What Is Prior Authorization & Why Do You Need It for Free Incontinence Supplies?

What is prior authorization? In the simplest terms, it's like getting permission from your insurance company before they'll cover a medical expense. 

If you want free incontinence supplies through insurance, you may need to obtain this prior authorization to ensure coverage. Depending on your insurance plan, it's often a required step where your insurance company determines whether the products you need are medically necessary. Without it, you could face delays or denials in receiving your supplies, leading to unexpected out-of-pocket costs.

A couple of things can help the process go smoothly. First, always have a current prescription from your doctor. You'll likely need this when you first start getting supplies through insurance and then again each year as part of the renewal process. Second, some cases also require updated clinicals. This means you'll need to have seen your healthcare provider (or your child's provider) within the last 12 months. It's important to stay current on those visits!

Prior authorization is when you obtain approval from your health insurance plan before getting care. Some insurance companies may require prior authorization before receiving health care services, medical supplies, or prescription drugs.

Without prior authorization, some healthcare plans may deny coverage, which leaves you paying more for your services or treatments out of pocket.

Prior authorization may also be called preauthorization, preapproval, or precertification.

If your health insurance company requests prior authorization for incontinence supplies, the process will be started by your healthcare provider at the time of your services or prescription if they are in-network with your insurance plan. However, if your provider is out-of-network or is unaware that you require prior authorization for a certain health service, you may need to request it.

If you or your loved one has qualified for free incontinence products with Aeroflow Urology, we can also apply for prior authorization on your behalf.

After you or your healthcare provider sends the prior authorization request, they should approve or deny your request. They may also ask for further information before approving your care. The prior authorization process may take up to 10 days following the request to be completed. 

If you're checking your eligibility for free incontinence supplies through insurance with Aeroflow Urology, prior authorization can only be initiated once we receive all the documents from your healthcare provider. The quicker you ask your provider to provide us with a signed prescription and your most recent clinicals, the shorter the process!

Incontinence supplies, such as adult diapers, adult pull-ons, pediatric diapers, pediatric pull-ups, and other supplementary items, are considered medical necessities by most health plans, including Medicaid.

Because of this, your insurance company may require that you obtain prior authorization for your incontinence product prescription after your healthcare provider recommends your products.

If your insurance requires prior authorization, you will not be able to receive your supplies for the first time without it, and you may experience disruptions in your ongoing shipments of free incontinence products if your prior authorization expires.

Disclaimer

Information provided on the Aeroflow Urology blog is not intended as a substitute for medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.