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Prior Authorization

Prior Authorization is the process by which Unity gives prior written approval for coverage of specific covered services, treatment, durable medical equipment (DME) and supplies. Prior Authorization will determine and authorize payment of:

Failure to obtain Prior Authorization may result in Unity not providing coverage for the service. Prior authorization lists differ depending on health plan type.

Unity's prior authorization lists:

Important Information Regarding Prior Authorizations for State and Local Government Members
Effective January 1, 2013, Unity Health Insurance must implement a new requirement for prior authorization for certain specialty services and expand a care coordination program for Unity members who are State and Local Government annuitants, employees and their dependents insured through Employee Trust Fund (ETF). The management of these programs has been delegated to the University of Wisconsin Medical Foundation (UWMF) Medical Management (MM) department. Learn more.

Submitting a Prior Authorization Request

Medication Prior Authorization

Other Prior Authorizations


For medication-related requests, contact the Pharmacy Program at 888-450-4884 or 608-265-7397.

For other requests, contact Medical Management at 888-829-5687 or 608-821-4200. 

For more information about other services that require prior authorization, please contact Unity Customer Service at 800-362-3310, Monday through Friday between 7am to 5pm.