• 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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455 results found for policy
https://www.premera.com/medicalpolicies/2.01.71.pdf#search=policy
MEDICAL POLICY - 2.01.71 Nonpharmacologic Treatment of Rosacea BCBSA Ref. Policy: 2.01.71 Effective Date: Mar. 1, 2026 Last Revised: Feb. 9, 2026 Replaces: 2.01.519 RELATED ...
https://www.premera.com/medicalpolicies/2.02.30.pdf#search=policy
MEDICAL POLICY - 2.02.30 Transcatheter Mitral Valve Repair or Replacement BCBSA Ref. Policy: 2.02.30 Effective Date: Aug. 1, 2025 Last Revised: Jul. 8, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/2.04.144.pdf#search=policy
MEDICAL POLICY - 2.04.144 Gene Therapy for Inherited Retinal Dystrophy BCBSA Ref. Policy: 2.04.144 Effective Date: Apr. 1, 2026 Last Revised: Mar. 23, 2026 Replaces: 8.01.536 ...
https://www.premera.com/medicalpolicies/5.01.512.pdf#search=policy
MEDICAL POLICY - 5.01.512 Botulinum Toxins BCBSA Ref. Policy: 5.01.05 Effective Date: Feb. 1, 2026 Last Revised: Jan. 26, 2026 Replaces: N/A RELATED MEDICAL POLICIES: 2.01.535 ...
https://www.premera.com/medicalpolicies/5.01.519.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.519 Increlex (mecasermin); Recombinant Human ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.533.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.533 mTOR Kinase Inhibitors Effective Date: Apr. 1, 2025 ... below to be directed to that section. POLICY CRITERIA | CODING | RELATED INFORMATION ...
https://www.premera.com/medicalpolicies/5.01.552.pdf#search=policy
PHARMACY POLICY - 5.01.552 Hetlioz (tasimelteon) Effective Date: Mar. 1, 2025 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/5.01.556.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: Dec. 9, 2025 Replaces: ...
https://www.premera.com/medicalpolicies/5.01.572.pdf#search=policy
PHARMACY POLICY - 5.01.572 Coverage Criteria for Excluded and Non-Formulary Drugs ... POLICY CRITERIA | CODING | RELATED INFORMATION EVIDENCE REVIEW | REFERENCES | HISTORY ∞ ...
https://www.premera.com/medicalpolicies/5.01.648.pdf#search=policy
PHARMACY / MEDICAL POLICY - 5.01.648 Insulin Therapy Effective Date: Jan. 1, 2026 Last ... POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE ...
https://www.premera.com/medicalpolicies/6.01.525.pdf#search=policy
MEDICAL / PHARMACY POLICY - 6.01.525 Therapeutic Radiopharmaceuticals in Oncology BCBSA Ref. Policy: 6.01.60 & 5.01.43 Effective Date: Apr. 1, 2026 Last Revised: Mar. 10, 2026 ...
https://www.premera.com/medicalpolicies/6.01.528.pdf#search=policy
MEDICAL POLICY - 6.01.528 Whole-Body Dual X-Ray Absorptiometry and Bioelectrical Impedance Analysis to Determine Body Composition BCBSA Ref. Policy: 6.01.40 Effective Date: Dec. 1, ...
https://www.premera.com/medicalpolicies/7.01.139.pdf#search=policy
MEDICAL POLICY - 7.01.139 Peripheral Subcutaneous Field Stimulation BCBSA Ref. Policy: 7.01.139 Effective Date: Jul. 1, 2025 Last Revised: Jun. 23, 2025 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/7.01.153.pdf#search=policy
MEDICAL POLICY - 7.01.153 Adipose-Derived Stem Cells in Autologous Fat Grafting to the Breast BCBSA Ref. Policy: 7.01.153 Effective Date: Apr. 1, 2026 Last Revised: Mar. 23, 2026 ...
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, 2026 Last Revised: Jan. 12, 2026 Replaces: N/A RELATED ...
https://www.premera.com/medicalpolicies/7.01.560.pdf#search=policy
MEDICAL POLICY - 7.01.560 Cervical Spine Surgeries: Discectomy, Laminectomy, and Fusion ... below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | ...
https://www.premera.com/medicalpolicies/7.01.567.pdf#search=policy
MEDICAL POLICY - 7.01.567 Surgical Treatments for Lymphedema and Lipedema BCBSA Ref. Policy: 7.01.162, 7.01.169, 7.01.173 Effective Date: Feb. 1, 2026 Last Revised: Jan. 12, 2026 ...
https://www.premera.com/medicalpolicies/7.01.72.pdf#search=policy
POLICY - 7.01.72 Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, Biacuplasty, and Intraosseous Basivertebral Nerve Ablation BCBSA Ref. Policy: ...
https://www.premera.com/medicalpolicies/7.01.95.pdf#search=policy
MEDICAL POLICY - 7.01.95 Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors BCBSA Ref. Policy: 7.01.95 Effective Date: Dec. 1, 2025 Last Revised: Nov. ...
https://www.premera.com/medicalpolicies/7.03.12.pdf#search=policy
MEDICAL POLICY - 7.03.12 Islet Transplantation for Chronic Pancreatitis and Donislecel-jujn for Type 1 Diabetes BCBSA Ref. Policy: 7.03.12 Effective Date: Dec. 1, 2025 Last ...