Prior authorization under the Plan is required in only a limited set of circumstances, but if you fail to obtain prior authorization in those circumstances your benefits are denied.
Prior authorization is required in the following circumstances:
- Home Health and Hospice Care
- Hospitalization
- Physical Therapy, Speech Therapy, Occupational Therapy and Chiropractic Care
- Major Dental Care Over $600
Otherwise, you do not need to obtain a prior authorization before you seek treatment.
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