Prescription

Forms and resources for prescription

20 resources in this category

Prescription Exception Request Letter

Template for requesting a formulary exception when a prescribed medication is not on your plan's drug list.

Letter

Step Therapy Exception Request Letter

Letter template for bypassing step therapy requirements when first-line medications have failed or are contraindicated.

Letter

Tier Exception Request Letter

Template for requesting a lower cost-sharing tier for a medication when no generic or preferred alternative exists.

Letter

Quantity Limit Override Request Letter

Letter template for requesting an exception to prescription quantity limits based on clinical necessity.

Letter

Brand Name Medication Exception Letter

Template for requesting brand-name medication when generic versions cause adverse reactions or are therapeutically inferior.

Letter

Medicare Part D Coverage Determination Guide

Guide to requesting coverage determinations and exceptions for Medicare Part D prescription drug plans.

Guide

Medicare Part D Redetermination Appeal Guide

How to file a redetermination appeal when your Medicare Part D plan denies a medication coverage request.

Guide

Specialty Pharmacy Prior Authorization Guide

Guide to navigating specialty pharmacy prior authorization for biologic, oncology, and other high-cost medications.

Guide

Prescription Drug Denial Appeal Letter

General appeal letter template for overturning denied prescription drug coverage with supporting medical evidence.

Letter

Insulin Coverage Appeal Letter

Appeal letter template for insulin coverage denials including specific insulin type medical necessity arguments.

Letter

ADHD Medication Prior Authorization Guide

Guide to prior authorization for ADHD medications including stimulants and non-stimulant alternatives for adults and children.

Guide

Biologic Medication Appeal Guide

Comprehensive guide to appealing denials for biologic medications used in autoimmune, oncology, and rare disease treatment.

Guide

Compound Medication Coverage Appeal Letter

Appeal letter for denied compounded medication coverage when commercially available formulations are unsuitable.

Letter

Pain Medication Prior Authorization Guide

Guide to obtaining prior authorization for pain management medications including documentation of alternative treatment trials.

Guide

Oncology Drug Prior Authorization Guide

Guide to prior authorization for chemotherapy and targeted cancer therapy drugs with NCCN guideline references.

Guide

Prescription Transfer and Mail Order Guide

Guide to transferring prescriptions to preferred pharmacies or mandatory mail-order programs to reduce out-of-pocket costs.

Guide

Patient Assistance Program Application Guide

How to apply for manufacturer patient assistance programs when insurance denies coverage for expensive medications.

Guide

Copay Assistance and Accumulator Adjustment Guide

Guide to navigating copay accumulators and maximizer programs that affect out-of-pocket cost calculations for specialty drugs.

Guide

Drug Formulary Exception Worksheet

Worksheet to document clinical justification for formulary exceptions including failed medication trials and adverse reactions.

Worksheet

Prescription Coverage Comparison Worksheet

Worksheet to compare prescription drug coverage across insurance plans during open enrollment.

Worksheet
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