Certain medical services and supplies require approval before they will be covered by your plan. Your Schedule of Benefits indicates which services, supplies or medications require pre-authorization. All pre-authorization requests are coordinated through your physician’s office, so your provider must ask for and receive approval before you receive care. Johns Hopkins EHP will review the service, drug or equipment for medical necessity. If pre-authorization is not given, then coverage for care, services or supplies may be limited or denied. Any costs for denied services that were the result of an in-network provider failing to receive pre-authorization are not your responsibility. For more information on pre-authorization guidelines through your EHP plan, refer to your EHP Benefits Explorer.
