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Medicare AdvantagePrior AuthMedium impact

We’re Reducing Prior Authorization Response Times for Medicare Members

BCBS Texas·TX·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jan 12, 2026
Days to comply

Summary

BCBS Texas is reducing prior authorization response times for Medicare members from 14 calendar days to 7 calendar days for nonurgent preservice and concurrent prior authorizations, effective January 1, 2026. Extensions up to 14 additional days are still possible when requested by member/provider or when additional clinical information is needed.

Action Required

Action needed
Before January 1, 2026: Update prior authorization tracking systems to reflect new 7-day response timeframes for Medicare members. Train staff to expect faster turnaround times and adjust scheduling workflows accordingly. Monitor for extension notifications and inform patients of their right to file expedited grievances if they disagree with extensions.