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Whether you are a Medicare member or receive insurance through your employer, you have the right to ask for an appeal, file a grievance, or appoint a representative.
If you have received an unfavorable Part D coverage redetermination, you can ask for a redetermination (appeal).
If you have received an unfavorable Part C determination, you can ask for a reconsideration (appeal).
If you believe that waiting for a decision under the standard time frame could seriously jeopardize the life or health of the member, you may request an expedited appeal.
If you are dissatisfied with any aspect of your healthcare plan, Customer Care, your provider or treatment facility, you can submit a grievance.
You have the right to appoint a representative to act on your behalf.
If you receive insurance through your employer, visit this page to learn how to file a grievance or appeal and seek a representative.
Learn more about plans through answers to frequently asked questions.
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