Introduction
If you have questions, concerns, or problems about your covered services or the care you receive, please let us know right away. Federal law guarantees your right to complain if you have concerns or problems with any part of your medical care as a plan member. You can also ask to see how many complaints we get.
The Medicare program has set the rules about what you need to do to make a complaint, and what we must do when we get your complaint. If you make a complaint, we must be fair in how we handle it. You cannot be disenrolled from Passport Advantage or penalized in any way if you make a complaint.
What to do if you have a complaint
If you have a complaint, the first thing you should do is call Member Services. We will try to resolve any complaint that you might have over the phone. If you request a written response to your phone complaint, we will respond in writing to you.
If we cannot resolve your complaint over the phone, we have a formal procedure to review your complaints. To make a complaint:
- Call us 7 days of the week between 8 a.m. and 9 p.m. at 1-800-578-0603, then press 1. TTY users please call 1-888-857-4816.
- Fax us your complaint at 1-888-289-3008.
- Write to us at:
Passport Advantage Member Appeals
P. O. Box 13652
Philadelphia, PA 19101-3652
You can have someone help you make a complaint. Send us this form to let us know who will help you: Appointment of Representative Form.
You can learn more about grievances by reading Section 10 in our Evidence of Coverage. You can learn more about appeals for prescription drugs by reading Section 12 in our Evidence of Coverage.
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