If you’ve ever had a doctor recommend a treatment—only to be told you need “approval first”—you’ve experienced prior authorization. For millions of seniors on Medicare Advantage plans, this process has become one of the biggest barriers to care. Reports and advocacy groups have raised alarms about rising denial rates, delays, and confusion, with some estimates showing sharp increases in rejected requests in recent years. Now, new April rule changes tied to 2026 Medicare policy updates are stepping in to address the problem. Here’s what’s changing—and what it means for your healthcare moving forward.
