Medical Policy

Overview & Search

Medical policies are scientific documents that define the technologies, procedures, and treatments that are considered medically necessary, not medically necessary, and investigational link to investigational policy. Our medical policies help us determine what technology, procedure, treatment, supply, equipment, drug, or other service we’ll cover.

View a list of all medical policies in alphabetical order

Medical policy does not override the health insurance contract that defines members’ benefits, nor is it intended to dictate to providers how to practice medicine. Physicians and other health care providers are expected to exercise their medical judgment in providing the most appropriate care.

We have FEP-specific medical policies that should be used to guide the care of our Federal Employee Program members.

To view the Federal Employee Program Medical Policy Manual, please visit FEPblue.org and search "medical policies"  

Members should consult with their doctor

Because our medical policies offer clinical guidelines for health care providers, we recommend that members talk with their physician if they have questions. Members should also refer to their specific benefits in their subscriber certificate for the terms, conditions, limitations, and exclusions of coverage.