Fact Sheet

Prior Authorization Facilitates Safe, Evidence-Based Care

Key Facts

  • Prior authorization ensures beneficiaries receive the most clinically appropriate and cost-effective care.
  • Nearly 80 percent of Medicare Advantage enrollees are in plans that utilize prior authorization.
  • Prior authorization protects patients from unexpected medical bills and reduces exposure to duplicative and unnecessary services.
  • Prior authorization allows patients to access an equally effective, lower-cost generic prescription medication.
  • Health plans work to simplify the process for providers and reduce uncertainty for beneficiaries.