• Home
• About HIRSP
• Plans
• Members
• Providers
• Agents

Prior Authorization

HIRSP will cover medically necessary and appropriate services consistent with the HIRSP policy. Prescription drugs must be obtained at a HIRSP certified network pharmacy. A partial list of covered services follows.

Refer to the policy for a full list of covered services, exclusions, conditions, and limitations.

• Prior Approval Request Form

Additional Information:

• Understanding Your Explanation of Benefits Statement: Sample copy with notations explaining benefit information
• Your Right to an Independent Review
• Other information about HIRSP is available under Chapter 149, Wis. Stats.