With step therapy, more expensive brand-name drugs are usually covered as a back-up in the program if:
- You鈥檝e already tried the generic drugs covered in your step therapy program
- You can鈥檛 take a generic drug (for example, because of an allergy)
- Your doctor decides, for medical reasons, that you need a brand-name drug
If one of these situations applies to you, your doctor can request an override or a 鈥減rior authorization鈥 for you, allowing you to take a back-up prescription drug. Once the override is approved, you鈥檒l pay the appropriate copayment for this drug.
If the override isn鈥檛 approved, you will either have to pay full price for the back-up drug or take an alternative.
If you have more questions, please call Express Scripts Pharmacy at the number on your ID card.
Reviewed 2024-08-29
