A tiering exception is a request asking your plan to charge you the cost-sharing of a lower formulary tier for a drug that normally sits on a more expensive tier. It is typically granted when lower-tier alternatives would not be as safe or effective for you. Your prescriber usually needs to support the request with a medical explanation.
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Disclaimer: This definition is provided for general educational purposes only and is not legal, medical, or insurance advice. Insurance rules, deadlines, and terminology vary by plan, state, and over time. Always check your own plan documents and confirm current details before acting.