Coverage of Conditions and Treatments (Coverage Decisions)

Use this lookup tool to determine coverage decisions, or if prior authorization is needed for the treatment or condition. Note: For Self-insured employer claims, you must contact the employer or their claims administrator.

List also available in PDF format.

See Treatment Guidelines and Resources for additional information.

Certain occupations are at increased risk of exposure to infectious disease due to the work environment, such as first responders, animal handlers, etc. Infectious diseases may be transmitted through a number of means, including but not limited to blood, saliva and other bodily fluids. If, in the course of employment, a worker is exposed to an infectious disease, rapid medical treatment may be required to prevent infection.

For more information see Post Exposure Prophylaxis and Testing.