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Prior Authorization

Approval required from your plan before you can get certain drugs or services covered.
Aaron Sims
Reviewed byAaron Sims

Medicare Term

Definition

Approval required from your plan before you can get certain drugs or services covered.

Prior authorization (also called pre-authorization or pre-approval) means your Medicare Advantage or Part D plan requires you to get approval before it will cover a specific drug, procedure, or service. If you don't get prior authorization when required, you may have to pay the full cost out of pocket.

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