Hear: 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>Hear in as “Life Equipment” host Marielle Segarra and well being reporter Sarah Boden untangle the crimson tape that may make the prior authorization course of irritating.</p> <p>When the physician says you want a prescription or therapy, typically you want approval out of your medical insurance first. That’s referred to as prior authorization. With out that sign-off, insurance coverage gained’t pay.</p> <p>What triggers the necessity for prior authorization isn’t totally clear. It’s one other “black field” a part of the well being care system.</p> <p>You would possibly assume insurance coverage firms principally goal costly therapies or care approaches when a disagreement over effectiveness prompts a previous authorization evaluate. Usually that’s not the case. Some medical doctors complain they spend loads of time filling out paperwork to attempt to safe approval for medication or therapies which are routine.</p> <p>Within the meantime, sufferers will 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 tough 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 among the core working applications at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Be taught extra about <a href="https://www.kff.org/about-us/">KFF</a>.</p> <h3>USE OUR CONTENT</h3> <p>This story will be republished without cost (<a href="https://kffhealthnews.org/news/article/wyoming-rural-health-transformation-funding-grants/view/republish/">particulars</a>).</p> <p>
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