Prior AuthorizationSometimes 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
- 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).