Which services require prior authorization?

Some common procedures or treatments that require prior authorization are:

  • Ambulance services, nonemergency
  • BOTOX®
  • Bariatric surgery
  • Back or spine surgery
  • Cardiology procedures
  • Durable medical equipment, or DME, purchases greater than $1,500
  • Devices for sleep apnea
  • Home care
  • Magnetic resonance imaging, or MRI
  • Positron emission tomography, or PET, scans
  • Sleep studies

For a more detailed list of procedures or treatments, log in to hap.org and click on “Member Resources” in the “My Plan” tab. Then, under “Forms,” click on “Member Prior Authorization List.”

Note: The list above and our Member Prior Authorization List are meant to give an overview only and are not complete lists of all treatments or procedures that require prior authorization. Prior authorization requirements vary by plan type. If you need more information about a specific procedure and its requirements, call Customer Service at the number on your ID card.

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