A grievance is any dispute expressing dissatisfaction with any aspect of the plan operations or its activities. Grievances can be received by customer service representatives via mail or telephone.
In order to exercise this right, you must file your grievance no later than 60 days after the event or incident that precipitates the grievance. Most grievances are answered in 30 days. If we need more information and the delay is in your best interest or if you ask for more time, we can take up to 14 more days (44 days total) to answer your grievance. Upon completion of our review, we will let you know by phone or in writing advising you of our decision.
If our plan does not agree with some or all of your complaint, or if our plan doesn’t take responsibility for the problem you are complaining about, we will let you know. Our response will include our reason for this answer. Our plan must respond whether we agree with your complaint or not.
For more information regarding the Medicare Grievance Process, please refer to the Chapter in your Evidence of Coverage entitled, "What to Do If You Have a Problem or Complaint."
Who may file a grievance?
You or your appointed legal representative may file a grievance. You can name a relative, friend, attorney, doctor, or someone else to act for you. Others may already be authorized under state law to act for you. You may download the Appointment of Representative form.
When do I file a grievance?
It is best to file a grievance as soon as you experience a problem you want to complain about. However, your complaint must be filed within 60 days after you had the problem.
Where to send a grievance:
Attention: Appeals, Complaints, and Grievances Department
P.O. Box 211088
Bedford, TX 76095
1 (800) 668-3813
8:00 am — 8:00 pm, your local time, 7 days a week
How to file an expedited or fast grievance:
If you would like our plan to use our Expedited/Fast Grievance Process because we denied your request for a "fast coverage decision" or a "fast appeal", or we extended a coverage decision or appeal about your Cigna-HealthSpring CarePlan Part C medical care, you must contact Customer Service. If you have a fast complaint, it means we will give you an answer within 24 hours. For more information about making complaints and the grievance process, see the section on "Making Complaints" in the Chapter named "What to do if You Have a Problem or Complaint" in your Evidence of Coverage.
You have the right to file a complaint:
If you have a complaint, you can submit feedback directly to Medicare using the Medicare Complaint form at https://www.medicare.gov/medicarecomplaintform/home.aspx (English) / https://www.medicare.gov/MedicareComplaintForm/home.aspx?language=Spanish (en Español).
Number of grievances, appeals, and exceptions made by members:
To obtain the aggregate number of Cigna-HealthSpring CarePlan grievances, appeals and exceptions, or the financial condition of Cigna-HealthSpring CarePlan, please call us at 1 (877) 653-0327, TTY:7-1-1, 8:00 am — 8:00 pm Central time, 7 days a week.