Medicare Part B Prescription Drugs
Medicare Part B Step Therapy
In some cases, we require you to first try certain “preferred” drugs to treat your medical condition before we will cover another “non-preferred” drug for that condition. For example, if a preferred and non-preferred drug both treat your medical condition, we may not cover the non-preferred drug unless you try the preferred drug first. If the preferred drug does not work for you, we will then cover the non-preferred drug.
Please note, this program applies to members who are new to therapy.
View our:
2025 preferred drug list
2024 preferred drug list
Medicare Part B Prior Authorization
All non-preferred drugs require prior authorization to ensure safe and effective use. The prior authorization criteria are consistent with Medicare requirements defined in CMS National Coverage Determinations (NCDs) and relevant Local Coverage Determinations (LCDs).
View our 2024 prior authorization drug list.
View our 2025 prior authorization drug list