Pharmacy (Part D) Coverage Determinations, Appeals and Grievances


You have a right to make a complaint if you have concerns or problems with any part of your care as a UCare member. The Medicare program has established rules about what you need to do to make a complaint about Part D services or benefits and what UCare is required to do when we receive a complaint. A complaint will be handled as a grievance, coverage determination, or an appeal, depending on the nature of the complaint. Click the links on the right side of this page to get more information about coverage determinations, appeals and grievances.

Get More Information

If you want more information about coverage determinations, filing an appeal or grievance, or appointing a representative, please use the links in the upper right column of this page.

Instructions for Appointing a Representative (PDF)

Request for Redetermination of Medicare Prescription Drug Denial Form (PDF)

Physician Prior Authorization Forms

Coverage Determinations
Get more information about coverage determinations.

Appeals
Learn more about appeals.

Grievances
Find out more about grievances.

If you have questions about the status of an appeal or grievance request, please call

UCare Member Complaints, Appeals, and Grievances at 612-676-6841 or 1-877-523-1517 toll free

If you are hearing impaired, call 612-676-6810 or 1-800-688-2534 toll free.

You can also file a complaint with Medicare using the Medicare Complaint Form (external site).


Questions?

Call UCare Customer Services if you:


TTY: 612-676-6810 or 1-800-688-2534 toll free.

UCare Medicare
Customer Services: 612-676-3600 or 1-877-523-1515 toll free,
24 hours a day, seven days a week.
 

UCare Medicare with Fairview & North Memorial
Customer Services: 612-676-6520 or 1-888-618-2595 toll free,
24 hours a day, seven days a week.

EssentiaCare
Customer Services: 218-722-4915 or 1-855-432-7025 toll free,
24 hours a day, seven days a week.
 

UCare’s Minnesota Senior Health Options (MSHO)
Customer Services: 612-676-6868 or 1-866-280-7202 toll free,
8 am to 8 pm, seven days a week.

UCare Connect + Medicare (SNBC) (HMO SNP)
Customer Services: 612-676-3310 or 1-855-260-9707 toll free,
8 am to 8 pm, seven days a week.


H2456_H5937 061918 DHS Approved (06272018) CMS Approved (07202018)
Y0120_B_061918 CMS Approved (07202018)
June 2018