Request for Medicare prescription drug coverage determination
How to contact us when you are asking for a coverage decision about your Part D prescription drugs:
Submit online or fill out the paper form (PDF).
Fax urgent: 1-855-446-7893
Fax standard: 1-855-446-7892
Call: Contact Member Services.
Attn: Pharmacy Prior Authorization/Member Prescription Coverage Determination
200 Stevens Drive
Philadelphia, PA 19113