Prior authorization

Prior authorization

Read the Prior Authorization List.

Aetna Better Health of Ohio must pre-approve some services before you get them.  We call this prior authorization.  This means that your providers must get permission from us to provide certain services.  They will know how to do this.  We will work together to make sure the service is what you need.

Except for certain providers all out-of-network services require pre-approval.  You may have to pay for your services if you do not get pre-approval for services that are:

  • provided by an out-of-network provider or
  • not covered by Aetna Better Health of Ohio.

If the pre-approval for your services is denied, you can file an appeal.

Please see the member handbook for more information on pre-approval steps, self-referrals and exact services requiring prior authorization.