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A grievance is a complaint or dispute filed with your Medicare Advantage Plan or Medicare private drug plan (Part D) about any part of the plan’s operations, behavior, or activities. You must file a grievance orally or in writing within 60 days of the event or incident. For example, you may file a grievance if you are dissatisfied with the condition of a health care facility or the facility’s operating hours, or if you have a complaint about the behavior of those working for the facility or the private health or drug plan, itself. An appeal, not a grievance, is the appropriate way to complain about a denial of coverage. However, Medicare Advantage Plans and drug plans must respond to grievances within 24 hours if they involve the plan’s failure to grant an expedited appeal (and in the case of a drug plan, you have not yet purchase the medication). A Medicare drug plan must notify you of its decision about other grievances within 30 days of receiving them (but can extend that time up to 14 calendar days).

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