Prior Authorization

Prior Authorization

Wed, 02/12/2020 - 09:40

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary.

Insurance companies make this confusing by using several terms that mean the same.

• Sometimes called precertification, prior approval or preauthorization.

Your health insurance or plan may require prior authorization for certain services before you receive them, except in an emergency.

♦ Prior authorization isn’t a promise your health insurance will cover the cost.

Related content

Prior Authorization

• Why do I need it ?

• What if prior authorization is denied ?