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HealthPartners

Coverage criteria policies

Growth hormone drugs – Wisconsin

These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan will be used to determine your coverage.

Administrative Process

Under most Wisconsin plans, growth hormones are a benefit exclusion. If coverage is offered through the plan, a prior authorization is required. All requests that require prior authorization will be reviewed against the coverage criteria listed in the HealthPartners Growth Deficiency Therapy coverage policy.

Coverage

Growth hormone drugs are generally excluded from coverage for Wisconsin Group Medical Plans, and therefore not covered. Please check your member contract.

Products

This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy, contact Member Services at 952-883-7979 or 1-800-233-9645.

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Policy activity

  • 10/01/2005 - Date of origin
  • 08/14/2017 - Effective date
Review date
  • 04/2017
Revision date
  • 08/14/2017

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