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How do I request a formulary copay exception (specific to Select Drug Program members only)?

April 26, 2017copay drug exception formulary members program request select

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How do I request a formulary copay exception (specific to Select Drug Program members only)?

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Physicians may request coverage of a non-formulary medication at the formulary copayment when all formulary alternatives have been exhausted or when there are contraindications to using the formulary alternatives. The physician should complete the Non-Formulary Exception Request, providing detail to support use of the non-formulary medication, and fax the request to 215-241-3073 or 1-888-671-5285.