Medicare Advantage member resources

Appeals and grievances

Learn about your Blue KC Medicare Advantage plan’s rights, including:

• Initial organizational determinations
• Appeals and exceptions
• Grievances

Information about Organization & Coverage Determinations, Appeals and Grievances

Also note that each Blue Medicare Advantage plan’s Evidence of Coverage book describes our grievance, coverage determination (including exceptions) and appeals processes.

At any time during the grievance or appeal process, you may appoint a representative to assist you in the process. We must receive in writing, from you to designate a representative for an Appeal and Grievance. You can complete and submit the CMS-1696 AOR form available in the link below, or contact our Customer Service department for additional information.

Downloadable forms:

• Medicare Prescription Drug Coverage Determination Request Form
• Medicare Prescription Drug Coverage Redetermination Form
• Blue Medicare Advantage Prior Authorization Request From
• CMS-1696 Appoint a Representative for an Appeal and Grievance

To obtain information about the aggregate number of grievances, appeals and exceptions filed with Blue KC, contact us.

To file a grievance or complaint visit the Medicare.gov website.