An “exception” is a type of coverage determination. You, your doctor, or your appointed representative may ask for an exception to our Part D coverage rules in a number of
Please situations such as:
• Asking the Plan to cover your drug even if it is not on the formulary.
• Asking the Plan to waive coverage restrictions or limits on your drug.
• Asking the Plan for a non-preferred Part D drug at the preferred cost sharing level. This is a request for a “tiering exception.”
Last updated: 09/01/2015
Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal.