• 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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456 results found for policy
https://www.premera.com/medicalpolicies/9.02.503.pdf#search=policy
POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ... In some cases, other imaging such as MRI or ultrasound, are needed. This policy explains ...
https://www.premera.com/medicalpolicies/15.01.009.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.009 Metabolite Markers of Thiopurines Testing Ref. Policy: G2115 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/15.01.030.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.030 Diagnostic Testing of Iron Homeostasis and Metabolism Ref. Policy: G2011 Effective Date: Feb. 6, 2026 Last Revised: Feb. 6, 2026 ...
https://www.premera.com/medicalpolicies/15.01.040.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.040 Biomarker Testing for Autoimmune Rheumatic Disease Ref. Policy: G2022 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: ...
https://www.premera.com/medicalpolicies/15.01.043.pdf#search=policy
1 ROUTINE TEST MANAGEMENT POLICY - 15.01.043 Pathogen Panel Testing Ref. Policy: G2149 Effective Date: Feb. 6, 2026 Last Revised: Jun. 17, 2026 Replaces: N/A RELATED POLICIES: ...
https://www.premera.com/medicalpolicies/15.01.048.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.048 Testing for Alpha-1 Antitrypsin Deficiency Ref. Policy: M2068 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/5.01.575.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.575 Dupixent (dupilumab) Effective Date: Jul. 1, 2026 ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/5.01.648.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.648 Insulin Therapy Effective Date: Aug. 1, 2026 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/15.01.006.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.006 Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing Ref. Policy: G2164 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, ...
https://www.premera.com/medicalpolicies/15.01.012.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.012 Fecal Calprotectin Testing in Adults Ref. Policy: G2061 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/15.01.021.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.021 Gamma-glutamyl Transferase Testing in Adults Ref. Policy: G2173 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/15.01.027.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.027 Human Immunodeficiency Virus (HIV) Ref. Policy: M2116 Effective Date: Feb. 6, 2026 Last Revised: Feb. 6, 2026 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/15.01.029.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.029 Vitamin B12 and Methylmalonic Acid Testing Ref. Policy: G2014 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/15.01.038.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.038 In Vitro Chemoresistance and Chemosensitivity Assays Ref. Policy: G2100 Effective Date: Feb. 6, 2026 Last Revised: Feb. 6, 2026 Replaces: ...
https://www.premera.com/medicalpolicies/15.01.044.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.044 Therapeutic Drug Monitoring for 5-Fluorouracil Ref. Policy: M2067 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/15.01.047.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.047 Venous and Arterial Thrombosis Risk Testing Ref. Policy: M2041 Effective Date: Feb. 6, 2026 Last Revised: Oct. 14, 2025 Replaces: N/A ...
https://www.premera.com/medicalpolicies/15.01.049.pdf#search=policy
ROUTINE TEST MANAGEMENT POLICY - 15.01.049 Testing of Homocysteine Metabolism-Related Conditions Ref. Policy: M2141 Effective Date: Feb. 6, 2026 Last Revised: Feb. 6, 2026 ...
https://www.premera.com/medicalpolicies/4.02.503.pdf#search=policy
Assisted Reproduction Services BCBSA Ref. Policy 4.02.04 Effective Date: Jun. 1, 2026 Last ... section is for your general knowledge and is not to be taken as policy coverage criteria. ...
https://www.premera.com/medicalpolicies/5.01.614.pdf#search=policy
MEDICAL POLICY - 5.01.614 Erythroid Maturation Agents Effective Date: May 1, 2026 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/9.02.506.pdf#search=policy
below to be redirected to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ... This policy describes when dental restorations are covered. Cosmetic dental restorations ...