Making complaints less complex

We hope every healthcare experience you have is a positive one. That’s why we offer you a variety of tools to express your concerns. One of those tools is the ability to file a complaint (sometimes called a “grievance”).

Do you have a complaint?

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. Not sure if you need to file a complaint or an appeal? Read some examples of situations where you might need to file a complaint.

Things to know before you file a complaint:

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 Assistance Program (SHIP) for free, personalized help filing a complaint.

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

Basic information about you

  • First and last name
  • Date of birth
  • State you live in
  • Zip code
  • Email address
  • Preferred call back time, phone number, and response language

Medicare card information

  • Medicare number
  • Effective date

Health or drug plan information

  • Your health or drug plan name
  • Your health or drug plan contract ID

Complaint topic

  • Benefits
  • Prescription drugs
  • Services
  • Something else

Medicare’s Blue Button can help

The Blue Button provides you an easy way to download your personal health information to a file. You can download the file of your personal data and save the file on your own personal computer. You can access the Blue Button through your account on MyMedicare.gov.