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Prior Authorization

Sometimes the plan must give its OK before you get a service. This is called prior authorization. Services that need this OK include those that are elective or non-urgent. You can get a prior authorization by asking your doctor or facility.

No prior authorization is needed for the following services:

  • PCP visits and immunizations
  • Preventive and screening services
  • Routine physical exams, vision exams, hearing exams and testing
  • Emergency room visit services
  • Mammograms
  • Family planning services
  • Most outpatient behavioral health care

You can find more about these services in your member handbook.

You can call Member Services Monday–Friday, 8 a.m. to 5 p.m., at 1-800-608-8158 (TTY 1-877-650-0952).


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Last Updated On: 12/31/2015