At Preferred Care Partners, we provide our members with an extensive formulary. There may be instances when you need a drug that is not covered in our plan, or the restrictions on a drug may not meet your needs. To ensure you receive optimum care, we provide you with the following options when your prescription is not covered:
- Contact Member Services to confirm that the medication is not covered.
- Ask your doctor if you can switch to another drug that we cover.
- Contact Member Services if you would like to provide your doctor with a list of covered drugs used to treat similar medical conditions.
- Ask us to make an exception to cover your drug using the Coverage Determination Request Form.
- Pay out-of-pocket for the drug and then request an exception using the Coverage Determination Request Form.