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Part D Appeals

Part D Appeals – What is an appeal?

An appeal is the process to review a decision you may not like. The negative decision is called a coverage determination. You would file an appeal if you want us to review it again and change our mind about what Part D drug benefits are covered for you or what we will pay for a drug.

Making an appeal

You, your doctor, or your appointed representative may file an appeal in the following ways:

  • Telephone: 1-877-941-0482 / (TTY 711)
  • FAX: 1-844-273-2641

OR

  • Mail

IlliniCare Health
Attn: Medicare Appeals and Grievances
7700 Forsyth Blvd
St Louis, MO 63105

If we again do not agree, you may appeal to the State under its Fair Hearings system within one hundred twenty (120) calendar days after the date of our letter.

Please keep one copy of the fair hearing request for your information.

If you have questions, please call IlliniCare Health Member Services at 1-877-941-0482. Hours are 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on holidays, you may be asked to leave a message. Your call will be returned within the next business day. TTY users call 711. The call is free.