Prior Authorization - Patient Page

    Prior Authorization (also referred to as utilization management) is a process by which insurance companies review procedures and medications to determine whether they will provide coverage, before the service is rendered. Not all medical procedures and medications are subject to prior authorization, but many are. Below please find links to prior authorization policies, listed by insurance company, that are available online. Prior authorization is generally obtained by the physician office. However, it is important for patients to be aware of their rights regarding services that are denied prior authorization. For more information regarding coverage under your plan, please call the phone number on the back of your insurance identification card. 

    Additional Resources:



    Aetna Better Health of NJ (Medicaid Managed Care Organization)

    Aetna Medicare Advantage

    Amerigroup (Medicaid Managed Care Organization)



    Clover Health (Medicare Advantage)

    Horizon Blue Cross Blue Shied of NJ

    Horizon Medicare Advantage

    Horizon NJ Health (Medicaid Managed Care Organization)


    United Healthcare

    United Healthcare Community Plan (Medicaid Managed Care Organization)

    United Healthcare Medicare Advantage

    Wellcare (Medicaid Managed Care Organization)

    Wellcare Medicare Advantage


    >>View Provider Prior Authorization Page

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