Details about filing a complaint/grievance
The Centers for Medicare and Medicaid Services (CMS) calls complaints about the service you get from Priority Health or from our doctors, hospitals, pharmacies, etc., "grievances." When you let us know that you have a problem with us or with our network of doctors, hospitals, pharmacies, or other health care providers, it is called "filing a grievance."
How to file a grievance
Call Customer Service first
We will try to resolve any complaint that you might have over the phone. If you ask for a written answer to your phone complaint, we will answer you in writing.
If you prefer, you may send us your grievance in writing to:
Priority Health Medicare Grievances
1231 East Beltline NE, MS 1150
Grand Rapids, MI 49525
You can also deliver it in person, or fax it to us at 616.975.8827, or call Customer Service for help.
More details about filing a grievance
To better understand the services you are entitled to under your Priority Health Medicare plan, including more details about asking for coverage exceptions and filing a complaint, read Chapter 9, "What to do if you have a problem or complaint," in your Evidence of Coverage booklet.
- 2023 PriorityMedicare EOC
- 2023 PriorityMedicare Compass EOC
- 2023 PriorityMedicare Edge EOC
- 2023 PriorityMedicare Ideal EOC
- 2023 PriorityMedicare Key EOC (Regions 1, 2)
- 2023 PriorityMedicare Key EOC (Regions 3, 4)
- 2023 PriorityMedicare Key EOC (Region 5)
- 2023 PriorityMedicare Kroger EOC
- 2023 PriorityMedicare Merit EOC
- 2023 PriorityMedicare ONE EOC
- 2023 PriorityMedicare Select EOC
- 2023 PriorityMedicare Value EOC
- 2023 PriorityMedicare Vital EOC
Filing an appeal if you are not happy with our decision
If you aren't satisfied with the coverage decision we make, you or your prescriber can ask us to reconsider. This is called "filing an appeal." Learn how.
Call Customer Service (toll‑free)
888.389.6648 (TTY 711)
8 a.m. to 8 p.m., 7 days a week