Many of our plans have special drug management programs for members. Not all benefit plans are the same. Please ask your clients to check their specific benefits booklet or speak with a benefits coordinator to find out which programs apply to them.
Most of our members need prior authorization for certain drugs. Learn what these drugs are in our Prior Authorization Drug List. Some plans have more drugs that need prior authorization.
This program limits the amount of certain drugs a member’s plan will cover. Learn which drugs have quantity limits in our Quantity Management Drug List.
This program may make a medication plan easier to follow. It lowers the number of tablets members have to take each day. See the drugs included in the program in 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. Members must try one or more Step One Drugs before their plan will cover Step Two Drugs. If a member's doctor does not think Step One Drugs will work for the member, he or she must submit documentation explaining why. Although Step One Drugs are less costly than Step Two drugs, both are effective treatments. View the Step Therapy Drug List.
