Prior authorization is designed to help prevent you from being prescribed medications you may not need, those that could interact dangerously with others you may be taking, or those that are potentially addictive.
It’s also a way for your health insurance company to manage costs for otherwise expensive medications.
What is the process for a prior authorization?
Prior authorization (PA) is any process by which physicians and other health care providers must obtain advance approval from a health plan before a specific procedure, service, device, supply or medication is delivered to the patient to qualify for payment coverage.
How long does a prior authorization last?
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.
What is a prior authorization form?
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 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.