Part B drug step therapy
The Centers for Medicare & Medicaid Services (CMS) allows us to use step therapy requirements for Part B drugs. We have done so and use the 2026 CVS Caremark® Advanced Biosimilars - First Medical Preferred Drug List - Medicare Part B Step Therapy (PDF).
Prior authorization (PA)
Your provider can ask for:
- PA for Medicare Part B drugs
- An exception for non-preferred Medicare Part B drugs instead of preferred Part B drugs: usually applies when you’re already in an active course of treatment
Just ask your provider to send a supporting statement with their request. We’ll review:
- Standard requests within 72 hours
- Expedited requests within 24 hours
Glucose meters and supplies
We cover blood glucose meters and test strips from TRUE/Trividia meters. We also cover Dexcom and FreeStyle Libre continuous glucose monitors and sensors. Other brands will not be covered unless you get approval from us first.
Learn more about Part B
Read about Part B drugs in Chapter 4, Benefits Chart in the Mercy Care Advantage:
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