Certain drugs on Health Partners Medicare formularies have step therapy requirements. Step therapy helps assure that you receive the most appropriate and cost effective drug to treat your condition.

Here’s how it works: When step therapy applies, Health Partners Medicare requires you to try certain drugs to treat your medical condition first before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, Health Partners Medicare may not cover Drug B unless you try Drug A first. If Drug A does not work for you, Health Partners Medicare will then cover Drug B.

Drugs subject to step therapy are marked with an “ST” code in our print and online formularies. View the specific step therapy requirements for drugs covered by your plan by clicking on one of the links below.

2024 Step Therapy

• Pennsylvania: SNP Plans
• Pennsylvania and New Jersey: HMO and PPO Plans

Part D Step Therapy Authorization Forms - The following forms are downloadable in PDF format. 

• Febuxostat - Step Therapy - Medicare
• Livalo - Step Therapy - Medicare
• Nurtec - Step Therapy - Medicare
• Sancuso - Step Therapy - Medicare

Part B Step Therapy

2023 Step Therapy

• Prime & Complete Plans Step Therapy Requirements
• Special Plan Step Therapy Requirement 
• Silver & Platinum Plans Step Therapy Requirements

Part D Step Therapy Authorization Forms - The following forms are downloadable in PDF format. 

• • Febuxostat - Step Therapy - Medicare
  • Livalo - Step Therapy - Medicare
  • Nurtec - Step Therapy - Medicare
  • Sancuso - Step Therapy - Medicare
• Part B Step Therapy