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Clinical Policies and Guidelines

Find policy information about medications and medical procedures, devices and technologies, learn about our prior authorization procedures, and access our outpatient drug formulary in this section.

Also download prior authorization forms for medical procedures, oral/topical drugs and home self-administered injectables.

In This Section

Drug Formulary, Policy and Forms

Search our drug formulary database, get prior authorization forms, and find information on oral and topical drugs, home-injectable drugs and more.

Medical Policies and Procedures

Learn about our medical policies, policy goals and our process for making coverage decisions for new technologies.

Medication Policy

Read about our medication policy for injectable drugs, and find information about office-administered drugs for Medicare members.

Medical Policy and General Prior Authorization Requirements for Out-of-Area Members

Use this tool to find medical policy or general prior authorization requirements for out-of-area members.