Appeals & Complaints

If you or an authorized representative wish to file an Appeal or Complaint, you may call Cigna-HealthSpring Member Services toll free at 1-877-653-0327 (TTY: 7-1-1) Monday to Friday, 8 a.m. to 5 p.m. Central Time, excluding state-approved holidays. If the call is after hours, please leave a message and your call will be returned within 1 business day.

To submit an Appeal related to any service other than prescription drugs you can send a fax to 1-877-809-0783 or mail your request to:

Cigna-HealthSpring
Attention: Appeals and Complaints Department
PO Box 211088
Bedford, TX 76095

To submit an Appeal for prescription drugs, you can fax an appeal request to 1-866-766-6405. Or you can write us and send your request to:

Cigna-HealthSpring
Attention: STAR+PLUS Appeals
PO Box 24207
Nashville, TN 37202

Fair Hearing

As a member of Cigna-HealthSpring, if you appeal a decision and disagree with our decision, you have the right to ask for a fair hearing. You may name someone to represent you by writing a letter to us, stating the name of the person you want to represent you. A doctor or other medical provider may be your representative. If you want to challenge a decision made by us, you or your representative must ask for the fair hearing within 120 days of the date on the letter we sent you with our decision. If you do not ask for the fair hearing within 120 days, you may lose your right to a fair hearing.

To ask for a Fair Hearing, you or your representative can call us at 1-877-653-0327 (TTY: 7-1-1). Or write us at:

Cigna-HealthSpring
Attention: Appeals and Complaints Department - Fair Hearing
PO Box 211088
Bedford, TX 76095
Fax: 1-877-809-0783

To ask for a Fair Hearing for prescription drugs/pharmacy, you or your authorized representative can mail or fax a letter to:

Cigna-HealthSpring
STAR+PLUS Appeals
PO Box 24207
Nashville, TN 37202
Fax: 1-866-593-4482
Call : 1-877-653-0327 (TTY: 7-1-1)

If you ask for a fair hearing, you will get a packet of information letting you know the date, time and location of the hearing. Most fair hearings are held by telephone. At that time, you or your representative can tell why you need the service the health plan denied. HHSC will give you a final decision within 90 days from the date you asked for the hearing.

How to File an Appeal

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FAQs

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