Have you ever gone to pick up a new prescription medication, only to be told your insurance plan won’t cover it until you try a different medication first? This requirement is an insurance limit known ...

Step therapy occurs when your insurer requires you to use medication alternatives before another, possibly more expensive, treatment option. Depending on specific factors, you can work with your ...

Step therapy is when Medicare Part D plans ask beneficiaries to try a more affordable drug before approving higher-cost prescriptions. In Medicare, Part D covers general prescription drugs, whereas ...

Insurers argue that step therapy—taking drug treatment one step a time—prevents wasteful spending by directing patients to less expensive, but still effective, treatments. But patient advocacy groups ...

For many people living with psoriasis, finding a treatment that truly works can feel life-changing — clearer skin, fewer flares, and a sense of control. But before some people can access the most ...

The frequency with which 7 of the largest Medicare Advantage plans impose step therapy protocols in their Part B drug coverage decisions varies substantially. Objectives: First, to examine 7 large ...

Even when doctors prescribe a medication, some insurance companies require you to try lower-cost drugs first, which could delay your ability to get the treatment you need. Samantha Rynearson was 21 ...

Insurers limit the use of certain prescription drugs by requiring step therapy—that is, by allowing access only after alternatives have been tried and have failed. Using data from seventeen of the ...

The Massachusetts House passed a bill which aims to curb the use of step therapy by health insurers. Drugs that are designated with a “step therapy” condition of reimbursement are only paid for by ...

The broader implementation of step therapy in Medicare Advantage could significantly influence the treatment access and experience as well as health outcomes for millions of patients with diverse ...