Formulary Exception Process. We have a formulary exception process that allows you to request coverage for a prescription drug that is not in our formulary. This process is available when (i) the requested prescription drug is NOT a generic equivalent of a formulary drug and your doctor determines that a formulary drug is not effective for you; or (ii) the requested non-formulary prescription drug has a generic equivalent and you have a clinical reason why you are unable to take the generic prescription drug (such as, you have had an adverse reaction to the generic medication). The process for obtaining an exception is described below.
Appears in 3 contracts
Sources: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement