Preapprovals

Some services may need preapproval (an OK) from us before you get them. Your primary care provider (PCP) will ask for the preapproval for you. That’s part of why it’s important to see your PCP first for health issues that aren’t emergencies and for annual well-visits.

Preapproval is needed for these services

Seeing a doctor outside your plan, unless it’s an emergency
Some mental health and substance abuse services
Some ambulance transportation
Inpatient hospital admissions
Outpatient surgeries
Certain outpatient procedures and tests
Nonemergency surgeries
Therapy services

You don’t need preapproval for these services

Urgent care
Emergency care
Family planning

Have questions?

Call Member Services at 1-855-690-7800 (TTY 711) from 8 a.m. to 5 p.m. local time for more information about preapprovals or to check on the status of a preapproval request.