What is What Is Step Therapy?
Step therapy is an insurer requirement that patients try lower-cost drugs before the plan will cover a more expensive medication. Exceptions are available with a physician's medical-necessity letter.
Practical Example
When a U.S. consumer researches step therapy, understanding the mechanics up front helps them compare providers, avoid hidden fees and choose the option that best fits their budget and long-term goals.
Why It Matters
Getting step therapy right can save households hundreds to thousands of dollars each year and prevents disputes that end up in state regulator complaints or court.
Frequently Asked Questions
Because it affects the price you pay, the protections you keep and the options you have — details that shift with each new regulatory cycle.