When can I file a grievance?

If you are dissatisfied with any aspect of your healthcare plan, Customer Care, your provider or treatment facility, you can submit a grievance at any time. Grievances do not include claims or service denials, as those are classified as appeals. You can use the Appeal, Complaint or Grievance Form, PDF opens in new window to appeal.

Who can submit a grievance request?

You (member) or a person you appoint. Refer to the How to appoint a representative, opens in new window section for additional information.

How can I submit a grievance request?

Online request for appeals, complaints and grievances

Fax or mail the form

Download a copy of the following form and fax or mail it to Humana:

Appeal, Complaint or Grievance Form – English, PDF opens in new window

Fax number:

1-855-251-7594

Mailing address:

Humana Grievances and Appeals
P.O. Box 14165
Lexington, KY 40512-4165

Puerto Rico members:

Use the following form and fax and/or mailing address:

Appeal, Complaint or Grievance Form – English, PDF opens in new window

Appeal, Complaint or Grievance Form – Spanish, PDF opens in new window

Fax number:

1-800-595-0462

Mailing address:

Humana Puerto Rico
Grievances and Appeals Unit
P.O. Box 191920
San Juan, PR 00919-1920

Call the number on the back of your ID card

You can also submit a grievance, get help filling out the form or check the status of a previously filed grievance by calling Customer Care.

Call Customer Care toll-free at the number on the back of your member ID card. If you use a TTY, call 711. Puerto Rico members call 1-866-773-5959.

  • Our hours are Monday – Friday, 8 a.m. – 8 p.m.

Multi-language interpreter services, PDF opens in new window

To obtain information on an aggregate number of Medicare grievances, appeals and exceptions filed with the Plan, please call the number on the back of your ID card.

After we receive the request, Humana will make a decision and send written notice within thirty (30) calendar days.

You may submit feedback online directly to the Centers for Medicare & Medicaid Services. Fill out the Medicare Complaint Form with the information and concern. If your complaint involves a sales agent, please include the name of the sales agent when filing your complaint, if available.