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Medical Policy Manual

Issue 1: 2015

Use and Disclosure of Data


The medical policies contained in this manual are the property of Blue Cross of Idaho.

The policies are used for the express purpose of assisting physicians and other healthcare providers in providing evidence based cost effective care.

Our medical policies are designed for informational purposes only and are not an explanation of benefits, of a contract.  Receipt of benefits is subject to satisfaction of all terms and conditions of the coverage.  Medical technology is constantly changing, and we reserve the right to review and update our policies periodically.

Any reproduction or dissemination of policies is expressly prohibited other than for the assistance in the care of our members.

Blue Cross of Idaho Medical Policy for determination of medical necessity versus investigational care are only applicable to Blue Cross of Idaho members.  For our Host members, the determination of medical necessity versus investigational care is determined by the Home Plan Medical Policy,  as related to its  administration of the Member’s benefits and coverage. 

These policies may not apply to all lines of business such as the Federal Employee Program, Medicare Advantage, and certain self-insured groups.

By continuing further, you agree to the above referenced guidelines. If you disagree, please exit the program.




For Blue Cross of Idaho`s definition of medically necessary and investigational, please click here.

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