Exceptions & Complaints

We hope you will always be happy with the services you receive from your PriorityMedicare plan. If you have questions, concerns, or problems with your covered services or the care you receive, call Customer Service right away.

This section gives you information about:

Asking Us To Make An Exception In Your Coverage
Learn how to ask us to cover a drug that is not on our approved drug list, or make an exception to our rules about how and when certain drugs and services are covered under your plan.

Appealing Our Decisions About Your Coverage
Learn how to ask us to cover the cost of services or drugs that are not covered by your plan, or to reconsider a decision if it is not in your favor.

Filing Complaints (Grievances) About Service
Learn how to complain about the service you receive from us or from our network of doctors, hospitals, pharmacies, and other health care providers.

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Naming an Authorized Representative
If you want someone else, like a spouse, child, or friend, to act for you when you make a complaint or appeal a decision, you can sign a form that makes that person your official "authorized representative." Here is how:

1. Print the Appointment of Representative form here. (120KB PDF)
2. Write in the name of the person you want to act for you. Sign and date the form.
3. Have your representative sign and date the form.
4. Mail the form to us at PriorityMedicare Service Coordinator, 1231 East Beltline NE, MS 1165, Grand Rapids, MI  49525. You can also deliver it in person, or fax it to us at 616 975-8880 or 942-0995, or call Customer Service for help.

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Obtain Aggregate Numbers
To obtain the aggregate number of grievances, appeals, and exceptions filed with the plan, call Customer Service.




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