You have a right to appeal if you think CVS Caremark:
CVS Caremark will consider your appeal thoroughly and promptly. It is important to let CVS Caremark know as soon as possible that you wish to file an appeal. We accept request for a redetermination in any format. If you wish to file a regular appeal (also called a “standard appeal”), you may complete a Request for Redetermination of Medicare Prescription Drug Denial Form and send your request within sixty (60) days from the date of the notice of coverage determination from CVS Caremark to:
CVS Caremark Part D Services
P.O. Box 52000
Phoenix, AZ 85072-2000
To request a fast appeal, you may call Participant Services at 1-855-675-7630 TTY (711), 24 hours a day, 7 days a week.
If you are concerned about the quality of care you have received (for example, you believe our pharmacist provided you with the incorrect dose of a prescription), you may also file a complaint with Livanta, at 1-866-815-5440 (TTY 1-866-868-2289), Monday – Friday from 8:30am to 4:30pm, the State’s Quality Improvement Organizations, or QIO, which is a group of doctors and health professionals who monitor the quality of care given to Medicare beneficiaries. The QIO review process is designed to help stop any improper medical practices.