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Coverage criteria policies

HealthPartners has Medical Policies that contain coverage criteria that describe how we make coverage decisions for certain health care services and items. Which coverage criteria apply to your plan depends upon the state in which the plan was purchased, which is not necessarily your state of residence. For a customized experience, log on to myHealthPartners. For questions, call the Member Services number on the back of your member identification card.

The information regarding coverage guidelines is regularly updated and is subject to change without notice. Read moreā€¦

Medicare plans

For Medicare coverage criteria, click here.

For a list of services requiring Medicare prior authorization, click here.

If unsure of the keyword spelling, enter the first three letters of the word followed by an asterisk (*). Example: enter acu* to locate the acupuncture policy.

Policy search filters

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Viewing 6 of 321 policies
Policy name Policy category Product Prior authorization required
Feeding/oral function therapy, pediatric Medical Services
Iowa
MHCP
Minnesota
North Dakota
South Dakota
Wisconsin
Yes
Flutter device Equipment/Supplies
Iowa
MHCP
Minnesota
North Dakota
South Dakota
Wisconsin
No
Foot care Medical Services
Iowa
MHCP
Minnesota
North Dakota
South Dakota
Wisconsin
No
Formula - amino acid based elemental - Minnesota Health Care Programs Equipment/Supplies
MHCP
Yes
Functional electrical stimulation (FES) in the home Equipment/Supplies
Investigational
Iowa
Minnesota
North Dakota
South Dakota
Wisconsin
No
Functional electrical stimulation (FES), neuromuscular electrical stimulation (NMES) - Minnesota Health Care Programs Equipment/Supplies
MHCP
Yes
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Viewing 6 of 321 policies