Drugs Requiring Step Therapy
Step Therapy requires the trial and failure of one or more prerequisite drugs before the step therapy medication will be covered. Step therapy promotes the appropriate use of equally effective but lower cost drugs, most often generics, as first line therapy.
Drugs Requiring Step Therapy |
Step Therapy Policies |
To Initiate a Coverage Review |
|---|---|---|
Angiotensin II Receptor Blockers (ARBs) |
Visit www.medco.com/coverage or call 1-800-753-2851 |
|
Migraine Medications |
Visit www.medco.com/coverage or call 1-800-753-2851 |
|
Nasal Steroids |
Visit www.medco.com/coverage or call 1-800-753-2851 |
|
Non-Sedating Antihistamines |
Visit www.medco.com/coverage or call 1-800-753-2851 |
|
Osteoporosis medications |
Visit www.medco.com/coverage or call 1-800-753-2851 |
|
Proton Pump Inhibitors |
Visit www.medco.com/coverage or call 1-800-753-2851 |
|
Selective Serotonin Reuptake Inhibitors (SSRIs) |
Visit www.medco.com/coverage or call 1-800-753-2851 |
|
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) |
Visit www.medco.com/coverage or call 1-800-753-2851 |
Provider Instructions
To initiate and/or complete prior authorizations (coverage reviews) with Medco, prescribers have several options available. First, prescribers with a Personal Identification Number (PIN) and password can log on to Medco's prescriber coverage review website (www.medco.com/coverage) to view existing coverage review cases for their patients, initiate a coverage review case for their patients (a rejected pharmacy claim must be on file in order to initiate a case), or complete a coverage review case (answer the coverage criteria questions required to determine coverage).If a prescriber does not have, or does not know their PIN and password, please call Medco at 1-800-496-5661, 8:00am to 9:00pm, eastern time, Monday thru Friday, and a PIN and password will be provided.
Another option to initiate and/or complete a coverage review case is to contact Medco's coverage review department at 1-800-753-2851, twenty-four hours a day, seven days a week.

