Medical Policies

Premera offers access to more than 300 medical policies online. And since we're continually updating these pages, we encourage you to visit often. The policies are in Adobe PDF format.

To access our Medical Policies, please read and agree to the disclaimer statement.

Disclaimer:

Premera's medical policy should be used as a guide in evaluating the medical necessity of a particular service or treatment. The Company adopts these policies after careful review of published and peer-reviewed scientific literature, national guidelines and local standards of practice. Since medical technology is dynamic, the Company reserves the right to review and update policies as appropriate. Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits.

Members and their providers will need to consult the member's benefit plan to determine if there is any exclusion or other benefit limitations applicable to this service or supply. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered for a particular member. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that are considered medically necessary.

The Medical Policies contained within this website do not apply to Medicare Advantage network members. Access Medical Policies relating to Medicare Advantage.

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I have read and I agree to the disclaimer. Go to Medical Policies for Premera HMO Core Plus