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’re unhappy with some aspect of your coverage, you can file a grievance or appeal and seek a representative to act on your behalf.
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