Filing a Grievance
Learn when and how you can file a Medicare coverage related complaint.
What is a grievance?
A grievance or complaint is any dispute expressing your dissatisfaction with any aspect of the plan’s operations or its activities. Grievances can be received by customer service representatives online, by mail, fax, email or telephone.
If our plan does not agree with some, or all, of your complaint or if our plan isn’t responsible for the problem you are complaining about, we will let you know. Our response will include our full reason for disagreeing. We must respond whether we agree with your complaint or not.
To obtain the aggregate number of HealthSpring grievances, appeals and exceptions, or the financial condition of HealthSpring, please contact us.
Who may file a grievance?
You or your appointed legal representative may file a grievance. You can name a relative, friend, attorney, doctor or someone else to act for you. Others may already be authorized under state law to act for you. To appoint a legal representative, the proper documentation must be submitted to HealthSpring. Examples of appropriate representation documents may include, but are not limited to, a durable power of attorney, a health care proxy, an appointment of guardianship or other legally recognized forms of appointment. You may also download and complete the Appointment of Representative form below.
When do I file a grievance?
It is best to file a grievance as soon as you experience a problem you want to complain about. You must file your grievance no later than 60 days after the event or incident that causes the grievance. Most grievances are resolved within 30 days. If we need more information and the delay is in your best interest, or if you ask for more time, we can take up to 14 more days (44 days total) to respond to your grievance. Upon completion of our review, we will notify you by phone or in writing.
How do I file an expedited or fast grievance?
If you would like our plan to use our Expedited/Fast Grievance Process because we denied your request for a "fast coverage decision" or a "fast appeal," or we extended a coverage decision or appeal about your Medicare Part C medical care, you must contact Customer Service. If you have a fast complaint, it means we will give you an answer within 24 hours.
You have the right to file a complaint:
If you have a complaint, you can send your feedback straight to Medicare using the Medicare Complaint form.
Where do I send a grievance?
For Medicare Advantage plans – except Arizona
Mail:
HealthSpring Medicare
Attention: Grievance Department
P.O. Box 188080
Chattanooga, TN 37422
Email: Member.Grievances@HealthSpring.com
Phone:
8 a.m. – 8 p.m., 7 days a week.
(Hours apply Monday - Friday, April 1 - September 30.A voicemail system is available on weekends and holidays).
Fax: 1-888-586-9946
For Medicare Advantage plans in Arizona
Mail:
HealthSpring Medicare
Attention: Grievance Department
P.O. Box 188080
Chattanooga, TN 37422
Email: Member.Grievances@HealthSpring.com
Phone:
8 a.m. – 8 p.m., MT, 7 days a week.
(Hours apply Monday - Friday, April 1 - September 30.A voicemail system is available on weekends and holidays).
Fax: 1-888-586-9946
For Medicare Part D standalone plans
Mail:
HealthSpring Medicare
Attention: Grievance Department
P.O. Box 269005
Weston, FL 33326-9927
Email: Not currently available for HealthSpring standalone Part D Prescription Drug plans.
Phone:
8 a.m. – 8 p.m., 7 days a week.
(Our automated phone system may answer your call during weekends from April 1 - September 30).
Fax: 1-800-735-1469
More Member Resources and Services
How to file an appeal and overall process.
Find out about coverage decisions and exceptions.
Get info if you need to file a medical prior authorization.