Delaware Department Of Insurance Prior Authorization Lookup
Latest Delaware Department Of Insurance prior authorization updates5
- Prior AuthAdministrative/Operational PolicyEff. 2025-11-03Implementation of Senate Bill No. 12 — Delaware Pre-Authorization Act of 2025Governs implementation of Delaware's Pre-Authorization Act (SB 12) establishing uniform standards and timelines for pre-authorization, utilization review, appeals, and electronic provider portals for health insurers, health-benefit plans, health-service corporations, and utilization review entities operating in Delaware.All Delaware Department of Insurance updates
- Prior AuthAdministrative/Operational PolicyEff. 2020-03-20Additional Guidance Relating to COVID-19 (Domestic and Foreign Insurers Bulletin No. 116)State-level bulletin issuing mandatory and advisory guidance to insurance carriers, producers, and adjusters doing business in Delaware regarding cancellations/nonrenewals, telemedicine reimbursement, waiver of prior authorization and cost-sharing for COVID-19 testing and treatment, and communications during the COVID-19 State of Emergency.All Delaware Department of Insurance updates
- Prior AuthClinical/Medical PolicyEff. 2014-09-30Tobacco Cessation Preventive Service CoverageRequires coverage of tobacco cessation preventive services (screening, counseling, FDA‑approved medications) without cost-sharing or prior authorization for applicable Delaware non-grandfathered plans.All Delaware Department of Insurance updates
- Prior AuthClinical/Medical PolicyEarly MMR vaccination coverage for infants ages 6–11 months during measles outbreakDirects Delaware-regulated carriers to cover a single early MMR dose for infants 6–11 months during the active measles outbreak, with no cost-sharing, no prior authorization, provider attestation accepted, and operational updates required during the outbreak.All Delaware Department of Insurance updates
- Prior AuthAdministrative/Operational PolicyGuidance Regarding Nationwide Drug ShortageThis bulletin provides guidance to insurance carriers and pharmacy benefits managers authorized in Delaware about managing drug shortages (pediatric antibiotics and ADHD medications), including prior authorization flexibility and expedited reviews. It affects carriers and PBMs operating in Delaware.All Delaware Department of Insurance updates
Tool Description
Search Delaware Department Of Insuranceprior authorization policies by drug name, procedure, or policy title. Results include any policy that mentions prior authorization requirements (drug coverage criteria, imaging guidelines, site-of-service rules) not just documents titled “prior authorization.” Every result links to a full policy page with clinical criteria, covered billing codes, documentation requirements, and effective dates.
Filter by payer, specialty, policy type, or effective year; or search directly for a drug (“Wegovy,” “Ozempic”), a procedure (“MRI,” “knee arthroplasty”), or a policy number.
Coverage spans 110+ payers. Jump straight to the busiest prior-auth publishers: UnitedHealthcare, Cigna, Aetna, Anthem, and Centene. You can also browse the full policy updates feed.
Pair a prior-auth search with the billing code lookup to confirm the CPT or J-code on the claim, the payer lookup for plan footprint, and payer profiles for contacts and coverage context.
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Prior auth requirements change all the time. Keep up with every payer policy update in the live policy feed, or browse payers with prior authorization policies.
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