• 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/5.01.610.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.610 Pharmacologic Treatment in Assisted Reproduction ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.619.pdf#search=policy
MEDICAL POLICY - 5.01.619 Intravitreal and Suprachoroidal Corticosteroids BCBSA Ref. Policy: 9.03.23 Effective Date: May 1, 2025 Last Revised: Apr. 8, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/5.01.623.pdf#search=policy
PHARMACY POLICY - 5.01.623 Topical Drugs for Actinic Keratosis and Other Dermatologic ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.627.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.627 Thymic Stromal Lymphopoietin (TSLP) Inhibitors ... Medical Necessity criteria within this policy DOES NOT apply to Alaska fully- insured ...
https://www.premera.com/medicalpolicies/5.01.650.pdf#search=policy
MEDICAL POLICY - 5.01.650 Bispecific Antibodies Effective Date: Sep. 1, 2025 Last ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.652.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.652 Miscellaneous Pharmacologic Treatments of Psoriasis ... Medical Necessity criteria within this policy DOES NOT apply to Alaska fully- insured ...
https://www.premera.com/medicalpolicies/7.01.134.pdf#search=policy
MEDICAL POLICY - 7.01.134 Steroid-Eluting Sinus Stents and Implants BCBSA Ref. Policy: 7.01.134 Effective Date: May 1, 2025 Last Revised: Apr. 7, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/7.01.143.pdf#search=policy
MEDICAL POLICY - 7.01.143 Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy BCBSA Ref. Policy: 7.01.143 Effective Date: Nov. 1, 2025 Last Revised: Oct. ...
https://www.premera.com/medicalpolicies/7.01.159.pdf#search=policy
MEDICAL POLICY - 7.01.159 Sphenopalatine Ganglion Block for Headache BCBSA Ref. Policy: 7.01.159 Effective Date: Feb. 1, 2025 Last Revised: Jan. 13, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/7.01.606.pdf#search=policy
MEDICAL POLICY - 7.01.606 Balloon Dilation of the Eustachian Tube BCBSA Ref. Policy: 7.01.158 Effective Date: Dec. 1, 2025 Last Revised: Nov. 11, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/1.01.29.pdf#search=policy
MEDICAL POLICY - 1.01.29 Tumor Treating Fields Therapy BCBSA Ref. Policy: 1.01.29 Effective Date: Dec. 1, 2025 Last Revised: Nov. 24, 2025 Replaces: N/A RELATED MEDICAL POLICIES: ...
https://www.premera.com/medicalpolicies/10.01.520.pdf#search=policy
BENEFIT COVERAGE GUIDELINE - 10.01.520 Review for Coverage in the Absence of a Medical Policy, Pharmacy Policy, or Utilization Management Guideline Effective Date: Sep. 1, 2025 ...
https://www.premera.com/medicalpolicies/2.02.506.pdf#search=policy
MEDICAL POLICY - 2.02.506 Wearable Cardioverter-Defibrillators as a Bridge to Implantable Cardioverter-Defibrillator Placement BCBSA Ref. Policy: 2.02.15 Effective Date: Oct. 3, ...
https://www.premera.com/medicalpolicies/2.04.521.pdf#search=policy
MEDICAL POLICY - 2.04.521 Evaluation of Biomarkers for Alzheimer Disease BCBSA Ref. Policy: 2.04.14 Effective Date: Aug. 1, 2025 Last Revised: Oct. 1, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/5.01.555.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.555 Pharmacologic Treatment of Interstitial Lung Disease ... below to be directed to that section. POLICY CRITERIA | CODING | RELATED INFORMATION ...
https://www.premera.com/medicalpolicies/5.01.556_2026-01-02.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.556 Rituximab: Non-oncologic and Miscellaneous Uses BCBSA Ref. Policy: 5.01.24 Effective Date: Jan. 2, 2026* Last Revised: Oct. 27, 2025 Replaces: ...
https://www.premera.com/medicalpolicies/5.01.568.pdf#search=policy
PHARMACY POLICY - 5.01.568 Venclexta (venetoclax) BCL-2 Inhibitor Effective Date: Apr. 1, ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.575.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.575 Dupixent (dupilumab) Effective Date: Sep. 1, 2025 ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.578.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.578 Amyotrophic Lateral Sclerosis (ALS) Medications ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.585.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.585 Pharmacologic Treatment of Phenylketonuria Effective ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...