I have received a specific treatment in the past, but now it is not covered by my plan. What can I do? - Community Health Plan of Washington - Medicare Advantage

I have received a specific treatment in the past, but now it is not covered by my plan. What can I do?

For medically necessary services, a prior authorization acts as a guideline for what the insurance will and will not cover. There may be an alternative treatment, such as a similar prescription drug or service, that is covered by the plan. In that case, your doctor will switch you to this service. However, if you need a specific treatment that is not currently covered, you can ask us to make an exception to our coverage rules. We will take your health needs into account when we make our decision. Learn more about coverage exceptions.

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Nurse Advice Line
Doctors in an emergency room with patient,What kind of care do you need? Not every medical issue needs emergency care. If you have a medical issue that doesn’t seem to be life-threatening, but you’re not sure what to do, you can call our Nurse Advice Line for help. They can help you decide if you should see a primary or urgent care doctor. The Nurse Advice Line is free and available 24/7 for members at 1-866-418-2920 (TTY Relay: 7-1-1).

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