This is not a guarantee of coverage. Also check our policy criteria and the member's benefit plan to confirm eligibility or limitations of benefits or coverage. HealthPartner's Prior Authorization procedures and service items are typically consistent across products. Where differences exist, this tool reflects Commercial coverage status. Information in this application may change.
Prior authorization requirements for some procedures and services do not apply to members of self-insured groups. For self-insured patients, please use the Authorizations and Referrals app to start a prior authorization request. You can check whether a patient is a member of a self-insured group using the Eligibility Inquiry tool.
This application does not support authorization requirements for medications billed to the pharmacy benefit or genetic testing. To validate if an authorization is needed for medications billed to the pharmacy benefit, review the drug list (formulary).
For genetic testing, review the coverage policy.