QUEST Integration Formulary Exception Request

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You or your provider may make a request to cover a drug that isn’t in the HMSA QUEST Integration drug formulary.

To Make A Request

Print out the form and take it to your provider to complete. After we have the completed request form, we’ll give you an answer within:

  • 72 hours, or
  • 24 hours, if your medical condition requires a decision sooner.

Ask your provider to make the request by phone, fax, or mail.

Phone: 1 (855) 220-5732 toll-free.

Fax: 1 (855) 762-5206 toll-free.

Mail:
HMSA
P.O. Box 30980
Honolulu HI 96820-9930
Attn: PA department

If you have questions about the process or want to know the status of a request, contact CVS/caremark. CVS/caremark is HMSA’s pharmacy benefits manager. Call 1 (855) 220-5732 toll-free, 24 hours a day, seven days a week. TTY users, please call 1 (800) 863-5488 toll-free.

CVS/caremark provides pharmacy benefit management services and manages HMSA’s drug formulary for HMSA’s commercial, Medicare, and HMSA QUEST Integration plans. CVS/caremark is an independent company.