Learn Which Health Services Need Prior Authorization

Date: 10/02/26

Superior HealthPlan members can get all covered Medicaid benefits that are medically necessary, but some services must be reviewed before you can receive them.

This review is called prior authorization and is submitted by doctors, nurses and other healthcare professionals. They can submit these requests to Superior by phone, fax or online.

If a prior authorization request is decided not to be appropriate or medically necessary, you will receive a letter explaining why it was not approved. This is called an adverse determination, or medical necessity denial. If you receive a denial letter, you can ask Superior to review the prior authorization request again. This is called an appeal of adverse determination.

You can get more information or find a full list of the Medicaid and CHIP covered services that need prior authorization by visiting Superior’s Prior Authorization webpage. If you have any questions, call Member Services at 1-866-912-6283.