You may have a concern you’d like to tell us about or disagree with a decision we’ve made about your coverage.
You can make a complaint or file an appeal to get help for your situation. It’s important to follow the right process for the problem you are having. Your plan documents explain each process in detail.
If you need help to make a complaint, request a review or file an appeal, call the number on the back of your member ID card.
Where to find information in your member materials
Your member contract, Evidence of Coverage, Summary of Coverage and Disclosure or Member Handbook explains in detail how to make a complaint or file an appeal. You can log in or create your Member Account to get access to materials specific to your plan.
Details
What to do if you have a problem or concern
There are two types of processes for handling problems and concerns. Your member contract, Evidence of Coverage, Member Handbook or Summary of Coverage and Disclosure includes detailed information about each process. The process you use depends on the kind of problem you are having.
Appeals process
Use this process if the problem is about coverage or payment for medical services or prescription drugs.
If we have told you we will not cover or pay for a medical service in the way you want: We will review the decision and let you know if we will change it or not. Refer to your plan documents for more information or contact the phone number on the back of your ID card.
If we say no to all or part of your appeal, you can choose to take your appeal further: There are up to five levels of appeal. Refer to your plan documents for more information.
Complaints process
Use this process if the problem is not related to benefits or coverage.
You can make a complaint about the quality of care you receive, waiting times, customer service and other concerns. Making a complaint is also known as “filing a grievance.”
Call the customer service number on the back of your ID card. We will inform you if you need to take additional steps.
If you prefer, you can explain the problem in writing and ask us to resolve it. Refer to your plan documents for more information.
Contact info
Where to reach us for medical complaints and appeals
For Medicare Advantage, Platinum BlueSM and Medicare Supplement plan members
Mailing address:
Blue Cross and Blue Shield of Minnesota
P.O. Box 982800
El Paso, TX 79998-2800
Customer Service numbers:
Medicare Advantage (PPO) plans: 1-800-711-9865, TTY 711
Platinum Blue (Cost) plans: 1-866-340-8654, TTY 711
Medicare Supplement plans: 1-800-531-6686, TTY 711
Fax numbers:
Medicare Advantage plans: (651) 662-9517
Platinum Blue plans: (651) 662-9517
Medicare Supplement plans: (651) 662-9517
For Blue Plus / SecureBlueSM members
Mailing address:
Blue Plus / SecureBlue
Blue Plus Receiving Center
P.O. Box 982816
El Paso, TX 79998-2816
Customer Service number: 1-888-740-6013, TTY 711
Fax number: (651) 662-6287
Where to reach us for prescription drug complaints & appeals
Mailing address:
For Medicare Advantage prescription drug (MAPD) and Platinum Blue with Rx plans:
Attn: Medicare Grievance Dept
P.O. Box 64813
St. Paul, MN 55164-0813
For MedicareBlueSM Rx plans:
MedicareBlue Rx
Appeals & Grievances Receiving Center
P.O. Box 22348
Tampa, FL 33631
Customer Service numbers:
Platinum Blue with Rx plans: 1-800-489-7336, TTY 711
Medicare Advantage prescription drug (MAPD) plans: 1-800-490-1251, TTY 711
MedicareBlueSM Rx plans: 1-888-832-0075, TTY 711
Fax numbers:
Medicare Advantage prescription drug (MAPD) and Platinum Blue with Rx plans: 1-888-285-2242
MedicareBlueSM Rx plans: 1-855-874-4705
If you want information about how to obtain an aggregate number of grievances, appeals, and exceptions filed with the plan, you can call customer service. You can also ask about the plan's performance ratings including how it has been rated by plan members and how it compares with other Medicare health plans.
To request this information, please call the customer service phone number on the back of your member ID card, 8 a.m. to 8 p.m., daily.
Blue Cross offers PPO, Cost and PDP plans with Medicare contracts. Enrollment in these Blue Cross plans depends on contract renewal. SecureBlueSM is an HMO SNP plan with a Medicare contract and a contract with the Minnesota Medical Assistance program. Enrollment in SecureBlueSM depends on contract renewal.
S5743_090926_P01_M
Y0138_090926_P01_M