Filing complaints about your 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:

  • Customer service: For example, you think the customer service hours for your plan should be different.
  • Access to specialists: For example, you don't think there are enough specialists in the plan to meet your needs.
  • Information from your plan: 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.
  • Problems with an appeal: 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.
  • Drug errors: 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 gotten the drug, the plan must give you a decision no later than 24 hours after it gets the complaint.  

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 search for your plan's contact information.