Step therapy means a protocol or
Step therapy means a program for Insureds who take Prescription Drugs for an ongoing medical condition, such as arthritis, asthma or high blood pressure, which ensures the Insured receives the most appropriate and cost-effective drug therapy for their condition. The Step Therapy program requires that before benefits are payable for a high cost Covered Drug that may have initially been prescribed, the Insured try a lower cost first-step Covered Drug. If the prescribing Physician has documented with SHL why the Insured’s condition cannot be stabilized with the first-step Covered Drug, SHL will review a request for Prior Authorization to move the Insured to a second-step drug, and so on, until it is determined by SHL that the prescribed Covered Drug is Medically Necessary and eligible for benefit payment.
Step therapy means a protocol by a healthcare insurer
Examples of Step therapy in a sentence
Step therapy usually requires the use of one or more prerequisite drugs prior to the use of another drug.
More Definitions of Step therapy
Step therapy means requiring that a lower-cost alternative to
Step therapy means a utilization review protocol, policy or program in which an
Step therapy means a process that establishes a required order of use for a specific Prescription Medication. For example, a Step Therapy may require that medication “X” be used for a period of time before medication “Y” or that a weaker strength of a medication be used for a period before a stronger strength of the same medication.
Step therapy is a program for Members who take Prescription Drugs for an ongoing medical condition, such as arthritis, asthma or high blood pressure, which ensures the Member receives the most appropriate and cost-effective drug therapy for their condition. The Step Therapy program requires that before benefits are payable for a high cost Covered Drug that may have initially been prescribed, the Member try a lower cost first-step Covered Drug. If the prescribing Physician has documented with HPN why the Member’s condition cannot be stabilized with the first-step Covered Drug, HPN will review a request for Prior Authorization to move the Member to a second-step drug, and so on, until it is determined by HPN that the prescribed Covered Drug is Medically Necessary and eligible for benefit payment.
Step therapy means a protocol that
Step therapy means a type of protocol that specifies the
Step therapy means a type of protocol that specifies the sequence in which different prescription drugs for a given medical condition and medically appropriate for a particular patient are to be prescribed.