Grievances & Appeals
Grievances & Appeals 2025
Call Member Services at 1-833-866-6559 (TTY: 1-800-955-8770)
Hours: 8 a.m. to 8 p.m. local time, seven days a week, from October 1 through March 31, except for Thanksgiving and Christmas. From April 1 through September 30, we are open 8 a.m. to 8 p.m. local time, Monday through Friday, except for major holidays.
Late Enrollment Penalty (LEP) Appeals
Medicare beneficiaries may incur a late enrollment penalty (LEP) if there is a continuous period of 63 days or more at any time after the end of the individual's Part D initial enrollment period during which the individual was eligible to enroll but was not enrolled in a Medicare Part D plan and was not covered under any creditable prescription drug coverage.
Medicare Advantage (Part C) and Prescription Drug (Part D): Appeals & Grievances
You have the right to file a grievance or submit an appeal and ask us to review your coverage determination.
- How to File an Appeal or Grievance
- Part D Coverage Determination Form
- Part D Coverage Redetermination Form
Rights and Responsibilities upon Disenrollment
You have the right to ask us to reconsider this decision. You can ask us to reconsider by filing a grievance with us. You can look in your “Evidence of Coverage” for information about how to file a grievance, contact us at 1-833-866-6559 (TTY users: 1-800-955-8770) or click here for more information. Upon request, Medicare Advantage and Prescription Drug plans are required to disclose grievance and appeals data to enrollees in accordance with regulatory requirements. You can contact us at 1-833-866-6559 (TTY users should call 1-800-955-8770) to request this information.
Appoint a Representative
You can appoint someone to act on your behalf. Go to Medicare.gov to download the Appointment of Representative form.
Send a complaint to Medicare
You can file a complaint about your Medicare health or drug plan. Go to Medicare.gov to file a Medicare Complaint Form.
Go to Medicare.gov