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Medical Policy

By continuing to the medication policy manual, you understand and agree to the following terms and conditions:

Medication Policy Manual Terms and Conditions

Description
The Regence Group (TRG) Medication Policy Manual contains Medication Policies approved by TRG.  Medication Policies are based upon research of scientific literature, government approval status, and evidence-based treatment guidelines supporting clinical best practices/standards of care.

Use
TRG Plans use Medication Policies as guidelines for coverage determinations in all health care insurance products, unless otherwise indicated.  TRG Plans include Regence BlueShield, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah, and Regence BlueShield of Idaho, and any of their affiliated or subsidiary companies.

Conflict with Plan Documents
In the event of a conflict between a Medication Policy and a Plan document under which a member is entitled to Covered Services, the Plan document will govern.  Plan documents include, but are not limited to, Subscriber Contracts, Summary Plan Documents, and other coverage documents prepared by a Plan.

Restrictions and Limitations

  • Medication Policies DO NOT determine the schedule of benefits.  Rather, Medication Policies are used in the process to determine if a service will be paid by a Plan.
  • Medication Policies are interpreted and applied in the sole discretion of the Plan.
  • Medication Policy application is subject to state and federal laws and specific instructions from Plan Sponsors or self-insured groups.
  • Medication Policies DO NOT constitute medical advice and DO NOT guarantee any results or outcomes.  If you are a member, you should discuss any related health care questions with your health care provider.
  • Medication Policies are the property of TRG and you are strictly prohibited from using them for any commercial use whatsoever.  Commercial use does not include use of the Medication Policies for purposes related to the health care of a TRG Plan member.  In additional, Current Procedural Terminology (CPT) codes and descriptions are the property of the American Medical Association with all rights reserved.
  • There is no obligation to update this site and the Medication Policies displayed may be out of date.
Continue to the Medication Policy Manual Go to the Medication Policy Manual