What Is Step Therapy?

One question Blue Cross Blue Shield of Michigan members ask us about prescription drugs is how we're reducing costs.

One way we do that is through our step therapy program. It works to make sure you get the safest, most effective and reasonably-priced drug available.

Step therapy means trying less expensive options before "stepping up" to drugs that cost more.

Here's an example of the step therapy process. Let's say you're having allergy problems. You should first try using an over-the-counter medication. If that doesn't help you, try a Tier 1 medicine. If that too doesn't work, we'll review if you met the step therapy requirements before your plan will help pay for the Tier 3 medication.

Prior authorization and step therapy ensure that medically sound and cost-effective medications are prescribed appropriately. 

Details about prescription drugs and step therapy aren't just available to your doctor and pharmacist. They're available to you too, three different ways.