Policies - New Hampshire

WellSense Health Plan uses criteria for reimbursing and covering specific services or medications. The following policies are used as a guide by the plan to make determinations regarding health care reimbursement and healthcare coverage. Our policies undergo regular updates; check back often for the most up-to-date information.

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Providers are reminded that member eligibility is determined before medical coverage policies and reimbursement guidelines are applied to any claim. As a result, the Plan can not guarantee payment when a member is ineligible or a non-covered benefit is rendered. Please review our Provider Manual for more information.