What is a Grievance?
A grievance is a complaint about any problem you had with Healthfirst Medicare Plans or one of our network pharmacies that does not relate to coverage for a prescription drug. Grievances do not relate to payment for or approval of a prescription drug, which are known as coverage determinations. If you (your appointed representative) have a grievance, please call Member Services at 1-888-260-1010, or TTY 1-866-236-1069 for the hearing or speech impaired, 24 hours a day, 7 days a week. We will try to resolve any complaint over the phone.
You may also send your grievance to the following address:
P.O. Box 53991
Phoenix, AZ 85072-3991
All grievances will be acknowledged promptly and in writing once the Appeals & Grievances Department has completed its investigation.
If you are complaining about the decision by CVS Caremark not to expedite an initial determination or an appeal, you can request an expedited grievance. CVS Caremark will respond to you within 24 hours.