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).
Medicare
Part C coverage reconsideration
If you have received an unfavorable Part C determination, you can ask for a reconsideration (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.
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 to act on your behalf.