Making Complaints Less Complex

Resources > Making complaints less complex

We hope every healthcare experience you have is positive, and we offer a variety of tools to help you express any concerns you have. One of those tools helps you file a complaint (sometimes called a “grievance”).

If you have a concern or a problem that isn’t a request for coverage or reimbursement, you have the right to file a complaint. If you’re not sure if you need to file a complaint or an appeal, see some examples provided by your plan. Each plan has specific rules you’ll need to know and follow when filing a complaint. If, after filing a complaint, your plan doesn’t address the issue, call 1-800-MEDICARE for assistance. You can also call your State Health Insurance Program (SHIP) for free, personalized help filing a complaint.

Information you’ll need to have ready when filing a complaint:

Personal information:

Name, date of birth, state you live in, zip code, email address, preferred call-back time, phone number, preferred language

Medicare card information:

Medicare number, effective date

Health or drug plan information:

Your health or drug plan name and contract ID

Complaint topic:

Benefits, prescription drugs, services, other

Helpful tools from Medicare:

A Personal Health Record (PHR)

A PHR is a record with information about your health that you, or someone helping you, can keep for easy reference using a computer. You control the health information in your PHR and can get to it anywhere, at any time, with internet access.

The Blue Button

The Blue Button tool provides you an easy way to download your personal health information to a file on your computer. The Blue Button is accessible through your account on MyMedicare.gov.