Many of our plans have special drug management programs for members. Not all benefit plans are the same. Please check your specific benefits booklet or speak with your benefits coordinator to find out which programs apply to you.
Most of our members need prior authorization for certain drugs. You can find out what these drugs are by viewing our Prior Authorization Drug List.
This program limits the amount of certain drugs a member’s plan will cover. You can see which drugs have quantity limits by viewing our Quantity Limit Drug List.
This program may make your medication plan easier to follow. It lowers the number of tablets you have to take each day. You can see the drugs included in the program by viewing our Dose Management Drug List.
Step therapy programs group drugs into two categories. Step One Drugs are safe, effective and affordable. Most people should try these drugs first. They often work as well as more expensive drugs, at a lower cost. Step Two Drugs are more expensive. You must try one or more Step One Drugs before your plan will cover Step Two Drugs.
If your doctor does not think Step One Drugs will work for you, he or she must submit documentation explaining why. Although Step One Drugs are less costly than Step Two drugs, both are effective treatments for most people.
View the Step Therapy Drug List.
