Your insurer will then decide whether or not to cover your medicine, and you should hear back from your pharmacist about their decision within two days.
Remember, if you are approved, a prior authorization only lasts for a set period of time, and you will likely have to re-apply again for future fills.
How does a prior authorization work?
How does the prior authorization process work? Prior authorizations for prescription drugs are handled by your doctor’s office and your health insurance company. Your insurance company will contact you with the results to let you know if your drug coverage has been approved or denied, or if they need more information.
What is the purpose of prior authorization?
Prior authorization (PA) is a requirement that your physician obtain approval from your health insurance plan to prescribe a specific medication for you. PA is a technique for minimizing costs, wherein benefits are only paid if the medical care has been pre-approved by the insurance company.
What does a prior authorization mean?
A prior authorization (PA), sometimes referred to as a “pre-authorization,” is a requirement from your health insurance company that your doctor obtain approval from your plan before it will cover the costs of a specific medicine, medical device or procedure.
What is pre authorization for insurance?
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification. Preauthorization isn’t a promise your health insurance or plan will cover the cost.