A requirement that you try less expensive treatments before your insurer will approve a more expensive option. Also called fail-first. Many states have laws that allow exceptions to step therapy requirements.
Pharmacy bills and specialty drug charges have specific dispute rights. Here is how to challenge a denial, a tier placement, or an incorrect charge.
Read articleStep Therapy: What It Is and How to Get an ExceptionStep therapy requires you to try cheaper drugs before your insurer covers the one your doctor prescribed. Here is how it works and how to get a step therapy exception.
Read articleWhat Is a Formulary and How Does It Affect Your Drug CostsA formulary is your insurance plan list of covered drugs organized by tier. The tier determines your copay. Here is how formularies work and how to get exceptions.
Read articleWhat to Do When Insurance Denies a ClaimInsurance denied your claim? Learn the exact steps to appeal a health insurance denial in 2026, from reading the denial letter to external independent review.
Read articleWhy Cigna Uses EviCore and What That Means for Your Prior AuthorizationCigna outsources prior authorization decisions to EviCore for many services. Here is how that process works and how to appeal an EviCore denial.
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