Authorization requirements added to select filgrastim medicines covered by Medicare Advantage plans starting Aug. 1, 2022

To help our members access affordable health care, beginning Aug. 1, 2022, members with a Medicare Advantage Prescription Drug (MAPD) plan newly starting the following medications, will require prior authorization and step therapy:

• Granix - refer to the Granix prior authorization form to request an authorization
• Neupogen - refer to the Neupogen prior authorization form to request an authorization

For specific criteria, visit the Medical Benefit Drug List on our website.

Covered alternatives

Nivestym and Zarxio are preferred medications and do not require prior authorization.

Impact to members

Medicare members with a MAPD plan that had a claim on file for Granix or Neupogen within the last 365 days are exempt from this authorization requirement. This requirement only applies to Medicare members with a MAPD plan newly starting the medication.