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 Member Resolution Coordinator
1231 East Beltline NE, MS 1115
Grand Rapids, MI 49525

You can also deliver it in person, or fax it to us at 616.942.0995, 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.

Filing an appeal if you are not happy with our decision

If you aren't satisfied with the coverage decision we make, you can ask us to reconsider. This is called "filing an appeal."

Go to instructions for filing an appeal.