What is an appeal?

An appeal is a special kind of complaint you make if you disagree with a decision (determination) made by the Plan.
For example, you may disagree with the decision (determination) that your request for prescription drugs was denied, or reimbursement for prescription drugs you have already
received was denied.

An appeal to BlueCHiP for Medicare about a Part D prescription drug coverage determination is called a prescription plan “redetermination.” You, your doctor, or other medical provider may file an appeal of the initial determination (decision), or you can name (appoint) someone to do it for you.

Last updated: 03/21/2012

H4152_2014website697 Approved

Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal.