Exception and Appeals Process Information

Know the process to ask for a change

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.

Medicare

Part D coverage redetermination

If you have received an unfavorable Part D coverage redetermination, you can ask for a redetermination (appeal).

Part D: request an appeal

Medicare

Part C coverage reconsideration

If you have received an unfavorable Part C determination, you can ask for a reconsideration (appeal).

Part C: request an appeal

Medicare

Expedited appeals

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.

File an expedited appeal

Medicare