Health Net
Steglatro (ertugliflozin)
Hormones : Drugs for Diabetes
  • Diabetes Type 2: SGLT2 + Combo:
    Age Requirement: >= 18
    Duration: 1 plan year
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Reauthorization Required: Yes
    Duration of Reauthorization: = 1 plan year
    Supporting Documentation Requirements: 1 of Chart Notes;Lab Tests;Medication History

  • Prior Authorization: Diabetes Type 2: SGLT2 + Combo:
    Documented Diagnosis: Yes
    Medical Test Required: Yes
    Age Requirement: >= 18
    Duration: 1 plan year
    Reauthorization Required: Yes

  • Step Therapy: Chronic Kidney Disease:
    ST Single Brand

    Diabetes Type 2: SGLT2 + Combo:
    ST Single Generic

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