Did you know that many services and procedures require an OK for coverage from Premera before you get them? This is called preapproval, and it helps you:
Premera uses a team of experienced doctors, nurses, and healthcare analysts to determine if a medical procedure is appropriate and supported by clinical best practices.
Healthcare providers who are in the Premera network are familiar with the process for getting preapproval. They can contact Premera on your behalf. In-network doctors have all of the medical information needed to ask that your medical service be reviewed and approved for coverage. Always ask your healthcare provider about requesting preapproval before you schedule a service or procedure.
If your doctor provides a service that requires preapproval without requesting one, you may have to pay part or all of the cost, above your usual cost shares. For complete information about your plan's medical benefits and preapproval requirements, read or download your benefit booklet.
To avoid extra costs, always ask your healthcare provider to request preapproval before you have a planned medical service.
*The above is not a complete list and shows only some of the services and drug treatments that require preapproval or prior authorization. Your doctor has the current list and medical information needed to request a preapproval or prior authorization on your behalf.
Note: If you have a prescription plan benefit, some drugs must be approved for coverage through our Pharmacy preapproval program. Learn more about drugs requiring approval.
Services that do not require preapproval
You might be contacted by AIM Specialty Health or eviCore. Read more about these companies and how they work with us.
We're always trying to make healthcare work better. That means offering you a helpful web experience. Please tell us how we're doing.