Enter the Drug Identification Number (DIN) or Drug Name of the prescription medication you are looking to confirm.
Should the prescription drug you are searching for not be covered by the plan, you may be eligible to complete a Drug Exception Request.
In the event that the drugs available on the Formulary are not effective in treating the condition, an exception process is in place. To be eligible for an exception, you must have tried one alternative drug that is eligible on the Formulary.
An exception drug request form is available below or from your Benefits Plan Office and must be completed by your physician. Completed forms may be returned to your Benefits Plan Office, can be faxed directly to the insurance company, or sent via email to firstname.lastname@example.org.
Request for Coverage of Exception Status Drug form
Your drug plan may have certain exclusions, regardless if showing eligible under the prescription search tool. Please refer to the exclusions
section for further details.