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If your patient’s medication is not listed, you can ask us to make a medication exception to our coverage rules if they are a member of one of our plans that offer prescription drug coverage. 

Medication Exception Form

If your patient was denied your request for coverage of (or payment for) a prescription drug, you have the right to ask us for a redetermination (appeal) of our decision. You have 60 days from the date of our Notice of Denial of Medicare Prescription Drug Coverage to ask us for a redetermination.

Medication Redetermination Form