revised: Sep. 9, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/5.01.589.pdf#search=policy
PHARMACY POLICY - 5.01.589 BRAF and MEK Inhibitors Effective Date: Nov. 1, 2025 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.591_2026-02-06.pdf#search=policy
MEDICAL POLICY - 5.01.591 Immune Checkpoint Inhibitors Effective Date: Feb. 6, 2026* Last Revised: Nov. 11, 2025 Replaces: N/A *This policy has been revised. Click here to view the ...
https://www.premera.com/medicalpolicies/5.01.596.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.596 Pharmacologic Treatment of Osteoporosis Effective ... Medical Necessity criteria within this policy DOES NOT apply to Alaska fully- insured ...
https://www.premera.com/medicalpolicies/5.01.599.pdf#search=policy
PHARMACY POLICY - 5.01.599 Pharmacologic Treatment of Sleep Disorders Effective Date: ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/7.01.565.pdf#search=policy
MEDICAL POLICY - 7.01.565 Ablation of Peripheral Nerves to Treat Pain BCBSA Ref. Policy: 7.01.154 Effective Date: Dec. 1, 2025 Last Revised: Nov. 10, 2025 Replaces: 7.01.154 ...
https://www.premera.com/medicalpolicies/7.01.583.pdf#search=policy
MEDICAL POLICY - 7.01.583 Amniotic Membrane and Amniotic Fluid BCBSA Ref. Policy: 7.01.149 Effective Date: Jul. 1, 2025 Last Revised: Oct. 1, 2025 Replaces: N/A RELATED MEDICAL ...
https://www.premera.com/medicalpolicies/7.03.05.pdf#search=policy
MEDICAL POLICY - 7.03.05 Small Bowel, Liver and Multivisceral Transplant BCBSA Ref. Policy: 7.03.05 Effective Date: Dec. 1, 2025 Last Revised: Nov. 10, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/8.01.42.pdf#search=policy
MEDICAL POLICY - 8.01.42 Hematopoietic Cell Transplantation for Primary Amyloidosis BCBSA Ref. Policy: 8.01.42 Effective Date: Apr. 1, 2025 Last Revised: Mar. 10, 2025 Replaces: ...
https://www.premera.com/medicalpolicies/8.01.62.pdf#search=policy
MEDICAL POLICY - 8.01.62 Electronic Brachytherapy for Nonmelanoma Skin Cancer BCBSA Ref. Policy: 8.01.62 Effective Date: Oct. 1, 2025 Last Revised: Sep. 8, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/8.01.63.pdf#search=policy
MEDICAL POLICY - 8.01.63 Chimeric Antigen Receptor Therapy for Leukemia and Lymphoma BCBSA Ref. Policy: 8.01.63 Effective Date: Mar. 1, 2025 Last Revised: Jul. 1, 2025 Replaces: ...