Prior Authorization Facilitates Safe, Evidence-Based Care

Key Facts

• Prior authorization ensures beneficiaries receive the most clinically appropriate and cost-effective care.
• 99 percent of Medicare Advantage enrollees are in plans that utilize prior authorization.
• Prior authorization protects patients from unexpected medical bills and reduces exposure to duplicative and unnecessary services.
• Prior authorization allows patients to access an equally effective, lower-cost generic prescription medication.
• Health plans work to simplify the process for providers and reduce uncertainty for beneficiaries.