Health Insurance Basics
What is health insurance prior authorization?
Prior authorization is a requirement by your health insurance plan that you get approval before receiving certain medical services or medications. If you do not get prior authorization, the plan may not cover the service. Prior authorization is required for many specialist visits, procedures, and medications.
Key Points
- Prior authorization: plan approval required before certain services
- Required for: specialist visits, procedures, medications
- If you do not get prior authorization: plan may not cover the service
- You can appeal a denied prior authorization
- An independent agent can help you find plans with fewer prior authorization requirements