Authorizations

Upper Peninsula Health Plan (UPHP) does require some services and items to be reviewed prior to you receiving those services or items. This is called prior authorization. This approval from UPHP may be required before you get a service, medical equipment, or fill a prescription in order to be paid for by UPHP. Work with your provider to see if an authorization has been given. UPHP provides information to UPHP network providers on what services require prior authorization. You may also call UPHP Customer Service at 1-800-835-2556 (TTY: 711) to make sure you have the authorization you need. UPHP does not require referrals.

Your health care services are to be directed by your primary care provider (PCP) or specialist. You must use UPHP in-network providers for your care when available. These are health care providers that have a contract with UPHP as a provider of care. Use of out-of-network providers will require prior authorization from UPHP unless stated otherwise. Your UPHP provider can send in a prior authorization request for you to receive out-of-network services and/or for the services listed below.