Plain-English definitions for every Medicare term — from ABN to ZIP enrollment. No jargon, no confusion.
Showing 2 results for "Prior authorization" — clear search
Approval that your Medicare Advantage or Part D plan may require before you receive certain services or medications. Without prior authorization, the plan may not cover the cost. Original Medicare rarely requires prior authorization.
Also known as: Preauthorization, Pre-approval
Processes used by Medicare Advantage and Part D plans to ensure services and drugs are medically appropriate and used efficiently. Includes prior authorization, step therapy, and quantity limits.
Also known as: UM, Utilization review
Ready to use your new knowledge?
Browse completely free. Your contact info is never shared until you choose to reach out.
Find My Agent →