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Preapproval Requirements

Updated November 2018

What is preapproval?

Preapproval confirms that a service you’re getting will be eligible for benefits. By getting a service preapproved, you reduce your risk of having to pay for a service that isn’t covered.

Usually, your doctor will take care of getting a service preapproved, but not always. If you don’t get preapproval for a service that requires it, your benefits may be reduced by up to $500, and you risk having to pay the entire cost of the service yourself.

Which services need preapproval?

arrow These requirements apply to ALL members: arrow These requirements apply ONLY to non-Medicare members:

How do I request preapproval?

When you know you’ll be getting a service that needs to be preapproved, you (or your doctor) must submit a request ahead of time. This allows time to review the service to make sure it’s eligible for benefits.

For some services, you need to contact UniCare. For other services, such as diagnostic imaging or pharmacy, your doctor must contact AIM Specialty Health®. AIM is a UniCare-affiliated company that provides support for UniCare’s preapproval process.

Information you need to provide

When submitting a request for preapproval, be sure to have the following information available:

How to reach UniCare Member Services

If you aren’t sure whether you need to get preapproval, or if you have other questions about preapprovals, please contact UniCare Member Services:


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