Automated Step Therapy
Paperless Prior Authorization for Prescription Drugs
What will you get?
- Cost-savings for you and your family
- Eligible claims automatically approved and paid
- A seamless pharmacy experience by following the steps
Step 1: Start with a first-step drug
Step 2: If needed, you can qualify for a second-step drug
You may have been initially prescribed a second step drug.
If you have not tried any first-step therapy options, work with your health care provider to switch your prescription to a first-step drug to try first.
It's easy to switch to a first-step drug. A pharmacist can support you by completing a therapeutic substitution. You don’t have to return to the health professional who provided the prescription or leave the pharmacy empty-handed.
Some members may qualify for a second-step alternative treatment but may need to take a few additional steps:
Do you have proof that you’ve taken the first-step drug, but we don’t have your history on our system?
Do you have a health-related reason for needing to start on a second-step therapy without initially trying a first-step option?
Check the summary of benefits in your booklet (often available when you log in to your account) for Automated Step Therapy or if you do a drug search on the Mobile app message “Preferred or Step Drug must be submitted” will show.
Prior Authorization is a pre-approval process that determines reimbursement eligibility for particular benefits.
No, once the drug is in your history it automatically remains eligible provided you have continued to take the second step or a first step drug over in the past two years.
Drug manufacturers use a wide range of criterion in setting the prices for individual drugs, and a higher cost is no assurance of better outcomes. Whether it is first- or second- step, all drugs have been fully reviewed for safety and effectiveness by Health Canada.
If you have questions on Automated Step Therapy you can reach us at 1-877-849-8509 from Monday to Friday between 8.00 AM - 5.00 PM local time.
*Automated Step Therapy was developed in line with provincial government regulations