General Overview--How To File a Grievance or Appeal

You have the right to file a complaint/grievance with the plan. You must file your complaint/grievance within 60 calendar days of the date of the event that led to your complaint/grievance. Some examples of why you might file a complaint/grievance include the following…read full article 

What if my plan won’t cover a drug I need?

If your pharmacist tells you that your Medicare drug plan won’t cover a drug you think should be covered, or it will cover the drug at a higher cost than you think you are required to pay, you have the right to the following…read full article 

How to Appeal

1. Appeal through your plan-The first level of appeal is called a “redetermination.” The plan’s initial denial notice will explain how to file this appeal. You must request this appeal within 60calendar days from the date of the coverage determination notice. You or your appointed representative must file a written standard request…read full article