2026 Medicare Part D step therapy criteria
A Priority Health Medicare Part D step therapy criteria list specifying prerequisite drug trials or alternatives required before coverage of listed outpatient prescription drugs (multiple products with drug-specific prior-try requirements). Applies to Medicare Part D plans covered by Priority Health.
Document lists 2026 Medicare Part D step therapy criteria with drug-specific prerequisite requirements and an alphabetical index.
Summary of changes and scope
This bulletin summarizes Priority Health's Medicare Part D step therapy (prior trial) policy for 2026: a drug-specific list of outpatient prescription products that require documented prior trials or specified alternative agents before coverage. Policy number: ID: 26328, Version 15. Status: CURRENT. Changes: Last updated June 2026 (see document-level changes list for the single change note).
Step therapy prerequisite criteria (drug-specific)
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