What is Prior Authorization?
Some medical services, surgical procedures, and medications require IHN-CCO’s written approval before you can get them. This process is called Prior Authorization. It basically means that your provider has to ask permission to prescribe you a drug or have you undergo a treatment, service, or surgery that isn’t covered by your health plan.
How does it work?
Your provider fills out a form requesting permission to give you a certain drug, treatment, service, or surgery. If approved, it will be covered to some extent by IHN-CCO. If not, IHN may recommend an alternative that is covered, or you may opt to get the drug, treatment, service, or surgery anyway and cover the costs yourself.
What requires authorization?
IHN-CCO reviews and updates its Prior Authorization lists annually. For 2018, IHN-CCO requires Prior Authorization for the following: