These are drugs that usually aren’t self-administered. They are injected or infused while you are getting physician, hospital outpatient, or ambulatory surgical center services.
What is step therapy?
Step therapy is when we require a member to try a preferred drug to treat a medical condition before we will cover a non-preferred drug. If you have been treated with a non-preferred drug within the past 365 days, the step therapy requirements will not apply to you.
What drugs require step therapy?
Search for Medicare Part B step therapy at the following link to find a list of Part B Drugs that may be subject to step therapy: Medicare Part B step therapy policy.
Disclaimers
Tufts Health One Care is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees.
We have free interpreter services to answer any questions you may have about our health or drug plan. To get an interpreter, just call us at 1-855-393-3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m. Someone who speaks English can help you. This is a free service.
Contamos con servicios gratuitos de interpretación para responder cualquier pregunta que pueda tener sobre nuestro plan de salud o de medicamentos. Para conseguir un intérprete, solo tiene que llamarnos al 1-855-393-3154 (TTY: 711), los siete días de la semana, de 8:00 a. m. a 8:00 p. m. Alguien que habla español podrá ayudarle. Este es un servicio gratuito.
You can get this document for free in other formats, such as large print, formats that work with screen reader technology, braille, or audio. Call 1-855-393-3154 (TTY: 711), seven days a week, from 8 a.m. to 8 p.m. The call is free.
The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.