Prescription Drug Coverage

Medicare Part B Prescription Drugs

Medicare Part B covers outpatient prescription drugs and biologicals under certain conditions; for example, drugs provided as part of a physicians' service, and drugs furnished for use with covered durable medical equipment.

Many Medicare Part B drugs are administered by infusion or injection in physician offices, hospital outpatient departments, or other clinical settings under the supervision of healthcare professionals. Generally, Part B covers only drugs that are not usually self-administered.

Medicare Part B Step Therapy

Applies to members new to therapy

In some cases, we require you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, we may not cover Drug B unless you try Drug A first. If Drug A does not work for you, we will then cover Drug B. The list of preferred products should be used first.

2026 Preferred Drug List

Medicare Part B Prior Authorization

Certain medical drugs require prior authorization to ensure safe and effective use. The prior authorization criteria are consistent with Medicare requirements defined in CMS National Coverage Determinations (NCDs) and relevant Local Coverage Determinations (LCDs).

2026 Prior Authorization Drug List

Medicare Part B Drug Update

From time to time, adjustments are made to our prior authorization list—the list of drugs that require authorization from your doctor before they're prescribed. This update provides information on recent changes.

Part B Drug Update

Medicare Part B Medical Policies

Our medical policy and drug guidelines.

View Policies