Most people know the frustration of needing prior authorization from a health plan, often before they're even eligible for Medicare. Now, Humana, the second largest provider of Medicare Advantage plans, has announced it will reduce its use of prior authorizations and speed up the process for others.
Prior authorizations (PAs) are tools widely used by private insurance companies to contain costs. In addition to making sure your plan will cover the service, medication or equipment, PAs are also a way the health plan can decide if the care is medically necessary, safe, and cost effective. In 2023, Humana had an average of 3.1 prior authorization requests per MA enrollee and a denial rate of 3.5%, according to an analyzation of prior authorization data by KFF.
