Services That Require Prior Authorization
Prior authorization means HomeFirst approves the service before you receive it. For most covered services, your care team handles this step for you. Emergency services never need prior authorization.
| Service | Prior Authorization Required? |
|---|---|
| Home Care (nursing, home health aide, PT, OT, speech, medical social services) | Yes |
| Personal Care | Yes |
| Adult Day Health Care | Yes |
| Consumer Directed Personal Assistance Services (CDPAS) | Yes |
| Durable Medical Equipment (DME) | Yes |
| Medical/Surgical Supplies | Yes |
| Orthotics and Prosthetics | Yes |
| Personal Emergency Response Systems (PERS) | Yes |
| Podiatry | Yes |
| Outpatient Rehabilitation Therapy (PT, OT, speech, outside the home) | Yes |
| Nutrition | Yes |
| Private Duty Nursing | Yes |
| Home-Delivered or Congregate Meals | Yes |
| Social Day Care Services | Yes |
| Social and Environmental Supports | Yes |
| Respiratory Therapy | Yes |
| Audiology/Hearing Aids | Yes |
| Veterans Home Benefits | Yes |
| Nursing Home Care | Yes (arranged through your Care Management Team) |
| Dentistry | May be required |
| Optometry/Eyeglasses | No, for routine vision, may be required for medically necessary services |
Source: HomeFirst Managed Long-Term Care Plan Member Handbook (2025).