Preauthorization

A decision by your insurance company that a health care service, treatment plan, prescription drug, or durable medical equipment is medically necessary. Your health insurance plan may require preauthorization for certain services before you receive them, except in an emergency. Preauthorization isn’t a promise your health insurance or plan will cover the cost. Review your Summary Plan Description for more information about which services or supplies require preauthorization. Preauthorization may also referred to as prior approval and precertification. To ensure that you get timely access to necessary medications, New Hampshire requires that prior approvals for prescription drugs take place within 48 hours. Additionally, beginning on January 1, 2015, New Hampshire law allows a pharmacist to provide a patient with a 72-hour supply of a prescription drug and invoice the insurance company for the emergency need.

 

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