Step therapy is a requirement by some Medicare Part D plans and Medicare Advantage plans that you try less expensive medications before the plan will cover more expensive ones. For example, a plan may require you to try a generic medication before covering a brand-name medication.
Key Points
- Step therapy: try less expensive medications first
- Plan may require generic before brand-name
- Step therapy can be appealed if medically necessary
- Original Medicare does not have step therapy requirements
- An independent agent can help you find plans with fewer step therapy requirements