• 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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458 results found for policy
https://www.premera.com/medicalpolicies/5.01.549.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.549 Off-Label Use of Drugs and Biologic Agents Effective ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.576_2026-07-02.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: Jul. 2, 2026* Last Revised: Mar. 10, 2026 Replaces: N/A *View ...
https://www.premera.com/medicalpolicies/5.01.588.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.588 Pharmacologic Prevention and Treatment of HIV/AIDS ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.593_2026-07-02.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.593 Pharmacologic Treatment of Transthyretin-Mediated Amyloidosis BCBSA Ref. Policy: 5.01.30 Effective Date: Jul. 2, 2026* Last Revised: Mar. 10, ...
https://www.premera.com/medicalpolicies/5.01.629.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.629 Pharmacologic Treatment of Psoriasis Effective Date: ... Medical Necessity criteria within this policy DOES NOT apply to Alaska fully- insured ...
https://www.premera.com/medicalpolicies/5.01.632.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.632 Pharmacologic Treatment of Bladder Cancer Effective ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.643.pdf#search=policy
MEDICAL POLICY - 5.01.643 Prescription Digital Therapeutics for Substance Use Disorders BCBSA Ref. Policy: 5.01.35 Effective Date: Nov. 1, 2025 Last Revised: Apr. 1, 2026 ...
https://www.premera.com/medicalpolicies/5.01.653.pdf#search=policy
MEDICAL POLICY - 5.01.653 Miscellaneous Intravitreal Drugs Effective Date: Apr. 1, 2026 ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/7.01.144.pdf#search=policy
MEDICAL POLICY - 7.01.144 Patient-Specific Instrumentation (e.g., Cutting Guides) for Joint Arthroplasty BCBSA Ref. Policy: 7.01.144 Effective Date: Nov. 1, 2025 Last Revised: ...
https://www.premera.com/medicalpolicies/7.01.175.pdf#search=policy
MEDICAL POLICY - 7.01.175 Temporarily Implanted Nitinol Device (iTind) for Benign Prostatic Hyperplasia BCBSA Ref. Policy: 7.01.175 Effective Date: Mar. 1, 2026 Last Revised: Feb. ...
https://www.premera.com/medicalpolicies/7.01.563.pdf#search=policy
MEDICAL POLICY - 7.01.563 Ablative Treatments for Occipital Neuralgia, Chronic Headaches, ... below to be directed to that section. POLICY CRITERIA | CODING | RELATED INFORMATION ...
https://www.premera.com/medicalpolicies/7.01.594.pdf#search=policy
MEDICAL POLICY - 7.01.594 Percutaneous Revascularization Procedures for Lower Extremity Peripheral Arterial Disease BCBSA Ref. Policy: 7.01.178 Effective Date: Jan. 1, 2026 Last ...
https://www.premera.com/medicalpolicies/7.01.604.pdf#search=policy
MEDICAL POLICY - 7.01.604 Gastroesophageal Reflux Surgery in Adults BCBSA Ref. Policy: Not Applicable Effective Date: Feb. 6, 2026 Last Revised: Feb. 18, 2026 Replaces: N/A ...
https://www.premera.com/medicalpolicies/7.01.605.pdf#search=policy
MEDICAL POLICY - 7.01.605 Shoulder Arthrotomy in Adults Effective Date: Mar. 4, 2026 Last ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/7.01.607.pdf#search=policy
MEDICAL POLICY - 7.01.607 Autografts and Allografts in the Treatment of Focal Articular Cartilage Lesions BCBSA Ref. Policy: 7.01.78 Effective Date: Nov. 7, 2025 Last Revised: ...
https://www.premera.com/medicalpolicies/8.01.11.pdf#search=policy
MEDICAL POLICY - 8.01.11 Transcatheter Arterial Chemoembolization (TACE) to Treat Primary or Metastatic Liver Malignancies BCBSA Ref. Policy: 8.01.11 Effective Date: Nov. 1, 2025 ...
https://www.premera.com/medicalpolicies/9.03.508.pdf#search=policy
MEDICAL POLICY - 9.03.508 Orthoptic Training for the Treatment of Vision or Learning ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/1.01.537.pdf#search=policy
MEDICAL POLICY - 1.01.537 Low Intensity Pulsed Ultrasound Fracture Healing Device BCBSA Ref. Policy: 1.01.05 Effective Date: Jul. 1, 2025 Last Revised: Jun. 23, 2025 Replaces: ...
https://www.premera.com/medicalpolicies/2.04.123.pdf#search=policy
MEDICAL POLICY - 2.04.123 Serum Biomarker Panel Testing for Systemic Lupus Erythematosus and Other Connective Tissue Diseases BCBSA Ref. Policy: 2.04.123 Effective Date: Sep. 1, ...
https://www.premera.com/medicalpolicies/2.04.514.pdf#search=policy
MEDICAL POLICY - 2.04.514 Protein Biomarkers for Diagnosis and Risk Assessment of Prostate Cancer BCBSA Ref. Policy: 2.04.33 Effective Date: Jan. 1, 2026 Last Revised: Dec. 9, ...