CVS Caremark - Appeals Department 2026

1. Click ‘Get Form’ to open the CVS Caremark - Appeals Department form in the editor.
2. Begin by filling out the Enrollee’s Information section. Enter the enrollee's name, date of birth, address, city, state, zip code, phone number, and member ID number.
3. If someone other than the enrollee or prescriber is making the request, complete the Requestor’s Information section with their name, relationship to the enrollee, address, city, state, zip code, and phone number.
4. In the 'Name of prescription drug' field, specify the drug you are requesting along with its strength and quantity per month.
5. Select the appropriate type of coverage determination request by checking one or more boxes that apply to your situation.
6. If applicable, provide additional information in the designated section and attach any supporting documents as needed.
7. Sign and date the form at the bottom before submitting it via mail or fax to ensure your request is processed.

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