Appeal Rights
Request for Redetermination of Medicare Prescription Drug Denial
If we deny 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.
Appeal Process
To appeal a decision, please follow these steps:
- Download the Request for Redetermination of Medicare Prescription Drug Denial form
- Complete the form and either mail or fax it to Prominence Health Plan at:
Prominence Health Plan
1510 Meadow Wood Ln.
Reno, NV 89502
Fax Number: 775-770-9004 — standard and expedited appeals
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.
If you have questions, please call 855-969-5882 (TTY: 711).
Enroll in a Prominence Health Plan Medicare Advantage plan.
The comprehensive provider network offers members excellent access to quality medical services.
