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This document serves as a prior authorization request form for the prescription drug Firazyr (Icatabant), outlining necessary criteria and information required from the prescribing physician and patient.
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How to fill out Caterpillar Prescription Drug Benefit

01
Obtain the Caterpillar Prescription Drug Benefit form from your HR department or online portal.
02
Fill in your personal information, including your employee ID, name, and contact details.
03
Provide information about your dependents if applicable.
04
List the medications for which you are seeking benefits, including their names and dosages.
05
Include the prescribing doctor's information, such as their name and contact details.
06
Sign the form to certify that the information provided is accurate.
07
Submit the completed form to the designated benefits office either online or in person.

Who needs Caterpillar Prescription Drug Benefit?

01
Employees of Caterpillar who are enrolled in the company’s health insurance plan and require prescription medications.
02
Dependents of Caterpillar employees who are covered under the health insurance plan can also benefit.
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Caterpillar Prescription Drug Benefit is a health insurance program that provides financial assistance for prescription medications to eligible Caterpillar employees and their dependents.
All eligible Caterpillar employees and their dependents who wish to access prescription drug benefits are required to file for the Caterpillar Prescription Drug Benefit.
To fill out the Caterpillar Prescription Drug Benefit, individuals need to complete the application form provided by Caterpillar, ensure all required information is included, and submit it to the appropriate benefits administration office as directed.
The purpose of the Caterpillar Prescription Drug Benefit is to help reduce the out-of-pocket costs for prescription medications for employees and their families, ensuring they have access to necessary medications.
The information that must be reported includes the employee's personal and contact details, dependent information, prescription details, and any other relevant medical information needed to process the benefit.
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