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Fill out bcbs formulary exception form online It's free
Use this form to request coverage of a drug that is not automatically covered under your drug plan. Provide the requested information to ensure timely assessment of your claim.
What is a formulary exception form?
Health plans have the option to change the formulary at any time, even in the middle of a plan year. If you need a medication that is not on your plan list, you can formally ask your insurer to cover the medication for you by submitting a formulary exception.
What is a coverage exception?
exception. A type of Medicare prescription drug coverage determination. A formulary exception is a drug plans decision to cover a drug thats not on its drug list or to waive a coverage rule. A tiering exception is a drug plans decision to charge a lower amount for a drug thats on its non-preferred drug tier.
What if my drug is not on the formulary?
If you need a drug that is not on your health plans formulary, you must get your plans approval or pay for the drug yourself. Your doctor should ask the plan for approval.
How long does a formulary exception last?
Normally, an approved exception will be good until the end of the current calendar year. Be sure to ask your plan if they will cover the drug after the year ends.
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It is usually helpful to include a letter of support from your prescribing physician. This letter should explain why similar drugs on the plans formulary at lower tiers are ineffective or harmful for you. Your plan must give you a decision within 72 hours of receiving the request.
What does it mean if a drug is removed from formulary?
First, understand that your health plan isnt saying you cant have the drug your healthcare provider prescribed. Instead, excluding a drug from its formulary is more like saying that it wont pay for that particular drug. You may still have it if you or someone else pays for it.
What is a formulary exception?
A formulary exception should be requested to obtain a Part D drug that is not included on a plan sponsors formulary, or to request to have a utilization management requirement waived (e.g., step therapy, prior authorization, quantity limit) for a formulary drug.
Related links
Exceptions
Sep 6, 2023 A formulary exception should be requested to obtain a Part D drug that is not included on a plan sponsors formulary, or to request to have a
Formulary Exception Form Bcbs. Web formulary exception member request form attn: Blue cross and blue shield of minnesota group purchaser. Medicare Part D
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