If your doctor prescribes injectable or biologic drugs to treat a condition, your D-SNP prescription benefit step therapy will first have you try using a preferred drug before covering a non-preferred drug. Taking these steps helps you keep your costs down and helps you avoid treatment limits.
Before starting a new medication, you can check your Medicare Part B Drug List to see if you’ll need to follow step therapy rules.
View 2023 Medicare Part B Step Therapy Drug List
View 2022 Medicare Part B Step Therapy Drug List
Here’s an example to help explain how step therapy might work.
Imagine Drug A (preferred) and Drug B (non-preferred) are both used to treat the same medical condition. Your D-SNP may require that you try Drug A (preferred) first. If Drug A does not work, Drug B (non-preferred) will be covered.
Here are some important things to keep in mind:
If you have questions about step therapy, or your prescription drug benefits, please call Member Services at 1-844-339-7684 (TTY 711).