US Medical Term · insurance
Authorization
Autorización
What it means
In health insurance, the HealthCare.gov glossary entry on this subject is headed preauthorization: a decision by a health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. It is sometimes called prior authorization, prior approval or precertification. A plan may require preauthorization for certain services before a person receives them, except in an emergency. Preauthorization isn't a promise that the insurance or plan will cover the cost. Medically necessary services or supplies are those needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine. In the prior authorization programs CMS runs for Medicare, the provider or supplier submits the request and receives the decision before services are rendered.
Authorization in Spanish
- Spanish term
- Autorización
- Gender and article
- feminine: la autorización
- Pronunciation
- ow-toh-ree-sah-SYOHN
| Other Spanish terms | Where it is used | Note |
|---|---|---|
| autorización previa | General | Form the CuidadoDeSalud.gov glossary uses as the heading and throughout its definition. |
| preautorización | General | Form used in the title of the CuidadoDeSalud.gov glossary page. |
| aprobación previa | General | Given by the CuidadoDeSalud.gov glossary as a name the same decision is sometimes called. |
| precertificación | General | Also given by the CuidadoDeSalud.gov glossary as a name the same decision is sometimes called. |
Autorización is feminine: la autorización. For the insurance sense covered here, CuidadoDeSalud.gov, an official website of the Centers for Medicare & Medicaid Services, heads its glossary entry Autorización previa on a page titled Preautorización, and says it is sometimes called aprobación previa or precertificación. The definition begins Una decisión de su aseguradora o plan de salud: it is a decision by the insurer or health plan.
Two sentences from that glossary are worth recognizing. Su seguro o plan de salud puede requerir autorización previa para ciertos servicios antes de que usted los reciba, excepto en caso de emergencia says the plan may require it for certain services before you receive them, except in an emergency. La autorización previa no es una promesa de que su plan o seguro de salud cubrirá el costo says it is not a promise that the plan will cover the cost. The same glossary's Spanish for "medically necessary" is necesario por razones médicas.
Phrases for an appointment
What a patient or a clinician might say, in English and Spanish:
| Who | English | Spanish |
|---|---|---|
| Patient | Does this procedure need authorization from my health plan? | ¿Este procedimiento necesita autorización de mi plan de salud? |
| Clinician | Yes. Our office will send the authorization request to your plan. | Sí. Nuestro consultorio enviará la solicitud de autorización a su plan. |
| Patient | How long does the plan take to make a decision? | ¿Cuánto tarda el plan en tomar una decisión? |
| Clinician | We will call you as soon as we receive the decision. | Le llamaremos en cuanto recibamos la decisión. |
| Patient | Has the authorization for my MRI been approved yet? | ¿Ya aprobaron la autorización para mi resonancia magnética? |
| Clinician | It was approved. Please bring the authorization number to your appointment. | Fue aprobada. Por favor, traiga el número de autorización a su cita. |
| Patient | If it is approved, does that mean my plan will pay the full cost? | Si la aprueban, ¿eso significa que mi plan pagará el costo completo? |
| Clinician | Not necessarily. Please ask your plan what your share of the cost will be. | No necesariamente. Por favor, pregunte a su plan cuál será la parte del costo que le corresponde. |
In 9 languages
| Language | Term |
|---|---|
| English | Authorization |
| Spanish (Español) | Autorización |
| Chinese (中文) | 授權 |
| Korean (한국어) | 승인 |
| Vietnamese (Tiếng Việt) | Ủy quyền |
| Filipino (Tagalog) | Awtorisasyon |
| Portuguese (Português) | Autorização |
| Thai (ภาษาไทย) | การอนุมัติ |
| Japanese (日本語) | 承認 |
Where you'll see it
Related terms
Your right to an interpreter in the United States
If English is not your primary language and you have difficulty communicating in English, you may need an interpreter or a translated document when you visit a doctor or dentist, go to the emergency room or pick up a prescription. The U.S. Department of Health and Human Services Office for Civil Rights states that two federal laws, Title VI of the Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act, require programs that receive its funding to provide language access services free of charge.
You can ask when you make the appointment or at the front desk: "I need an interpreter, please." «Necesito un intérprete, por favor.»
More terms: Insurance and billing
All terms in this area: Insurance and billing — Seguro médico y facturación
Sources
- Preauthorization - Glossary — HealthCare.gov, Centers for Medicare & Medicaid Services (CMS)
- Preautorización - Glosario — CuidadoDeSalud.gov, Centros de Servicios de Medicare y Medicaid (CMS)
- Medically necessary - Glossary — HealthCare.gov, Centers for Medicare & Medicaid Services (CMS)
- Necesario por razones médicas - Glosario — CuidadoDeSalud.gov, Centros de Servicios de Medicare y Medicaid (CMS)
- Prior Authorization and Pre-Claim Review Initiatives — Centers for Medicare & Medicaid Services (CMS)
- Limited English Proficiency (LEP): Your Right to Language Assistance Services — U.S. Department of Health and Human Services, Office for Civil Rights
This page is a language reference. It is not medical advice.
Last reviewed: October 7, 2026