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Fep Blue Tier Exception Form
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People also ask
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How do I request a tier exception?
Ask your plan how to send your tiering exception request. It is usually helpful to include a letter of support from your prescribing physician. This letter should explain why similar drugs on the plan's formulary at lower tiers are ineffective or harmful for you.
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How do I request a tier exception on Caremark?
Tier Exception There should be documentation to show that the lower-cost sharing alternative drug(s) were not effective. To request a tier exception: Fax a Tier Exception Form to CVS Caremark at 1-888-487-9257. Call CVS Caremark at 1-800-294-5979.
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What is the payer ID for the Federal Employee Program?
Federal Empoyee Program Electronic Payor ID: 84980 Providers must submit a complete claim for any services provided to a member.
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What is the maximum allowable charge for FepBlue?
$12,000 Self Plus One / $12,000 Self and Family; for Non-preferred providers $8,000 Self Only / $16,000 Self Plus One / $16,000 Self and Family The out-of-pocket limit, or catastrophic maximum, is the most you could pay in a year for covered services.
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