What’s important to you is important to us. If you are ever dissatisfied with any aspect of our plans, please contact us and let us know. We have a process in place to make sure we resolve your concerns as quickly as possible.
YOUR FIRST STEP
If you have a complaint or a problem, contact us right away. We may be able to resolve your complaint or approve a request over the phone.
You may also refer to Chapter 7 or Chapter 9 in your Evidence of Coverage, titled: What to do if you have a problem or complaint (coverage decisions, appeals, complaints). If you prefer to contact Medicare, you can call 1-800-Medicare (1-800-633-4227) or TTY/TDD 1-877-486-2048, 24 hours a day, 7 days a week. Or you can file a complaint at the Medicare websiteYou are now leaving HAP's Medicare-approved website . The Office of the Medicare Ombudsman (OMO)You are now leaving HAP's Medicare-approved website can help you.
You have the right to make a complaint if you have concerns or problems related to your coverage or care. An example of a grievance would be dissatisfaction with waiting times when you fill a prescription, the way your plan pharmacist or others behave or the cleanliness of a plan pharmacy.
After we receive your request for a service or medication, we will make what's called an "initial decision," and explain whether we will provide the prescription drug or medical service you are requesting or pay for one already received.
If we deny your request for a coverage decision or payment you have the right to request an appeal. To appeal a denial of a medical service, you must submit your request in writing. You may do this by sending a letter requesting an appeal and include information why you feel our decision should change. If we deny your request for a medication or payment of a medication that you have already received, you may also request an appeal. To make that request, use this form: Request for Redetermination of Part D Drug Denial (requires Adobe ReaderYou are now leaving HAP's Medicare-approved website).
Appointing a Representative
To obtain an aggregate number of grievances, appeals and exceptions filed with the plan, contact us.
You have the right to appoint someone to act on your behalf and request a coverage determination.