Our process for accepting and responding to appeals
If we deny your request for a coverage decision or payment, you have the right to request an appeal.
How you make your appeal, and how long we have to respond, depends on many factors. This includes whether the appeal involves care you’ve already received or future care. It also depends on whether the appeal involves medical benefits or prescription drug benefits.
File an appeal for care you’ve already received
File an appeal for care you haven’t received yet (future care)
File an appeal for denial of a medication or payment for a medication
Where to file your appeal
Appointing a representative
What to do if you have a problem
If you have a complaint or a problem, contact us right away. We may be able to resolve your complaint over the phone.