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Step Therapy for Part B Drugs

Some Part B drugs may require step therapy. 

Drugs that are injected or infused by your physician in their office, or in a hospital outpatient or ambulatory surgical center, are typically covered under your medical (Part B) benefit.  Some Part B drugs may require step therapy.  Step therapy means that a preferred drug must be tried before a non-preferred drug will be approved by your plan.  If you have already been on a non-preferred drug in the previous 365 days, you may continue using the non-preferred drug. 

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Only certain plans will require step therapy for these Part B drugs.  If you are using one of these drugs under the Part B benefit, please contact the customer service center at the phone number on the back of your ID card to determine if your plan is in scope.


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