Pharmacy Appeals

You may file an appealThe action you take if you don’t agree with a decision made about your benefit. 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
• Pre-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.