Some drugs have special requirements that must be met before we will cover them.
• Step therapy drugs require your doctor to first prescribe alternative options that are generally more cost effective without compromising quality. Step therapy may be waived if determined to be medically necessary.
• Preauthorization is required for certain drugs. This process must be completed by your doctor before you fill your prescription.
If your doctor believes that you require a certain medication that is either not on your formulary, normally requires step therapy, or exceeds a quantity limit, he or she may request an exception through the preauthorization process.