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Step Therapy for Part B Drugs

 

Clover Health may require a trial of a Part B preferred drug to treat a medical condition before covering another non-preferred Part B drug.

Note: The step therapy requirement does not apply to members who’ve already received treatment with a non-preferred drug within the past 365 days.

Part B preferred drugs

Clover Health’s Preferred Drug List can be found below for your convenience.

 
 

CY2024 Advanced Biosimilars First Medical Preferred Drug List

 

  1. Specialty Exceptions Alpha1-Proteinase Inh MED B-MED B BF-MED B ABF 3445-D P2024a
  2. Antimetabolites MED B MED B MED B ABF 5892-D P2024
  3. Specialty Exceptions Asthma MED B-MED B BF-MED B ABF 4659-D P2024
  4. Autoimmune MED B-MED B BF-MED B ABF 4649-D P2024
  5. Bone Metastases MED B-MED B BF-MED B ABF 3792-D P2024
  6. Botulinum Toxins MED B-MED B BF-MED B ABF 4248-D P2024
  7. Complement Inhibitors MED B-MED B BF-MED B ABF 3801-D P2024
  8. CSF-Long Acting MED B ABF 5280-D P2024
  9. CSF-Short Acting MED B-MED B ABF 4282-D P2024
  10. ESAs Med B BF-MED B ABF 5278-D P2024
  11. Factor VIII products MED B-MED B BF-MED B ABF 5894-D P2024
  12. Gaucher_s disease MED B-MED B BF-MED B ABF 4219-D P2024
  13. GnRH-Prostate MED B-MED B BF-MED B ABF 4257-D P2024
  14. Hyaluronates MED B-MED B BF-MED B ABF 4664-D P2024
  15. Immune Globulins MED B-MED B BF-MED B ABF 3797-D P2024
  16. IV Iron MED B-MED B BF-MED B ABF 5895-D P2024
  17. Multiple Sclerosis MED B-MED B BF-MED B ABF 3431-D P2024
  18. Osteoporosis MED B-MED B BF-MED B ABF 5826-D P2024
  19. PD1 PDL1 products MED B- MED B BF-MED B ABF 5888-D P2024
  20. rituximab products MED B ABF 5328-D P2024
  21. trastuzumab products MED B ABF 5269-D P2024
  22. VEGF Inhibitors for Ocular Indications MED B ABF 4951-D P2024