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Coverage Information

What to do if you have a problem or concern:

Please call us first.

Your health and satisfaction are important to us. When you have a problem or concern, please call us. We will work with you to try to find a satisfactory solution to your problem. 

You have rights as a member of our plan and as someone who is getting Medicare. We pledge to honor your rights, to take your problems and concerns seriously, and to treat you with fairness and respect. However, if for some reason your issue isn’t settled to your satisfaction, there are formal steps you can take.

Please read our Evidence of Coverage for more information. The PDF is located on your Plan Materials page. 

There are two types of formal processes for handling problems and concerns:
  • If your problem is about benefits or coverage, you need to use the process for Coverage Decisions and Appeals which can be found on the corresponding page which is available in the drop-down button on this page.
  • If your problem is not about benefits or coverage, you need to skip to the Grievances page which is available in the drop-down button on this page

Both of these processes have been approved by Medicare. To ensure fairness and prompt handling of your problems, each process has a set of rules, procedures and deadlines that must be followed by us and by you.

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Y0070_WCM_06390E CMS Approved 10/23/2017 Last Updated On: 10/1/2017