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Blue Advantage Medical Policies
Our Blue Advantage draft and final medical policies are displayed on this site. Medical policies are based on the most current medical research available at the time of the policy development.
Policies are written to cover a given condition for the majority of people. Each individual's unique clinical circumstances may be considered in light of current scientific literature. Medical policies are based on constantly changing medical science and the Plan reserves the right to review and update our policies as necessary.
We encourage practicing physicians to provide input related to developing, adopting and reviewing criteria for medical policy. Any licensed practitioner is welcome to provide comments, suggestions or concerns. Our internal policy committee will review and take your comments into consideration. For medical policy feedback, email comments to mpc@bcbsal.org.
Draft Policies
Select "Draft Policies" in the navigation on the left to view and find out how to submit comments on Blue Advantage draft medical policies.
Final Policies - Alphabetical Listing
Select "Final Policies" in navigation on the left to expand the menu to view our Blue Advantage final medical policies.
Search Policies
Use the search function above to locate Blue Advantage policies by name, number or keyword.
Local Coverage Determinations
If the policy you are searching for is not listed in the Blue Advantage medical policies, please refer to the following local coverage determinations sites:
- Palmetto GBA RHHI Local Coverage Determinations*
- CIGNA Government Services DME MAC Jurisdiction C Local Coverage Determinations*
- Blue Advantage will follow Palmetto GBA MolDX* when there is no Local Coverage Determination or National Coverage Determination related to a Molecular Diagnostic Test.
Effective for dates of service on and after February 26, 2018:
- Palmetto GBA, LLC MAC – Part A Local Coverage Determinations*/Articles*
- Palmetto GBA, LLC MAC – Part B Local Coverage Determinations*/Articles*
Effective for dates of service prior to February 26, 2018:
- Cahaba Government Benefit Administrators, LLC MAC – Part A Local Coverage Determinations
- Cahaba Government Benefit Administrators, LLC MAC – Part B Local Coverage Determinations
*Note: These links will take you out of the Blue Cross website. These sites are not the responsibility of, or under the control of, Blue Cross.
National Coverage Determinations
If the policy you are searching for is not listed in the Blue Advantage medical policies or the local coverage determinations, please refer to the CMS National Coverage Database*.
Last Updated: February 23, 2018
Notice of Nondiscrimination - Blue Advantage
Blue Cross and Blue Shield of Alabama complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. We do not exclude people or treat them differently because of race, color, national origin, age, disability or sex.