Medicare Part D Prescription Benefits:
Contact Us at 1-877-916-1234
File an Redetermination/Appeal
An appeal to the plan about a Part D Drug Coverage Decision we made is called a Redetermination (Appeal). Use this process to ask us to review a Part D drug Coverage Decision made by us. You cannot request a Part D Redetermination (Appeal) if we have not issued a Coverage Determination.
To start your Part D Redetermination (Appeal), you (or your representative or your doctor or other prescriber) must contact us. For a standard appeal:
Fax request to: 1-562-989-0958
Mail request to:
Attention: Grievances and Appeals Department
P.O. Box 22644
Long Beach, CA 90801-5644
If you are asking for a fast appeal, write to us at the address above or call our Member Services Department.
Your written request should include the following information:
- Member Name
- Member ID number - found on your VillageHealth membership card
- Name of the Part D drug that you are asking us to review
- Reason you do not agree with the initial Coverage Determination
- Date of initial Coverage Determination notice
Or simply download, fill out and submit the following form:
For more detailed information on the appeal process please refer to your Evidence of Coverage.
1-800-399-7226 for additional information. (TTY Users: 711). Hours are 8 a.m. to 8 p.m., seven days a week from October 1 to March 31. From April 1 to September 30 hours are 8 a.m. to 8 p.m. Monday through Friday. Messages received on holidays and outside of our business hours will be returned within one business day.