For questions about the appeals and grievances process or the status of an open appeal or grievance, please call: (833) 201-6413 TTY:711 or email our team at: healthymsplan@healthy-ms.com
Calls to this number are free, 8AM – 8PM CST 7 days/week from October 1 to March 31, and Monday through Friday from April 1 to September 30.
Any Healthy Mississippi, Inc. member may at any time during their enrollment, request appeal and grievance data, including aggregate number of Grievances, Appeals, and Exceptions, orally or in writing by contacting the Member Services.
Healthy Mississippi, Inc.
Appeals and Grievances Department
10 Canebrake Boulevard, Suite 110
Flowood, MS 39232
Fax: 888-710-8090
The process for coverage decisions and appeals can be found in your Evidence of Coverage (EOC) (Member Handbook). This is the process you use for issues such as whether something is covered or not and the way in which something is covered. Please refer to your EOC for more information. The EOC can be located by visiting healthy-ms.com/plan-documents/, under “Member Resources”
Download these forms to file a formal complaint or appeal regarding any aspect of the medical care or service provided to you. Your complaint or appeal may be in reference to your prescription drug benefits.
You may also submit feedback or complaints about your Medicare Advantage plan directly to Medicare by submitting a complaint through www.medicare.gov or by calling 1-800-Medicare. When submitting a marketing complaint, it is important to provide an agent or broker name, if possible.
Prescription drug appeals are called coverage determination requests. Please visit below for more information about prescription coverage determinations and prescription payment reimbursement requests.
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