2022 Part D Appeal Request
Request for Redetermination of Medicare Prescription Drug Denial
Because HealthTeam Advantage denied your request for coverage of (or payment for) a prescription drug, you have the right to ask us for a redetermination (appeal) of our decision. You have 60 days from the date of our Notice of Denial of Medicare Prescription Drug Coverage to ask us for a redetermination.
Expedited appeal requests can be made by phone:
- HealthTeam Advantage Plan I and Plan II PPO members call Elixir at 1-844-846-8003
- HealthTeam Advantage Diabetes & Heart Care HMO members call Elixir at 1-833-684-7256
Who May Make a Request: Your prescriber may ask us for an appeal on your behalf. If you want another individual (such as a family member or friend) to request an appeal for you, that individual must be your representative. Contact us to learn how to name a representative.