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Use the list below to see how your prescription drugs are covered.
2021 Drug List for Plans in Iowa and Wisconsin (PDF)
Step Therapy is a program focused on using cost-effective prescription drugs as first-line treatment when appropriate. The program is used for certain conditions where there are many treatment options available. Drugs that require Step Therapy are noted on the drug list. Some drugs may also require prior authorization.
In Step Therapy, you try the Step 1 preferred drug or drugs first. Step 1 drugs are cost efficient and effective options. If the Step 1 drug isn't effective, you can then try the Step 2 drug. In some cases, you may need to try more than one Step 1 drug before trying a Step 2 drug.
Step Therapy applies to all members, regardless of their plan type. That means that if you don't try the Step 1 drug or drugs first, then a Step 2 drug won't be covered. Your doctor may request an exception if your current drug is the best clinical option for you. If authorization is given, we'll continue coverage of your current drug. If the request is denied, you may appeal the decision.