Effective for fill dates on or after Jan. 1, 2025, the following coverage requirements will apply to the Part B Step Therapy program for Tufts Medicare Preferred, Tufts Health Plan Senior Care Options, and Tufts Health One Care:
- The following new categories will be added to the Part B Step Therapy program:
- Pemetrexed
- The following existing categories will be updated:
- Acromegaly
- Antiemetics
- Retinal Disorders
In addition to the changes listed above, coverage criteria will be updated to be drug class specific. For more information, refer to our updated Medicare Part B Step Therapy Medical Necessity Guidelines.
Annmarie Dadoly,
Senior Manager, Provider Communications
Joseph O’Riordan,
Editor
Susan Panos, Ellen Gustavson, Ryan Francis, Stephen Wong,
Writers
Kristin Edmonston,
Production Coordinator
Kristina Cicelova,
Graphic Designer