If we make a coverage decision and you are not satisfied with this decision, you can “appeal” the decision. An appeal is a formal way of asking us to review and change a coverage decision we have made.
When you make an appeal, we review the coverage decision we have made to check to see if we were following all of the rules properly. Your appeal is handled by different reviewers than those who made the original unfavorable decision. When we have completed the review we give you our decision.
If we say no to all or part of your Level 1 Appeal, you can go on to a Level 2 Appeal. The Level 2 Appeal is conducted by an independent organization that is not connected to us. (In some situations, your case will be automatically sent to the independent organization for a Level 2 Appeal. If this happens, we will let you know. In other situations, you will need to ask for a Level 2 Appeal.) If you are not satisfied with the decision at the Level 2 Appeal, you may be able to continue through additional levels of appeal.
Please view the Medicare Advantage appeals process flow chart if you would like a better understanding of how the appeal process works.
An appeal is a formal way of asking us to review and change a coverage decision we have made. For more information on making an appeal about your medical care, see Chapter 9 of the Evidence of Coverage (EOC): What to do if you have a problem or complaint (coverage decisions, appeals, complaints).
Calls to this number are free. We are available from 8 a.m. to 8 p.m., seven days a week. After 8 p.m. please leave a message and we will return your call the following day.
This number requires special telephone equipment and is only for people who have difficulties with hearing or speaking.
Calls to this number are free. We are available from 8 a.m. to 8 p.m., seven days a week.
|WRITE||Blue Cross of Idaho
P.O. Box 8406
Boise, ID 83707
Medicare beneficiaries may enroll in Blue Cross of Idaho Medicare Advantage plans through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
Call from 8 am to 8 pm
7 days a week
3000 E Pine Ave.
Meridian, ID 83642-5996
P.O. Box 8406
Boise ID 83707-2406
If you have special needs, the information on this site may be available in other formats or languages. To find out more call 1-888-494-2583.
Blue Cross of Idaho is a PPO, HMO or HMO POS health plan with a Medicare contract. Enrollment in Blue Cross of Idaho depends on contract renewal.