Pay attention: Why Do I Want Prior Authorization?

By Sarah Boden

February 17, 2026

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<br /> <span class="byline">Sarah Boden</span></p> <p>Pay attention in as “Life Equipment” host Marielle Segarra and well being reporter Sarah Boden untangle the pink tape that may make the prior authorization course of irritating.</p> <p>When the physician says you want a prescription or therapy, generally you want approval out of your medical insurance first. That’s known as prior authorization. With out that sign-off, insurance coverage gained’t pay.</p> <p>What triggers the necessity for prior authorization shouldn’t be absolutely clear. It’s one other “black field” a part of the well being care system.</p> <p>You would possibly suppose insurance coverage firms largely goal costly remedies or care approaches when a disagreement over effectiveness prompts a previous authorization evaluation. Typically that’s not the case. Some docs complain they spend plenty of time filling out paperwork to attempt to safe approval for medication or remedies which are routine.</p> <p>Within the meantime, sufferers might be left in ache, whereas their medical situations worsen.</p> <p><em>Well being Care Helpline helps you navigate the well being system hurdles between you and excellent care. Ship us your difficult query and we could faucet a coverage sleuth to puzzle it out. </em><a href="https://kffhealthnews.org/health-care-helpline-share-your-story/"><em>Share your story</em></a><em>.</em></p> <p><a href="https://kffhealthnews.org/about-us">KFF Well being Information</a> is a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working packages at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Study extra about <a href="https://www.kff.org/about-us/">KFF</a>.</p> <h3>USE OUR CONTENT</h3> <p>This story might be republished without spending a dime (<a href="https://kffhealthnews.org/news/article/medical-debt-wage-garnishment-state-legislation-patient-protection/view/republish/">particulars</a>).</p> <p>
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