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Tier Exception Form DOCX
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People also ask
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How do I get a Tier Exception approved CVS?
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 a tier exception letter?
For tiering exception requests, you or your doctor must show that drugs for treatment of your condition that are on lower tiers are ineffective or dangerous for you.
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How to write an exception letter?
A tiering exception request letter can help make medication more affordable for patients covered through Medicaid or TRICARE who may not be eligible to participate in savings programs but need assistance covering costs.
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How do I request a tier exception?
Once you have prior authorization approval, and before you fill the prescription at the pharmacy, speak to your doctor about submitting a request for a tier exception, and confirm that there is no other medication from your formulary that makes sense for your situation.
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What is a tier exception form?
A tiering exception request letter can help make medication more affordable for patients covered through Medicaid or TRICARE who may not be eligible to participate in savings programs but need assistance covering costs.
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How to write a tier exception letter?
The reason I am requesting a tiering exception is because the cost associated with [product] assigned tier would present a financial burden to [patient's name]. Furthermore, it prevents my patient from utilizing a medication that will help treat the [condition].
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How to get tier exception approved?
Call your insurance company and ask them if they have a tier exception process? Ask them if they have a form your medical provider can complete and submit on your behalf.
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