How to file a complaint (grievance)

You can file a complaint if you have concerns about the quality of care or other services you get from a Medicare provider. How you file a complaint depends on what your complaint is about.

You can file a complaint about:

What's the difference between a complaint and an appeal?

A complaint is about the quality of care you got or are getting. For example, you can file a complaint if you have a problem calling the plan, or you're unhappy with how a staff person at the plan treated you.

You file an appeal if you have an issue with a plan's refusal to cover a service, supply, or prescription. Learn more about appeals.

Need help filing a complaint?

Contact your State Health Insurance Assistance Program (SHIP) for free personalized help.

Note

For questions about a specific service you got, look at your Medicare Summary Notice (MSN) or log into your secure Medicare account. You can file an appeal if you disagree with a coverage or payment decision made by one of these:

  • Medicare
  • Your Medicare health plan
  • Your Medicare drug plan