Common use of Step Therapy Clause in Contracts

Step Therapy. Certain drugs require step‐therapy. This means that to receive coverage, you will need to try specific formulary drugs that are proven, safe and cost‐effective medicine before using the drug that requires step‐therapy. Your Provider will be required to submit documentation to obtain Approval for a drug requiring step‐therapy. Your Provider can request to bypass step‐ therapy by requesting Prior Approval.

Appears in 2 contracts

Samples: Member Benefit Agreement, Member Benefit Agreement

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Step Therapy. Certain drugs require step‐therapystep-therapy. This means that to receive coverage, you will need to try specific formulary drugs that are proven, safe and cost‐effective cost-effective medicine before using the drug that requires step‐therapystep-therapy. Your Provider will be required to submit documentation to obtain Approval for a drug requiring step‐therapystep-therapy. Your Provider can request to bypass step‐ step- therapy by requesting Prior Approval.

Appears in 2 contracts

Samples: Member Benefit Agreement, Member Benefit Agreement

Step Therapy. SAMPLE Certain drugs require step‐therapystep-therapy. This means that to receive coverage, you will need to try specific formulary drugs that are proven, safe and cost‐effective cost-effective medicine before using the drug that requires step‐therapystep-therapy. Your Provider will be required to submit documentation to obtain Approval for a drug requiring step‐therapystep-therapy. Your Provider can request to bypass step‐ step-therapy by requesting Prior Approval.

Appears in 1 contract

Samples: Member Benefit Agreement

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Step Therapy. Certain drugs require step‐therapystep - therapy. This means that to receive coverage, you will need to try specific formulary drugs that are proven, safe and cost‐effective cost - effective medicine before using the drug that requires step‐therapystep - ther apy. Your Provider will be required to submit documentation to obtain Approval for a drug requiring step‐therapystep - therapy. Your Provider can request to bypass step‐ step - therapy by requesting Prior Approval.

Appears in 1 contract

Samples: Benefit Agreement

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