To appeal an adverse coverage determination on Medicare Part D benefits, you can use our Redetermination Request Form. This form, along with any documentation to support your appeal, can be submitted by mail, fax or phone to:
Prime Therapeutics, LLC
Attention: Medicare Appeals Department
1305 Corporate Center Drive
Building N10
Eagan, MN 55121
Fax: 800.693.6703
Phone: 855.457.1352 (TTY 711)
If your health requires a quick response, you should ask us to make a "fast appeal", also known as an "expedited redetermination". You, your doctor, or your representative can request a "fast appeal" by contacting us at the address, fax, or phone number listed above.
Secure Email Request
You may also ask for a redetermination by making a secure email request through MyPrime.com.
Be sure to select Vibra Health Plan and your plan (Essential Coverage OR Enhanced Coverage).
You must file your appeal within 60 calendar days from the date of the initial coverage determination.
To request data on the total number of grievances, appeals, and exceptions filed with Vibra Health Plan, you may contact us at 844.388.8268 (TTY 711).
