AUTHORIZATIONS

Some services and supplies require approval by Ingham Health Plan in order to be covered. Certain services require a special medical review so that the plan can decide if the service is medically necessary and a covered benefit.

No authorization needed:

Office visits with your PCP or a Specialist

Routine outpatient diagnostic laboratory

Routine outpatient radiology services

Authorization Required before service:

Infusion Services

Injection Medications

Ophthalmologic exams and testing (Medically necessary - no vision services)

Outpatient Services

Physical Therapy (12 visits per year)

Radiation Therapy

Behavioral Health Treatment if services required beyond annual limit of 15 visits per year

Needs a special review to determine coverage:

  • Genetic testing
  • Reconstruction Surgery
  • Skin Procedures
  • Vein Treatments & Surgery
  • Any service that could be considered cosmetic or not medically necessary
  • Unclassified procedure codes

Your provider must submit an Authorization. Contact your provider prior to receiving these types of services.