Effective for fill dates on or after Jan. 1, 2025, the following coverage requirements will apply to the Part B Step Therapy program for Tufts Medicare Preferred, Tufts Health Plan Senior Care Options, and Tufts Health One Care:
- The following new categories will be added to the Part B Step Therapy program:
- Pemetrexed
- The following existing categories will be updated:
- Acromegaly
- Antiemetics
- Retinal Disorders
In addition to the changes listed above, coverage criteria will be updated to be drug class specific. For more information, refer to our updated Medicare Part B Step Therapy Medical Necessity Guidelines.