What is Prior Authorization?

For certain prescription drugs or treatments, special rules may restrict how and when the plan covers them. A prior authorization (PA), sometimes referred to as prior approval or precertification, is a type of restriction where a Medicare plan requests that your doctor get approval from the plan first before the plan will agree to cover the prescribed medication or treatment . Check your plan’s formulary or summary of benefits to see if you need a PA. If you are not sure call your plan for more information.

Call your Part D plan representative to learn more about its prior authorization policy.

Posted on: June 18, 2015
Vice President of Medicare Solutions

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