US Medical Term · administration
Prior Authorization
Autorización Previa
What it means
Prior authorization is approval from a health plan that may be required before a person gets a service or fills a prescription in order for the service or prescription to be covered by the plan, according to the HealthCare.gov glossary. Medicare.gov lists prior authorization among the rules a Medicare plan may have for the drugs a person takes, and describes it as approval, based on a plan's specific requirements, that the person and/or the prescriber must get from the plan for certain drugs before the plan will cover them. The prescriber may need to show that the drug is medically necessary. The person or the prescriber can contact the plan to ask for an exception to prior authorization. Medicare.gov describes step therapy as a type of prior authorization.
Prior Authorization in Spanish
- Spanish term
- Autorización Previa
- Gender and article
- feminine: la autorización previa
- Pronunciation
- ow-toh-ree-sah-SYOHN PREH-byah
Autorización previa is the heading of the CuidadoDeSalud.gov glossary entry, which defines it as aprobación de un plan de salud, and of the section on Medicare's Spanish page about drug plan rules. It is feminine: la autorización previa. The pages cited here capitalize only the first word in headings and write autorización previa in running text, not Autorización Previa. The Spanish dictionary defines the adjective previo as anticipado, que va delante o que sucede primero.
The CuidadoDeSalud.gov entry uses surtir una receta where the English entry says to fill a prescription. Medicare's Spanish page calls the prescriber recetador autorizado, writes necesario por razones médicas for medically necessary, and uses excepción for an exception and lista de medicamentos (Formulario) for the plan's drug list. For step therapy that page prints two forms, the heading Terapia en etapas and, in the sentence under it, terapia escalonada, which it describes as un tipo de autorización previa.
Phrases for an appointment
What a patient or a clinician might say, in English and Spanish:
| Who | English | Spanish |
|---|---|---|
| Patient | The pharmacy told me that my prescription needs prior authorization. | En la farmacia me dijeron que mi receta necesita autorización previa. |
| Clinician | Yes, your drug plan asks for it before it will cover this medicine. | Sí, su plan de medicamentos la pide antes de cubrir este medicamento. |
| Patient | Do I have to request it, or does your office do that? | ¿Tengo que solicitarla yo, o lo hace su consultorio? |
| Clinician | We will send the plan a form that explains why you need this medicine. | Enviaremos al plan un formulario que explica por qué necesita este medicamento. |
| Patient | What happens if the plan says no? | ¿Qué pasa si el plan dice que no? |
| Clinician | We can ask the plan for an exception, and I would write a supporting statement. | Podemos pedirle al plan una excepción, y yo escribiría una declaración de apoyo. |
| Patient | Does the plan want me to try a different medicine first? | ¿El plan quiere que pruebe primero otro medicamento? |
| Clinician | Please check with your plan to find out its specific coverage rules. | Por favor, consulte con su plan para averiguar sus reglas específicas de cobertura. |
In 9 languages
| Language | Term |
|---|---|
| English | Prior Authorization |
| Spanish (Español) | Autorización Previa |
| Chinese (中文) | 预授权 |
| Korean (한국어) | 사전 승인 |
| Vietnamese (Tiếng Việt) | Ủy quyền trước |
| Filipino (Tagalog) | Prior Authorization |
| Portuguese (Português) | Autorização Prévia |
| Thai (ภาษาไทย) | การอนุมัติล่วงหน้า |
| Japanese (日本語) | 事前承認 |
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
Related guide
→ US Guide: prior authorization and referralsSources
- Prior authorization - Glossary — HealthCare.gov, Centers for Medicare & Medicaid Services (CMS)
- Autorización previa - Glosario — CuidadoDeSalud.gov, Centros de Servicios de Medicare y Medicaid (CMS)
- Drug plan rules — Medicare.gov, Centers for Medicare & Medicaid Services (CMS)
- Reglas del plan de medicamentos — Medicare.gov en español, Centros de Servicios de Medicare y Medicaid (CMS)
- previo — Diccionario de la lengua española — Real Academia Española / ASALE
- 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 8, 2026