Step Therapy

What’s step therapy and how does it work?

Just because something’s expensive doesn’t mean it’s the best. If you’re a smart shopper, you’ll look for an option that costs less and works just as well.

That’s the idea behind step therapy. We use it to make sure you’re getting the most effective and reasonably-priced drug available. It keeps costs down for everyone.

How it works

Step therapy is trying lower-priced medications before taking a step up to one that costs more. Here’s an example of step therapy:

1. You take a generic drug to lower your cholesterol, but it’s not working.
2. Your doctor prescribes another medication, but it’s still not working.
3. Your doctor prescribes a different medication that works well. But it’s more expensive. You find out that it requires step therapy.

What if my prescription requires step therapy?

You or your pharmacist should tell your doctor. There may be another drug they can prescribe that doesn’t require step therapy. If not, you can call the number on the back of your WyoBlue Advantage ID card to start the approval process and tell us the information we need.

filling out and sending in a coverage determination form.

How do I know if a prescription requires step therapy?

Start by finding your plan’s drug formulary here. If you’re using the formulary—the list of drugs your plan covers—look for an ST after the name of your prescription.