Safety is Our Priority
New drugs and new drug information come to the market at an astounding pace. Additionally, a record number of drugs have been taken off the market because of safety issues that were identified after marketing. In order to help assure our members have access to safe, effective drug therapy and to protect against inappropriate use and waste, we require prior authorization and step therapy* on selected prescription medications.
Prior Authorization & Step Therapy Requirements
Use these links to access our Prior Authorization Request Forms:
Coverage Determination Request
* Step Therapy - In some cases, we require members to first try certain drugs to treat their medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat the medical condition, we may not cover Drug B unless the patient tries Drug A first. If Drug A does not work for the patient, we will then cover Drug B.