US Medical Term · insurance
Step Therapy
Terapia escalonada
Also: Terapia por pasos (regional variant)
In 9 languages
| Language | Term |
|---|---|
| English | Step Therapy |
| Spanish (Español) | Terapia escalonada |
| Chinese (中文) | 階梯療法 |
| Korean (한국어) | 단계적 치료 |
| Vietnamese (Tiếng Việt) | Liệu pháp từng bước |
| Filipino (Tagalog) | Step therapy |
| Portuguese (Português) | Terapia escalonada |
| Thai (ภาษาไทย) | การรักษาแบบขั้นบันได |
| Japanese (日本語) | ステップ療法 |
What it means
Step therapy, also called fail-first protocol, is an insurance cost-control practice requiring patients to try less expensive or generic medications or treatments before the insurer will cover a more costly or brand-name option. For example, your plan may require you to try and fail on two generic drugs before approving a brand-name biologic. If the first-step treatment does not work or causes side effects, you can request to move to the next step. Your doctor can request a step therapy exception if the required first-step treatment is medically inappropriate for you. Many states have laws protecting patients from unreasonable step therapy requirements.
How to say it
Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:
My doctor prescribed a medication, but my plan requires step therapy — how do I request an exception?
Mi médico recetó un medicamento, pero mi plan requiere terapia escalonada — ¿cómo solicito una excepción?
I already tried the first-step medication and it did not work — can I get an exception?
Ya probé el medicamento del primer paso y no funcionó — ¿puedo obtener una excepción?
Please send me the step therapy criteria for this drug.
Por favor envíenme los criterios de terapia escalonada para este medicamento.
Where you'll see it
Related terms
Sources
Last reviewed: September 2026