Medicare Prescription Drug Appeals & Grievances


December 2019: The Parts C and D Enrollee Grievance, Organization/Coverage Determinations and Appeals Guidance has been updated to include recent regulatory changes and will be effective January 1, 2020.  Questions related to the guidance or appeals policy may be submitted to the Division of Appeals Policy at

To access the guidance document, click on the link below titled "Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance" under "Downloads."

A list of specific contacts at Part D sponsors can be found at: /Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/PartDContacts

Use the navigation menu on the left side of this page to link to web pages with more detailed information on Part D such as grievances, coverage determinations and exceptions, appeals, and other guidance.

Web Based Training Course Available for Part D

The course covers requirements for Part D coverage determinations, appeals, and grievances. Complete details and a link to the training module can be found on the "Training" page (link on the left navigation menu on this page).  

Page Last Modified:
12/01/2021 07:02 PM