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Rx Management Programs
Prior Approval, Step Therapy, Quantity Limits
Drug costs are one of the biggest challenges to controlling health care costs. BCBSVT engages many tools to ensure members get the best possible medications at the best prices.
|Prior Approval||Some newer, more expensive or frequently over-utilized drugs may require your provider to get advance approval.||Formulary / Drug Lists|
|Step Therapy||Providers should always try less expensive drugs before using the newest, most expensive drugs.|
|Quantity Limits||If a prescription amount exceeds our criteria, your provider may need to provide documentation.
This ensures safe and effective amounts of a drug while controlling waste or inappropriate use.
Updated: November 2016