Pharmacy (Part D) Coverage Determinations, Appeals and Grievances

You have a right to make a complaint if you have concerns or problems with any part of your care as a UCare member. The Medicare program has established rules about what you need to do to make a complaint about Part D services or benefits and what UCare is required to do when we receive a complaint. A complaint will be handled as a grievance, coverage determination, or an appeal, depending on the nature of the complaint. Click the links on the right side of this page to get more information about coverage determinations, appeals and grievances.

Get more information
If you want more information about coverage determinations, filing an appeal or grievance, or appointing a representative, please use the links in the upper right column of this page.

Instructions for Appointing a Representative (PDF)

Request for Redetermination of Medicare Prescription Drug Denial Form (PDF)

Physician Prior Authorization Forms