Drug Management

Many of our plans have drug management programs for members. Not all benefit plans are the same. Please check your benefit information to find out which programs apply to you.

Prior Authorization

Most of our members need prior authorization for certain drugs. You can find out what these drugs are by viewing our Prior Authorization Drug List.

Quantity Limits

This program limits the amount of certain drugs a member’s plan will cover. You can see which drugs have quantity limits by viewing our Quantity Management Drug List.

Step Therapy

Step Therapy requires members to try cost‐effective “First Choice” medications before trying (or "stepping up to") more expensive “Second Choice” medications. Many people find the First Choice medications work just as well for them. View the Step Therapy Drug List.

Opioid Management Program

Opioid Management consists of daily quantity limits specific to each covered opioid drug and prior authorization requirements for certain prescribing situations. View the Opioid Management Program List.