• Overview
• Grievances (Complaints)
  • Making a Complaint
• Problems/Concerns about Part C Medical Benefits and Coverage
  • Coverage Decisions
  • Appeal a Coverage Decision
• Problems/Concerns about the Part D Prescription Drug Benefit
  • Coverage Decision/Exceptions
  • Appeal a Coverage Decision

PROBLEMS/CONCERNS ABOUT PART C MEDICAL BENEFITS AND COVERAGE

We encourage you to let us know right away if you have questions, concerns, or problems related to:

• Requests for Part C medical care or services or payments
• If you think you are asked to leave the hospital too soon.
• If you think your skilled nursing facility (SNF), home health (HHA) or comprehensive out patient rehabilitation facility (CORF) services are ending too soon.

To file your complaint or for additional information, please contact our Member Services Department at 386-615-4022 or 1-877-615-4022. Hours of operation is 7 days a week, 8 a.m. to 8 p.m. The hearing impaired may call TRS Relay 711.

The complaint will be handled as a grievance (complaint), coverage decisions, or an appeal depending on the subject of the complaint