ALERT! If UMP approves coverage of a Step 2 or Step 3 drug, you will pay the applicable cost-share of that drug, including the ancillary charge if it applies.

When a drug is part of the Step Therapy program, you have to try other drugs (Step 1) before UMP will cover another particular drug (Step 2). When a prescription for a step therapy drug is submitted “out of order,” meaning you haven’t first tried the Step 1 drug before submitting a prescription for a Step 2 drug, your prescription will not be covered. When this happens, your provider will need to prescribe the Step 1 drug for you. If you or your provider feel that you need the Step 2 prescription filled as originally written, your pharmacist or prescribing provider can call Washington State Rx Services at 1-888-361-1611 and request coverage. You will have to pay the entire cost of the drug if you have not tried the Step 1 drug and UMP hasn't authorized coverage before you get the Step 2 drug.

To find out if Step Therapy applies to your drug, you can check the online UMP Preferred Drug List, or call Washington State Rx Services at 1-888-361-1611.

Note: Only network pharmacies will check to see if Step Therapy applies to your prescription drug. If you get a Step Therapy drug at a non-network pharmacy, UMP might not pay any of the cost.