Prior Authorizations: What They Are and What I've Learned Today

When my father-in-law had a stroke on Thursday, our whole world stopped. In those moments, you don’t think about paperwork, forms, or insurance. You just want your loved one safe, treated, and on the road to recovery.

But very quickly, I found myself face-to-face with something many patients and families experience: prior authorizations.

What is a Prior Authorization?

A prior authorization (or “PA”) is when the insurance company requires approval before covering certain medications, treatments, or procedures. It’s meant to make sure the care is necessary and appropriate, but in reality, it can sometimes mean delays at a time when delays are the last thing you can afford.

Our Experience

After the hospital stabilized my father-in-law, his doctors recommended the next steps for recovery: specialized medications and therapy. I was told, “We’ll need prior authorization.”

I remember thinking, how can we possibly wait? He just had a stroke.

I went into advocate mode. I called the insurance company, the doctor’s office, and the hospital case manager. I explained over and over that this wasn’t routine; it was urgent. I asked about expedited review and made sure every piece of medical documentation was sent immediately.

It took persistence, but within a 'business day', we got the approvals after connecting with the correct parties. That meant my father-in-law could start the treatment he needed without further delay.

What I Want Other Families to Know

If you ever find yourself in a similar situation, here are a few things I learned:

• Ask about expedited review. In urgent cases, insurance companies are required to move faster and sometimes within 72 hours.

• Stay close to your doctor’s office. They’re the ones who submit the request, so make sure everything is sent quickly.

• Keep calling. Don’t be afraid to follow up with the insurance company multiple times a day if needed.

• Write everything down: Names, times, and reference numbers matter.

• Remember you’re the advocate. Sometimes the difference between waiting and moving forward is simply not giving up.

Final Thoughts

Walking through this with my father-in-law opened my eyes to how overwhelming the healthcare system can feel when you’re already hurting and scared. Prior authorizations may be part of the process, but patients and families shouldn’t feel powerless in the middle of it.

If you ever face this situation, please remember you can push for answers, you can ask for urgency, and you can be the voice your loved one needs when they can’t speak up for themselves.

It’s not about insurance codes or paperwork. It’s about people, families, and the moments that matter most.