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How do I file a complaint about my health or drug plan?

Use the Medicare Complaint Form or follow the instructions in your plan membership materials to submit a complaint about your Medicare health or prescription drug plan.

Complaints about your health or drug plan could include:

For example, you think the customer service hours for your plan should be different.    

For example, you don’t think there are enough specialists in the plan to meet your needs.

For example, the company offering your plan is sending you materials you didn’t ask to get and aren’t related to your plan, or the plan’s notices don’t follow Medicare’s rules.

For example, the plan isn’t following the appeals process or you disagree with the plan’s decision not to grant your request for a fast appeal or fast coverage determination.

Like being given the wrong drug or being given drugs that interact in a negative way.

To file a complaint about your Medicare prescription drug plan:

  • You must file it within 60 days from the date of the event that led to the complaint.
  • You can file it with the plan over the phone or in writing.
  • You must be notified of the decision generally no later than 30 days after the plan gets the complaint.
  • If it relates to a plan’s refusal to make a fast coverage determination or redetermination and you haven’t purchased or received the drug, the plan must give you a decision no later than 24 hours after it gets the complaint.  
Note

For questions about a specific service you got, look at your Medicare Summary Notice (MSN) or login to MyMedicare.gov. If you disagree with a coverage or payment decision made by Medicare, your Medicare health plan, or your Medicare Prescription Drug Plan, you can file an appeal.

How can I find contact information for my plan?

Generally, you can find your plan's contact information on your plan membership card. Or, you can get your plan's contact information from a Personalized Search (under General Search), or search by plan name.