An initial coverage decision about your Part D drugs is called a “coverage determination”. To ask for a coverage decision (including an exception), you must first ask us to make a coverage decision about the drug(s) or payment you need. You, your representative, or you doctor (or other prescriber) can do this. Start by calling, writing, or faxing us to make your request. Read more in Chapter 9 of our Evidence of Coverage.

  • Call: 1-844-859-6152 or TTY/TDD 711.
    • Calls to this number are free. Hours of operation are 7 days a week from 8 a.m. to 8 p.m. Eastern Time.
  • Fax: 502-585-8340
  • Write: Passport Advantage / Attn: Member Services/ 5100 Commerce Crossings Drive / Louisville, Kentucky 40229

 

Request for Coverage Determination Form, click here.
Request for Redetermination Form, click here.

 

 

 

 

Last Modified: November 20, 2017