A prior authorization (or preauthorization) is an approval for a prescribed procedure, health care service or medication before you receive the care. If you're enrolled in a TRICARE Prime plan, your primary care manager (PCM) will work with your regional contractor for the prior authorization. For all other plans, you need to contact your regional contractor for prior authorization. Each TRICARE region contractor has their own process on how prior authorizations are managed. You can see a list of services that require prior authorization on the TRICARE website. The site also has links to the regional contractor websites to see region-specific requirements. Prior authorization applies to more than 80 drugs under the pharmacy benefit. You work with your doctor to get the prior authorization, which is typically good for one year. You can check the status of your request for prior authorization on your regional contractor's website, which can be found on TRICARE'S View My Referrals/Authorizations webpage.
For more on TRICARE, visit the Military.com TRICARE section.
