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Pharmacy (Part D) 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 established 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 the nature of the complaint. Click the links on the right side of this page to get more information about coverage determinations, appeals and grievances.

Get more information
If you want more information about coverage determinations, filing an appeal or grievance, or appointing a representative, please use the links in the upper right column of this page.

Instructions for Appointing a Representative (PDF)

Request for Redetermination of Medicare Prescription Drug Denial Form (PDF)

Physician Prior Authorization Forms

Part C Organizational Determinations, Appeal and Grievances

Coverage Determinations
Get more information about coverage determinations.

Appeals
Learn more about appeals.

Grievances
Find out more about grievance.

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.

You can also file a complaint with Medicare using the Medicare Complaint Form.

Questions?

Call UCare Customer Services 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.

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


UCare Medicare, UCare SeniorSelect Customer Service

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UCare Connect + Medicare Customer Service

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