• 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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371 results found for policy
https://www.premera.com/medicalpolicies/10.01.518.pdf#search=policy
This policy provides background about different types of studies, outlines what services ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/2.04.518.pdf#search=policy
below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/9.02.502.pdf#search=policy
below to be redirected to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ... Untreated periodontal disease can lead to tooth loss. This policy describes dentally ...
https://www.premera.com/medicalpolicies/1.01.519.pdf#search=policy
Note: The Introduction section is for your general knowledge and is not to be taken as policy coverage criteria. The rest of the policy uses specific words and concepts familiar to ...
https://www.premera.com/medicalpolicies/11.01.523_2024-07-04.pdf#search=policy
POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/3.01.521.pdf#search=policy
below to be directed to that section. POLICY CRITERIA | CODING | EVIDENCE REVIEW | ... This policy supplements the medical necessity criteria by indicating what types of ...
https://www.premera.com/medicalpolicies/5.01.622.pdf#search=policy
Continuity of Coverage for Maintenance Medications This policy ONLY applies to Washington fully-insured members. This policy does not apply to member plans outside of Washington ...
https://www.premera.com/medicalpolicies/5.01.631.pdf#search=policy
below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ... This policy discusses when treatments for CDI may be considered medically necessary. Note: ...
https://www.premera.com/medicalpolicies/1.01.528.pdf#search=policy
Hearing aids are only covered when the member has a specific benefit. This policy explains ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/5.01.607.pdf#search=policy
This policy discusses when continuing coverage of maintenance medications may be ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/1.01.526.pdf#search=policy
Sometimes this equipment needs to be repaired or replaced. This policy explains when ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/10.01.535.pdf#search=policy
below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ... This policy includes additional preventive coverage for certain high-risk conditions that ...
https://www.premera.com/medicalpolicies/5.01.542.pdf#search=policy
In such cases, this policy describes the steps to ensure how a person can get their needed ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/5.01.546.pdf#search=policy
This policy describes when a compounded drug may be considered medically necessary. This policy is not intended to apply to infused admixtures. Note: The Introduction section is ...
https://www.premera.com/medicalpolicies/5.01.541.pdf#search=policy
This policy describes when a nonformulary drug may be covered. Note: The Introduction section is for your general knowledge and is not to be taken as policy coverage criteria. The ...
https://www.premera.com/medicalpolicies/9.03.507.pdf#search=policy
This policy describes when fundus photography may be considered medically necessary. Note: The Introduction section is for your general knowledge and is not to be taken as policy ...
https://www.premera.com/medicalpolicies/1.01.527.pdf#search=policy
This policy outlines when scooters may be covered. Note: The Introduction section is for your general knowledge and is not to be taken as policy coverage criteria. The rest of the ...
https://www.premera.com/medicalpolicies/3.01.522.pdf#search=policy
below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/10.01.531.pdf#search=policy
Note: The Introduction section is for your general knowledge and is not to be taken as policy coverage criteria. The rest of the policy uses specific words and concepts familiar to ...
https://www.premera.com/medicalpolicies/3.01.515.pdf#search=policy
Detoxification may take place in many different settings. This policy describes when ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...