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How to file a grievance or appeal a coverage decision?
Medicare Part C (Medicare Advantage) and Medicare Part D (Prescription Coverage) To file or check the status of a grievance or an appeal‚ contact us at: Grievances: 1-800-965-4022, 8 a.m. to 8 p.m., Monday through Friday, TTY/TDD 711 Ap...
How do I request a coverage determination or medical exception for a drug?
You, your authorized representative, or your prescribing doctor can ask for a coverage determination. Mail us a  Coverage Determination Request Form to: Health Alliance Medicare 3310 Fields South Drive  Champaign, IL 61822 Call us a...
How can I change or cancel / disenroll from my plan?
Changing Plan Types The Annual Enrollment Period (AEP) is the time each year, chosen by the Centers for Medicare and Medicaid Services (CMS), when you can enroll in a plan or switch to a new one. Unless you qualify for a Special Enrollment Per...
What are my rights and responsibilities upon disenrollment?
If you decide to disenroll from your Health Alliance Medicare Advantage plan, you are ending your membership. Disenrollment can be voluntary (your choice) or involuntary (not your choice). For more information on enrollment or disenrollment, see you...
National Coverage Determinations
When the Centers for Medicare & Medicaid Services (CMS) makes changes to the services that are covered, they update them through National Coverage Determinations. Learn more about National Coverage Determinations on  their website . CMS has...
Specific Drug Requirements
Certain covered drugs have special rules or limits, like step-therapy, preauthorization, and quantity limits, to keep you safe. Learn more about these and which drugs have them. How do I request a coverage determination or medical exception for a ...
Medication Therapy Management
Our Medication Therapy Management (MTM) program gives you free, personalized help to make sure you take your meds just as your doctor prescribed. You get one-on-one time talking with a registered pharmacist or licensed pharmacy intern. You can revie...
Medicare Part D Transition Process
As a new or continuing member, you might be taking drugs that are not on our formulary, or list of covered drugs, that require you to meet certain requirements, like preauthorization, step therapy, or quantity limits. If you're in the first 90 ...