Medication Prior Authorization

Step Therapy Program

Sometimes there are a lot of different drugs that treat the same illness. Some may cost very little and others may be very expensive, but work just as well. That’s why Quartz has the Step Therapy Program. Step Therapy means that members must try the most cost-effective medications before stepping up to a more expensive drug. Many members find the first medication very effective and never need to step up.

Step therapy medications need Prior Authorization for coverage. Every Prior Authorization Request for step therapy drugs is reviewed separately. Each drug has specific criteria for approval.

Preferred or non-preferred drugs may be included in a step therapy program.

Go to the Quartz formulary to see which drugs have a "ST". These require Prior Authorization.

Medical (General) Prior Authorization

For self-funded participants, please login to MyChart to view your Prior Authorization Lists.