Drug exception planner
Find the right request for a drug denial: formulary exception, step therapy exception, tier or quantity exception.
- Private: nothing leaves this tab
- General information, not legal advice
What it asks, and what it is not
What it asks. Why the drug was refused, what kind of coverage pays for it, whether you hold a written denial, and whether you have started the drug or are about to run out.
Everything you type stays in this browser tab. Nothing is sent anywhere, and no account is needed.
What it is not. It points you to the right kind of request. Your prescriber has to supply the medical reasons.
Answer the questions
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- Private: nothing leaves this tab
- General information, not legal advice
What it asks, and what it is not
What it asks. Why the drug was refused, what kind of coverage pays for it, whether you hold a written denial, and whether you have started the drug or are about to run out.
Everything you type stays in this browser tab. Nothing is sent anywhere, and no account is needed.
What it is not. It points you to the right kind of request. Your prescriber has to supply the medical reasons.
Related guides and checklists
- Guide
Drug not covered: formulary exceptions
How to ask your plan to cover a drug that is not on its formulary. See who supplies the medical reasons and the Medicare drug plan deadlines.
- Guide
Quantity limits, tier exceptions and forced switches
What to do when your plan limits how much of a drug you can get, charges a high tier price, or tells you to switch drugs. Also what Medicare drug plans must do.
- Guide
Step therapy exceptions
How to ask your plan to skip the "try this drug first" rule. See what a step therapy exception request must show, and where state rules and Medicare drug plan deadlines fit.