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Prior Authorization

Approval required from your plan before you can get certain drugs or services covered.
Reviewed by Aaron Sims, Licensed Life & Health Agent since 2012

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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