Coverage Determinations, Appeals, and Grievances

You have a right to make a complaint if you have concerns or problems with any part of your care as a UCare member. The Medicare program has helped set the rules about what you need to do to make a complaint about Part D services or benefits and what UCare is required to do when we receive a complaint. A complaint will be handled as a grievance, coverage determination, or an appeal, depending on what the complaint is about. Click on the buttons on the right side of your screen to get more information about coverage determinations, appeals, and grievances.

Questions?

Call UCare Customer Services at the phone numbers below if you:

• Have questions about coverage determinations, appeals, or grievances.
• Want to get an aggregate number of UCare grievances, appeals, and exceptions.
• Have questions about the status of a coverage determination request.

UCare for Seniors Customer Services: 612-676-3600 or
1-877-523-1515 (toll free), 24 hours a day, seven days a week.

UCare’s Minnesota Senior Health Options (MSHO) Customer Services: 612-676-6868 or 1-866-280-7202 (toll free), 8 a.m. to 8 p.m., seven days a week.

TTY: 612-676-6810 or 1-800-688-2534 (toll free).

If you have questions about the status of an appeal or grievance request, please call UCare Member Complaints, Appeals, and Grievances at 612-676-6841 or 1-877-523-1517 (toll free). If you are hearing impaired, call 612-676-6810 or 1-800-688-2534 (toll free).

Get more information

If you are a UCare for Seniors member and want more information about coverage determinations, appeals, and grievances, refer to your Evidence of Coverage (EOC) below:

UCare for Seniors Value EOC (PDF) See Chapter 7.

UCare for Seniors Value Plus/Classic EOC (PDF) See Chapter 9.

UCare for Seniors Standard D EOC (PDF) See Chapter 9.

If you are a UCare’s MSHO member and want more information about coverage determinations, appeals, and grievances, refer to your Evidence of Coverage (EOC) below:

UCare’s MSHO EOC (PDF) See Chapter 9.

Coverage Determinations, Appeals, and Grievances

You have a right to make a complaint if you have concerns or problems with any part of your care as a UCare member. The Medicare program has helped set the rules about what you need to do to make a complaint about Part D services or benefits and what UCare is required to do when we receive a complaint. A complaint will be handled as a grievance, coverage determination, or an appeal, depending on what the complaint is about. Click on the buttons on the right side of your screen to get more information about coverage determinations, appeals, and grievances.

Questions?

Call UCare Customer Services at the phone numbers below from 8 a.m. to 8 p.m., seven days a week, if you:

• Have questions about coverage determinations, appeals, or grievances.
• Want to get an aggregate number of UCare grievances, appeals, and exceptions.
• Have questions about the status of a coverage determination request.

UCare for Seniors Customer Services: 612-676-3600 or 1-877-523-1515 (toll free).

TTY: 612-676-6810 or 1-800-688-2534 (toll free).

If you have questions about the status of an appeal or grievance request, please call UCare Member Complaints, Appeals, and Grievances at 612-676-6841 or 1-877-523-1517 (toll free). If you are hearing impaired, call 612-676-6810 or 1-800-688-2534 (toll free).

Get more information

If you are a UCare for Seniors member and want more information about coverage determinations, appeals, and grievances, refer to your Evidence of Coverage (EOC) below:

UCare for Seniors Value EOC (PDF) See Chapter 7.

UCare for Seniors Value Plus/Classic EOC (PDF) See Chapter 9.