Coverage Redetermination

Because we, Aetna Better Health Premier Plan MMAI, 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.

Fill out the Coverage ReDetermination Form online. Alternatively, you can download or request a paper copy of this form and send it us by mail or fax.

Mail
Aetna Better Health Premier Plan MMAI                
Attn: Part D Appeals, Pharmacy Department                              
PO Box 818001
Cleveland, OH 44181-8001

Fax
Attn. Redeterminations
1-855-365-8109    

Expedited appeal requests can be made by phone at 1-866-600-2139 (TTY: 711), 24 hours a day, 7 days a week. The call is free.

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.