You may file a pharmacy appeal if you disagree with a decision on your pharmacy benefit. This includes if the following is denied:
- Your pharmacy claim,
- Your request for medical necessity, or
- Prior authorization
Your appeal must:
- Be in writing and signed,
- State specifically why you disagree,
- Include a copy of the claim decision, and
- Be postmarked or received by Express Scripts within a deadline of 90 calendar days from the date of the decision to:
Express Scripts, Inc.
P.O. Box 60903
Phoenix, AZ 85082-0903
You may submit more documentation to support your appeal. If you are still waiting for more documentation before the deadline, don’t miss the deadline. Submit your appeal with a statement that more documentation will be submitted at a later date (include expected date).
When we receive your request, we will review the decisions related to your entire course of treatment.