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Managing
Out-of-Pocket Costs Rx Management Programs Prior Approval List Step Therapy Quantity Limits Preferred Brand
Name List Generic Drugs Mail Order Pharmacy Health & Wellness News and Updates Becoming a Broker Health Care Reform
Out-of-Pocket Costs Rx Management Programs Prior Approval List Step Therapy Quantity Limits Preferred Brand
Name List Generic Drugs Mail Order Pharmacy Health & Wellness News and Updates Becoming a Broker Health Care Reform
Rx Management Programs
Prior Approval, Step Therapy, Quantity Limits
Overview
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.
Program Components
| Program | Description | Reference | CATAMOUNT Reference |
|---|---|---|---|
| Prior Approval | Some newer, more expensive or frequently over-utilized drugs may require your provider to get advance approval. | Prior Approval List |
Catamount Prior Approval List |
| Step Therapy | Providers should always try less expensive drugs before using the newest, most expensive drugs. | Step Therapy List |
|
| 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. |
Quantity Limits List | |
Updated: 05/05/2010
