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 drug

Part D coverage appeal

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


Part C coverage reconsideration

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


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.


Grievances and appeals

If you are dissatisfied with any aspect of your Medicare plan, Customer Care, your provider or treatment facility, you can submit a grievance and appeal.


Appoint a representative

You have the right to appoint a representative to act on your behalf.

Medical, drug and dental

Exceptions and appeals

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

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