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Home Medicare Member Resources and ServicesFiling a Grievance

Filing a Grievance

Learn when and how to file a complaint.

What is a grievance?

A grievance or complaint is any dispute expressing dissatisfaction with any aspect of the plan’s operations or its activities. Grievances can be received by customer service representatives online, by mail, fax, email, or telephone.

If our plan does not agree with some or all of your complaint, or if our plan doesn’t take responsibility for the problem you are complaining about, we will let you know. Our response will include our reason for this answer. Our plan must respond whether we agree with your complaint or not.

To obtain the aggregate number of Cigna Medicare grievances, appeals, and exceptions, or the financial condition of Cigna Medicare, please contact us.

Who may file a grievance?

You or your appointed legal representative may file a grievance. You can name a relative, friend, attorney, doctor, or someone else to act for you. Others may already be authorized under state law to act for you. In order to appoint a legal representative, the proper documentation must be submitted to Cigna Medicare. Examples of appropriate representation documents may include, but are not limited to, a durable power of attorney, a health care proxy, an appointment of guardianship, or other legally recognized forms of appointment. You may also download and complete the appointment of representative form below.

Download the Appointment of Representative form [PDF]

When do I file a grievance?

It is best to file a grievance as soon as you experience a problem you want to complain about. You must file your grievance no later than 60 days after the event or incident that precipitates the grievance. Most grievances are resolved within 30 days. If we need more information and the delay is in your best interest, or if you ask for more time, we can take up to 14 more days (44 days total) to respond to your grievance. Upon completion of our review, we will notify you by phone or in writing.

How do I file an expedited or fast grievance?

If you would like our plan to use our Expedited/Fast Grievance Process because we denied your request for a "fast coverage decision" or a "fast appeal," or we extended a coverage decision or appeal about your Cigna Medicare Part C medical care, you must contact Customer Service. If you have a fast complaint, it means we will give you an answer within 24 hours.

Where do I send a grievance?

For Cigna Medicare Advantage plans – except Arizona

Mail:
Cigna Medicare
Attention: Member Grievances
PO Box 2888
Houston, TX 77252

Email: membergrievances@healthspring.com

Phone: (TTY: 711)
8:00 am - 8:00 pm, 7 days a week.
(Hours apply Monday - Friday, April 1 - September 30.
A voicemail system is available on weekends and holidays).

Fax:

For Cigna Medicare Advantage plans in Arizona

Mail:
Cigna Medicare
Attention: Grievance Administration Division
PO Box 188080
Chattanooga, TN 37422

Email: membergrievances@healthspring.com

Phone: (TTY: 711)
8:00 am - 8:00 pm Mountain time, 7 days a week.
(Hours apply Monday - Friday, April 1 - September 30.
A voicemail system is available on weekends and holidays).

Fax:

For Cigna Medicare Part D standalone plans

Mail:
Cigna Medicare
Attention: Grievance Department
PO Box 269005
Weston, FL 33326-9927

Phone: (TTY: 711)
8:00 am - 8:00 pm, 7 days a week.
(Our automated phone system may answer your call during weekends from April 1 - September 30).

Fax:


More Member Resources and Services

Appeals
How to file an appeal and overall process.

Coverage Decisions
Find out about coverage decisions and exceptions.

Organization Determination
Get info if you need to file a medical prior authorization.

Back to Member Resources and Services

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Medicare Advantage and Medicare Part D Policy Disclaimers

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc. Cigna contracts with Medicare to offer Medicare Advantage HMO and PPO plans and Part D Prescription Drug Plans (PDP) in select states, and with select State Medicaid programs. Enrollment in Cigna depends on contract renewal.

Medicare Supplement Policy Disclaimers

Medicare Supplement website content not approved for use in: Oregon and Texas.

AN OUTLINE OF COVERAGE IS AVAILABLE UPON REQUEST. We'll provide an outline of coverage to all persons at the time the application is presented.

Our company and agents are not connected with or endorsed by the U.S. Government or the federal Medicare program. This is a solicitation for insurance. An insurance agent may contact you. Premium and benefits vary by plan selected. Plan availability varies by state. Medicare Supplement policies are underwritten by Cigna National Health Insurance Company, Cigna Health and Life Insurance Company, American Retirement Life Insurance Company or Loyal American Life Insurance Company. Each insurer has sole responsibility for its own products.

The following Medicare Supplement Plans are available to persons eligible for Medicare due to disability: Plan A in Arkansas, Connecticut, Indiana, Maryland, Oklahoma, Texas, and Virginia; Plans A, F, and G in North Carolina; and Plans C and D in New Jersey for individuals aged 50-64. Medicare Supplement policies contain exclusions, limitations, and terms under which the policies may be continued in force or discontinued. For costs and complete details of coverage, contact the company.

This website is designed as a marketing aid and is not to be construed as a contract for insurance. It provides a brief description of the important features of the policy. Please refer to the policy for the full terms and conditions of coverage.

American Retirement Life Insurance Company, Cigna National Health Insurance Company and Loyal American Life Insurance Company do not issue policies in New Mexico.

Kansas Disclosures, Exclusions and Limitations

Medicare Supplement Policy Forms: Plan A: CNHIC-MS-AA-A-KS, CNHIC-MS-AO-A-KS; Plan F: CNHIC-MS-AA-F-KS, CNHIC-MS-AO-F-KS; Plan G: CNHIC-MS-AA-G-KS, CNHIC-MS-AO-G-KS; Plan N: CNHIC-MS-AA-N-KS, CNHIC-MS-AO-N-KS

Exclusions and Limitations:

The benefits of this policy will not duplicate any benefits paid by Medicare. The combined benefits of this policy and the benefits paid by Medicare may not exceed one-hundred percent (100%) of the Medicare Eligible Expenses incurred. This policy will not pay benefits for the following:

(1) the Medicare Part B Deductible;

(2) any expense which You are not legally obligated to pay; or services for which no charge is normally made in the absence of insurance;

(3) any services that are not medically necessary as determined by Medicare;

(4) any portion of any expense for which payment is made by Medicare or other government programs (except Medicaid); or for which payment would have been made by Medicare if You were enrolled in Parts A and B of Medicare;

(5) any type of expense not a Medicare Eligible Expense except as provided previously in this policy;

(6) any deductible, Coinsurance or Co-payment not covered by Medicare, unless such coverage is listed as a benefit in this policy; or

(7) Preexisting Conditions: We will not pay for any expenses incurred for care or treatment of a Preexisting Condition for the first six (6) months from the effective date of coverage. This exclusion does not apply if You applied for and were issued this policy under guaranteed issue status; if on the date of application for this policy You had at least six (6) months of prior Creditable Coverage; or, if this policy is replacing another Medicare Supplement policy and a six (6) month waiting period has already been satisfied. Evidence of prior coverage or replacement must have been disclosed on the application for this policy. If You had less than six (6) months prior Creditable Coverage, the Preexisting Conditions limitation will be reduced by the aggregate amount of Creditable Coverage. If this policy is replacing another Medicare Supplement policy, credit will be given for any portion of the waiting period that has been satisfied.

Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website.

Y0036_23_788405_M | Page last updated 10/01/2022.