What type of treatments typically require pre-approval in managed care?

In managed care, pre-approval is often required for certain types of treatments to ensure that they are medically necessary and aligned with the plan’s coverage guidelines. Cosmetic procedures frequently fall into this category because they are usually not deemed medically necessary and can be considered elective. Therefore, insurance providers want to review these procedures beforehand to determine their appropriateness and whether they meet the criteria for coverage.

Emergency treatments typically do not require pre-approval since they are time-sensitive and must be addressed immediately to protect the patient’s health. Standard physical check-ups are generally covered without the need for prior authorization as they are routine preventative services. Similarly, the option stating that none of these treatments require approval does not align with how managed care operates, as certain treatments, particularly those that are not standard or necessary, indeed do necessitate pre-approval.