Definition
An insurance requirement that you try less expensive medications before the insurer will cover a more expensive drug. Also called "fail first." For example, you may need to try a generic before your plan will cover a brand-name medication. You can appeal step therapy requirements if medically inappropriate.
Related Terms
- Formulary
A list of prescription drugs covered by your health insurance plan, organized in...
- Generic Drug
A prescription medication that contains the same active ingredient as a brand-na...
- Specialty Drug
High-cost medications used to treat complex chronic conditions such as cancer, r...
- Deductible
The amount you must pay out of pocket for covered healthcare services before you...
- Copay
A fixed amount you pay for a covered healthcare service after you have met your ...
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