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Get Cigna Step Therapy Exception Form

CIGNA Medicare Part D Prescription Drug Plan Pharmacy Management Phone 800 558-9363 Fax 866 249-1172 P. O. Box 29030 Phoenix AZ 85038-9030 - Medication Coverage Determination Form Please Note This form is intended for prescriber use to request an Exception Prior Authorization or Step Therapy Exception for CIGNATURE Rx and CIGNA HealthCare for Seniors plan members. Failure to complete this form in its entirety may result in an adverse determinati.

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