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Member Grievance and Appeal Information 2024

If you do not agree with a decision made by Preferred Care Partners you can submit an appeal that is a formal way of asking us to review and change a coverage decision we have made.


You can make a complaint about us or one of our network pharmacies, including a complaint about the quality of your care. This type of complaint does not involve coverage or payment disputes.

File your Grievance or Appeal

You can download the form below and follow the steps listed to file your Grievance or Appeal.

  1. Download the Grievance and Appeal Request Form.
  2. Include copies of documents that help support the appeal.
  3. Mail or fax completed form and documentation to:

Grievance and Appeals for Medical Care - Part C

  • UHC Preferred Medicare Advantage FL-0001 (HMO)

    UHC Preferred Medicare Advantage FL-0002 (HMO)

    UHC Preferred Complete Care FL-0003 (HMO C-SNP)

    UHC Preferred Medicare Advantage FL-002P (HMO)

    • Mail

      Mail

      Preferred Care Partners, Inc. Appeals & Grievance Department PO Box 6106, MS CA 124-0157, Cypress, CA 90630 - 0016

    • Phone

      Phone

      Standard Appeal:

      1-866-231-7201 (TTY - 711) Toll-Free

      Expedite Appeal:

      1-877-262-9203 (TTY - 711) Toll-Free

    • Fax

      Fax

      Expedite Appeal:

      1-866-373-1081

Grievance and Appeals for Medical Care - Part C

  • UHC Preferred Dual Complete FL-D001 (HMO D-SNP)

    UHC Preferred Dual Complete FL-D01P (HMO D-SNP)

    • Mail

      Mail

      Preferred Care Partners, Inc. Appeals & Grievance Department PO Box 6106, MS CA 124-0187, Cypress, CA 90630 - 0016

    • Phone

      Phone

      Standard Appeal:

      1-866-231-7201 (TTY - 711) Toll-Free

      Expedite Appeal:

      1-855-409-7041 (TTY - 711) Toll-Free

    • Fax

      Fax

      Expedite Appeal:

      1-866-373-1081

Grievance and Appeals for Prescription Drugs - Part D

  • UHC Preferred Medicare Advantage FL-0001 (HMO)

    UHC Preferred Medicare Advantage FL-0002 (HMO)

    UHC Preferred Complete Care FL-0003 (HMO C-SNP)

    UHC Preferred Medicare Advantage FL-002P (HMO)

    • Mail

      Mail

      Preferred Care Partners, Inc. Appeals & Grievance Department PO Box 6106, MS CA 124-0197, Cypress, CA 90630 - 0016

    • Phone

      Phone

      Standard Appeal:

      1-866-231-7201 (TTY - 711) Toll-Free

      Expedite Appeal:

      1-800-595-9532 (TTY - 711) Toll-Free

    • Fax

      Fax

      Standard Appeal

      1-866-308-6294

      Expedite Appeal:

      1-866-308-6296

Grievance and Appeals for Prescription Drugs - Part D

  • UHC Preferred Dual Complete FL-D001 (HMO D-SNP)

    UHC Preferred Dual Complete FL-D01P (HMO D-SNP)

    • Mail

      Mail

      Preferred Care Partners, Inc. Appeals & Grievance Department PO Box 6106, MS CA 124-0197, Cypress, CA 90630 - 0016

    • Phone

      Phone

      Standard Appeal:

      1-866-231-7201 (TTY - 711) Toll-Free

      Expedite Appeal:

      1-855-409-7041 (TTY - 711) Toll-Free

    • Fax

      Fax

      Standard Appeal:

      1-866-308-6294

      Expedite Appeal:

      1-866-308-6296

As a member of our plan, you have the right to get several kind of information from us. This includes information about the number of appeals made by members and the plan’s performance rating including how it has been rated by plan members and how it compares to other Medicare Advantage health plans. To file a complaint directly to CMS: https://medicare.gov/MedicareComplaintForm/home.aspx


For detailed information on the process of filing a grievance or appeal and obtaining a coverage determination, refer to Chapter 9 of your Evidence of Coverage.