Prescription Coverage - Step Therapies

Quick Links:
» About Step Therapies
» Step Therapy Covered Medications

Other Prescription Management Controls:
» Prior Authorizations: Click Here
» Exclusions: Click Here
» Quantity & Age Limitations: Click Here
» Specialty Medications: Click Here
» Step Therapies: Click Here
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About Step Therapies

Certain prescriptions covered under the Health Plan require the use of an equally effective and less expensive prescription medication before a more expensive alternative will be considered for coverage. A listing of prescription medications requiring Step Therapy are listed below:

Disclaimer: The Health Plan reserves the right to add or remove medications from this list at any time, so please contact the Health Plan Administration office to verify whether a covered medication is subject to a Clinical Prior Authorization (CPA).
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Step Therapy Covered Medications

Acne Medications (Oral)
» Such as Oracea & Solodyn

Anti-Diabetic Injectables
» Such as Byetta

Anti-Inflammatory Drugs
» Such as Celebrex
» Must first try generic non-steroidal Anti-Inflammatory drugs before the Health Plan will cover Celebrex

Hypnotics
» Such as Ambien

Overactive Bladder Drugs
» Such as Detrol

Glucose Transporters
» Such as Invokana

Topical Immunomodulators
» Such as Elidel

Topical Corticosteroids
» Such as Topicort

Topical Acne Drugs
» Such as Metrogel

Ophthalmic Anti-Allergy Drops
» Such as Pataday

Disclaimer: The Health Plan reserves the right to add or remove medications from this list at any time, so please contact the Health Plan Administration office to verify whether a covered medication is subject to a Clinical Prior Authorization (CPA).
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