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Step Therapy Policy for Commercial Open, Select Self-Funded Commercial Closed, Child Health Plus, Essential Plan, Small Employer Group and Direct Pay Metal Plans
Step Therapy Policy for Commercial Open, Select Self-Funded Commercial Closed, Child Health Plus, Essential Plan, Small Employer Group and Direct Pay Metal Plans
(Actonel, Aczone 5%, Adapalene Lotion & Solution(RxFlex), Amitiza, Apidra, Aplenzin, Atelvia, Aubagio, Betaseron, bimatoprost (For CHP Only), Cambia, Cialis, Cloderm, Clocortolone pivalate, Desonate, Dexilant, Dificid, Doryx, Doxycycline ER, Edarbi, Edarbyclor, Edluar, Emsam, Enablex, Entresto, Ertaczo, Extina, Fanapt, Fiasp, Fosamax+D, Gelnique, generic naftifine 1%, Glatiramer, Glatopa, Gleevec, Halog, Hydrocortisone Butyrate 0.1% Lotion, Intermezzo, Kenalog, Khedezla, Lansoprazole, Latuda, Levalbuterol tartrate HFA, Levitra, Livalo, Lonhala Magnair, Loprox Shampoo. Loprox TS, Lumigan (For CHP Only), Mentax, Naftin, Namenda XR, Nexium, Novolog, omerprazole/sodium bicarbonate, Oracea, Oxistat, Oxytrol, Pandel, Pexeva, Plixda 0.1% Swab, Prevacid, Pristiq, Pulmicort Flexhaler, Rapaflo, Relpax, Rexulti, Rhopressa, Rozerem, Sancuso, Saphris, Savella, Silenor, Solutabs, Staxyn, Stendra, Sumavel, Trianex, Trulance, Venlafaxine ER, Verdeso, Vraylar, Vyzulta, Xolegel, Xopenex (concentrate, HFA or nebulizer solution/, Zegerid, Zioptan, Zolpimist, Zypitamag)

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