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Grievances or complaints

A grievance is a type of complaint you make about us or one of our network providers or pharmacies, including a complaint concerning the quality of your care. This type of complaint does not involve coverage or payment disputes.

What types of problems might lead you to file a grievance?

  • Problems with the service you receive from Customer Service
  • Problems with how long you have to wait at a network pharmacy
  • Having to wait too long to get your prescriptions filled
  • You believe our notices and other written materials are hard to understand

You have the right to ask Customer Service for a summary of information about the appeals and complaints filed by other members.

Filing a Grievance

Please call Customer Service if you have a complaint. We will work to resolve your complaint over the phone. We will send you a written response if you ask. We have a formal procedure called our Medicare Advantage Grievance and Resolution Process for complaints we cannot resolve over the phone. You can use this formal procedure by sending us your complaint in writing or by asking Customer Service to help you document a complaint.

Ways to connect
Mail

Blue Cross of Idaho
Medicare Advantage
P.O. Box 8406
Boise ID 83707

Phone or fax

Phone (8 a.m. to 8 p.m.)
1-888-494-2583 or TTY 711
Oct. 1 - Mar. 31, Seven days a week
Apr. 1 - Sept. 30, Monday - Friday

Fax
208-331-8829

We will mail an acknowledgement letter to confirm the facts and basis of written grievances. You will receive a written response to your complaint from us within thirty days of the day we receive your grievance. In some instances we will need additional time to address your concern. For questions on the status of an appeal you may call 888-494-2583 (TTY 711). See your Evidence of Coverage for more information about appeals and grievances.

MORE INFORMATION

For information on how to obtain an aggregate number of grievances, appeals and exceptions with Blue Cross of Idaho Medicare Advantage Plans, please contact Customer Service at 1-888-494-2583 or TTY 711. We are available:

  • Oct. 1 - Mar. 31: 8 a.m. to 8 p.m., seven days a week
  • Apr. 1 - Sept. 30: 8 a.m. to 8 p.m., Monday - Friday
To file a complaint directly to Medicare, you can do so by calling 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. Or you can submit the Medicare Complaint Form online.

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