WASHINGTON — One of the nation’s largest health insurers will use “step therapy” in some of its private Medicare plans next year, requiring patients to try cheaper drugs before pricey biologics and other costly medicines.

The decision by UnitedHealthcare is among the first signs that insurers plan to take advantage of a Trump administration initiative that policymakers argue will bring down drug costs for consumers.

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  • Where in the U.S. is this “STEP THERAPY” NOT already in practice??????????
    We’ve been “jumping through hoops” (PRIOR AUTHORIZATION FORMS) (for years) to get quality medication without “junk” fillers…etc… If you’re on medicare and ABSOLUTELY on medicaid, (you won’t even get most meds you need on MEDICAID) the people who need it badly!!!! THE GOVERNMENT OF THIS COUNTRY SHOULD BE ASHAMED!!!!! IT’S ALL ABOUT $MONEY$ IT’S VERY SICKENING! This article lacks fact!!!! Smh!

  • Many Medicare Part D plans already use step therapy. This is not new. To sidestep step therapy your prescriber can submit a statement why the other/cheaper/alternative drugs would be inappropriate options. Know the facts.

  • Wow pretty soon we won’t even have to bother going to the doctor. We can just ask the insurance company what they want us to have.
    How far does this have to go before the American people get enough of the government deciding for us. The drug and insurance companies keep lining their pockets at the cost of our lives.
    It’s disgusting and should be a crime.

  • I pay a high monthly payment for my Part D so that I can get the meds I need, we are already over priced for every little thing we get as it is. The little bit of increase I recieved last January, I didn’t even see cause when the insurance companies realized we were getting a cost of living increase they raised the hell out of my secondary ins and part D so the 2 insurances eat up the tiny tiny increase I got and I’ve paid out even more. Now you ppl want to play with what I have rightfully worked for , the ppl in the white house have lost there minds and that don’t know what it’s like to live on a fixed income. Over half of the ppl in white house were born into money so they dont know what the hell poverty is. All of Congress and the president should have to live a whole month or 2 like the poor and then they might understand what they are doing to ppl. If you do anything you should add Vision, Dental and Hearing Aides to Medicare , these are things we really need and if we have to pay out of pocket, well we just do without, so then we can’t see, our teeth hurt and we can’t here a damn thing.

    • I understand, I too am in your boat, however some of the drugs are just about labels thats all! Occasionally the cheeper ones work better… and point in case what companies have done to gouge us all is disgusting!!!you agree there yes??? I havent bought an epi pen because of the ridiculously priced thing. Now I am probably alone in my stand because people use medicare as a Freebie service which makes me cry…. my parents worked their bodys off for us to have what we all have and take for granted… we alot of people are ingrates not you sir or mam… we need to find a way to show these companies that they can’t just get fat on their name… I believe If you discover something you should be rewarded and refunded but theirs a fine line between that and sickly rich and Trump is trying to show us that if you look he is not trying to force cheep pills down ya but look at the fact that he is not siding on the rich guys side… I wish people could see what I am seeing…He once said his secretary paid more taxes than he did… many years ago and he didnt think that was right back then but the laws were built for him then… I think if we watch with reallly open minds and hearts and listen to him not them at all but what he actually says. You start to realize he’s trying to level the playing field without it hurting to much or ruffeling everyone’s feathers!!! But its hard to weed out the media and all their gobldie gook. However if you want to really do it MUTE TV and just read it change it to cc. If everyone would do this!!!! Its amazing what you hear!!! My opinion but I too am disabled and have had some of my meds taken away which my just have taken me to a road that may kill me. I AM WAITING TO FIND OUT. I am scared but I pray each day for god to help our government and seal the rift in our country… my god be with you too sir or mam and peace…amen

  • Humana charged me 500 hundred dollars for first three bottles of u-100 lantus insulin. 2nd three bottles of same insulin 300 hundred dollars. Same insulin that’s been around around a long time nothing new. Nothing but greed from health insurance companies

  • If you have employer based health insurance you are already receiving ‘step therapy’

    If you have Medicare Part D you are already receiving ‘step therapy’

    In most cases all it takes is a call from your doctor to explain to the insurance company why you need to get bumped up a step.

  • Shame on a country that disrespects its elderly. UnitedHealthcare is the AARP recommended plan! What is going on – greed over humans – disgusting.

  • You cut the medication I needed,to line your pockets,Part D is Generic!!!.Stop playing games with people’s lives,using the stock exchange for an excuse.
    Medicare and Medicaid,said what they will pay for and that settles it!!
    You’re just taking advantage of people,thats all.!!

    • Have you tried the cards that say 80 % off ir 90 or 70%
      I agree it’s awful. I have to pay 50 then I started finding out about the cards I have it down to 30.oo something because Medicare. DOES NOT cover this one kind of thyroid medicine,,, seriously really thyroid????
      But find someone or ask the pharmacist to find a card that works. I guess email me and ill send you a copy of mine however if we are in different states I doubt it works, you can usually find them sitting in drs. offices. But you can get them online too. Rediculous I know… I saw a young lady going through 10 of them one day… plus you can go to different pharmacies too and get way different prices, I would say check pricing by phone…. good luck.. so sorry… 🙁

  • These billionaires are always playing doctor without a license! Most plans leave you with a high deductible and copayments associated with test. Medicare benefits are enough to afford unnecessary testing, as their benefits are for life paid by the public. Most of individuals on Medicare/Medicaid had jobs and taxes deducted. However the increases gi to the rich who lie, and steal all the cost of government is on the no longer middle class struggling to make ends met!! Let them pass a bill that ALL of them live on the Social security and benefits associated with that for a year “NO OUTSIDE HELP “WITHOUT LYING OR CHEATING SO THEY CAN EXPERIENCE WHAT WE GO THROUGH. How would they like it if their benefits had a mandate to continue coverage?? Why don’t they try something new, telling the truth, leave our benefits alone, and give us a decent increase without taking it back by raising our part b cost!!

    • Taxbreaks given to the super rich = subsidizing the rich at the expense of healthcare, education and food, housing, medicare, medicaid for those who have always worked hard to keep their heads above water, people who suffer needlessly, because of the pittance zillionaires pay hourly employees. Zillionaires with several castle-like homes, who fly their private jets all over the world, who live off the blood, sweat and tears of their pittifully paid employees who suffer from a lack of affordable health care, healthy food, and decent affordable housing.
      The super rich survive on greed while ignoring employees who are in need.

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