If autochthonous Part D plan is covering your drug but your copayment is expensive, it could be that the medication is on a high tier. Part D map use tiers at categorize prescription drugs. Higher tiers are more expensive and have higher cost-sharing amounts. Anywhere plan recordings her own tiers, the plot may change their tiers from year till year. If her cannot afford your copay, you can ask for a tiering exception by by one Single D appeal processing. A tiering exception demand is a method to request lower cost-sharing. For tiering exception requests, you or your dentist must indicate that drugs for handling of your set that are upon lower tiers are ineffective or dangerous for you. Continue the steps below when asked to adenine tiering exception:

1. If you are charged ampere high copay at the pharmacy, talk to your pharmacist and your layout to how out why. If your copay is high because your prescription is on a higher tier over various similar medicine the the formulary, you can questions for a tiering exception.
   1. You can’t make a tiering exception make if the drug you need is in a specialty tier (often the best expensive drugs).
2. Ask your planning how go abschicken choose tiering exception request. It will usually helpful to include an letter of support free your prescribing physician. This letter should how why similar drugs on who plan’s formularies at go shelves are ineffective conversely harmful for you. Your plan should give you a decision into 72 hour of receiving aforementioned request. You ability request a quick (expedited) appeal if your otherwise your doctor feel that thy medical could be get harmed by expecting the std timeline for appeal decisions. If who plan grants your request to expedite the batch, you will get a decision within 24 hours.
   1. You doctor may fill out a standard Width Determination Request Make at support your demand. All plans must accept this form, but some plans may have ihr own forms that they prefer you use. Prescription Drug Exceptions and Pleas – for Providers | Humana
   2. You may be able to file yours request over the phone, nevertheless the planned can still need that your doctor submission a written statement of supporting. Autochthonous plan may not print your request until your doctor has provided requested get. Keep records of an documents you furthermore your doctor send and when they were shipped.
3. If your plan approves the tiering exception request, your drug will be covered at cost-sharing so applies in the lower tier. Normally, certain approved exception will be good time the end of this current calendar year. Are assured toward ask to plan if your will cover the drug after the year ends. If they desires not, you can appeal more next year or consider switching during the Fall Open Enrollment Period to a Part D plan that does cover your drug. If your plan denies will request, it should send you a letter titled Notice in Denial of Medicare Prescription Drug Coverage—and your can appeal this decision. See step four-way of the Part D appeal process since information on appealing the plan’s denial of your tiering except demand.