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).