April 1, 2024
Step therapy is a required process that applies to certain Medicare Advantage Part B prescription drugs. It requires customers to first try a preferred medication over a non-preferred medication that treats the same condition. If the preferred medication is proven to be ineffective or causes negative side effects, a non-preferred medication may then be covered.
Part B step therapy updates effective on April 1, 2024
As part of our continuing efforts to reduce drug costs while maintaining access for customers, enhancements to the Medicare Advantage Part B step therapy program became effective April 1, 2024.
| Step therapy | Affected drugs | Preferred or nonpreferred? | Part B precertification required? | Part B step therapy required? |
| Botulinum toxin | BOTOX® Dysport® Xeomin® DAXXIFY® | Preferred | Yes | No |
| Myobloc® | Non-Preferred | Yes | Yes | |
| Testosterone injectables | Depo®-Testosterone DELATESTRYL® | Preferred | No | No |
| AVEED® TESTOPEL® XYOSTED® | Non-Preferred | Yes | Yes | |
| Somatostatin | Somatuline® Depot | Preferred | Yes | No |
| Sandostatin® LAR Lanreotide | Non-Preferred | Yes | Yes |
Resources and forms
Drug/biologic step therapy requirements…………….. 2024 Part B Step Therapy Quick Reference Guide
Step therapy precertification forms…………………… MedicareProviders.Cigna.com/forms > Part B Drugs/Biologics: Drugs/Biologics Part B Step Therapy Precertification Forms
Part B precertification and step therapy requests…. Fax: 877.730.3858
Precertification team (additional assistance)……….. Phone: 888.454.0013
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