How to file a grievance
When will UnitedHealthcare give you an answer?
A grievance is a complaint. The complaint process is only used for certain types of problems. This includes problems related to quality of care, waiting times, and the service you receive. You need to file the grievance (complaint) within 60 calendar days of the item you want to complain about — whether by phone or writing to UnitedHealthcare.
Filing a grievance isn't the same as a request for a coverage decision. Grievances don't involve problems related to approving or paying for Medicare Part D drugs.
Some types of problems that can lead to filing a grievance include:
- Issues with the service you receive from Customer Service
- If you feel that you are being encouraged to leave (disenroll from) the plan
- If you disagree with our decision not to give you a "fast" decision or a "fast" appeal
- We don't give you a decision within the required time frame
- We don't give you required notices
- You believe our notices and other written materials are hard to understand
- Waiting too long for prescriptions to be filled
- Rude behavior by network pharmacists or other staff
- We don't forward your case to the Independent Review Entity if we do not give you a decision on time
How to file a grievance
If you have a complaint (grievance), contact UnitedHealthcare or call the number for Medicare Part D Grievances (for complaints about Medicare Part D drugs) listed on your member ID card. UnitedHealthcare will try to resolve your complaint over the phone.
If you prefer to write UnitedHealthcare — or you called and weren't satisfied — you can send it to us.
If you're filing a grievance because your request for a "fast coverage decision" or a "fast appeal" was denied, you’ll automatically get a "fast" complaint. Be sure to include the words "fast", "expedited" or "24-hour review" on your request. You can also call the number on your member ID card to file an expedited grievance.
Submit a written request for a grievance by completing the Medicare Plan Appeals & Grievances Form (PDF) (760.99 KB) and mailing or faxing it.