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Part B drugs and supplies

Part B of Original Medicare covers Medicare Part B drugs. You can get coverage for these drugs when medically necessary. 

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 the 2024 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

  • FreeStyle Libre® and Dexcom® are the preferred brands of continuous glucose meters and supplies.
  • OneTouch® is the preferred brand of glucose meters and test strips. 
  • Non-preferred diabetes supplies need PA.

Learn more about Part B

Read about Part B drugs in Chapter 4, Benefits Chart in the Mercy Care Advantage 2024 Evidence of Coverage (PDF).

 

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