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Is there an appeal process that allows enrollees to obtain benefits for a drug excluded from the Empire Plan Flexible Formulary?

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Is there an appeal process that allows enrollees to obtain benefits for a drug excluded from the Empire Plan Flexible Formulary?

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No. Drug exclusions and placements of medications on the Empire Plan Flexible Formulary are a component of your Benefit Plan Design and can not be appealed. Benefits will not be provided for a drug excluded from the Empire Plan Flexible Formulary regardless of the reason it is being prescribed.

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