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Referrals and Authorizations

Some health care services and medications may require Prior Authorization (PA). This is when your provider is requesting a service or drug that requires us to give our approval before you can get the services. Your provider is responsible for getting the PA and cannot bill you when they fail to do so.

Certain prescription drugs may be prescribed only in limited quantities or dosages. To receive an override for a quantity limit, your provider must complete a PA form.

To view a high level summary on referrals and authorization requirements click here.