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Part D Appeals

What is an appeal?

An appeal is the process to review a decision you may not like. The negative decision is called a coverage determination. You would file an appeal if you want us to review it again and change our mind about what Part D prescription drug benefits are covered for you or what we will pay for a prescription drug.

Filing an Appeal

You, your doctor, or your appointed representative may file an appeal in the following ways:

Call us:  1-844-239-7387 (TTY: 711)
Hours are from 8 a.m. to 8 p.m., seven days a week.  TTY users call 711. On weekends and on state or federal holidays, you may be asked to leave a message. Your call will be returned within the next business day.


Fax:  
Fax for Internal and Fast Appeal to 1-844-273-2671.

Mail:  Our address is:
Michigan Complete Health (Medicare-Medicaid Plan)
Attn: Medicare Appeals and Grievances
7700 Forsyth Blvd.
St Louis, MO 63105

Complete a Request for Redetermination Form - English (PDF).
If, again, we do not agree, you may appeal to the State under its fair hearings system within 120 calendar days after the date of our decision notice for drugs covered by Michigan Medicaid but excluded from your Part D benefit.