What are my grievance and appeal rights under Medicare Advantage plans?
You can file a grievance if you have a complaint about your plan coverage. You may file an appeal if you have received a denial for a medical service that you think should be covered by the plan. If you believe that waiting for a decision about a service could seriously harm your health, ask, or have your doctor ask, the plan for an expedited decision. Aetna must process grievances and appeals under the guidelines and timeframes required by Medicare. Refer to your Evidence of Coverage for detailed information about your Medicare appeal and grievance rights.
