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Complaints, coverage decisions and appeals

Process for Aetna Assure Premier Plus (HMO D-SNP) complaints, coverage decisions and appeals

Make us your first stop if you have a concern about your coverage or care.  Just call Member Services at 1-844-362-0934 (TTY: 711). You can call from 8 AM to 8 PM, 7 days a week. 


As a member, you have the right to: 


  • File a complaint about the quality of care or other services you get from us or from a provider. 

  • Ask for coverage of a medical service or prescription drug. In some cases, we may allow exceptions for a service or drug that is normally not covered.  

  • File an appeal if your request is denied. An appeal is a formal way of asking us to review and change a coverage decision we made. 


You’ll take different steps based on the type of request you have. 

Choose a topic to find the right process for you