What is Prior Authorization?

Updated on: October 24, 2018

Originally posted on: June 18, 2015

Certain prescription medicines or treatments have rules that require that you to get approval or precertification from the plan before the plan will agree to cover the drug or treatment. In situations where your medication or treatment requires a prior authorization you will need to ask your doctor to contact the plan directly with the medical reasons why you need the medication or treatment covered. Make sure to check your plan’s formulary or summary of benefits to see if you need a prior authorization (PA) before you are treated or fill your prescription to avoid any delays.