Submitting Prior Authorization

  • Premera requires prior authorization for many services before they take place. Not getting prior authorization beforehand can result in a payment penalty for you or the member. For a service requiring a pre-service review, there isn’t a penalty, but Premera will hold the claim and ask for medical records.

    Prior authorization submission websites

    Prior authorization requests are submitted on different websites for 2020 individual and non-individual plan members (groups, associations, etc.). Sign in to the appropriate website to complete your request.

    2020 individual plan members

    Code list

    (ID cards specify Individual Plan)

    Sign in

    Out-of-area providers

    Get info on submitting prior authorization as a provider outside of WA or AK.

    Learn more

    Federal Employee Program (FEP) members

    View the FEP-specific code list and forms.

    Learn more