Massachusetts

The first thing you need to do is file a complaint with your health plan. By Massachusetts law, complaints must be resolved within 30 days. Follow the steps below to file a complaint and grievance with your health plan:

• The law requires health plans accept your complaint by phone, mail, in person or electronically (by fax or e-mail).
• Tell them you want to file a formal complaint and then explain the problem.
• If you disagree with your health plan’s decision, you have the right to file a grievance.
• Find more information on Massachusetts health plans’ grievance processes here.

Below are links to the complaint forms for Massachusetts’s top health plans:

• Health New England
• AllWays Health Partners
  • Contact Customer Service for more information.
  • Log on to MyUHC.com and complete the “Appeals and Grievance Form”
  • Select: Claims and Accounts > Medical Appeals and Grievances > Member Service Request Form
  • Fax or mail the completed form to the UnitedHealthcare address listed in the instructions

  STEP TWO – File a Complaint

  You have the right to file a complaint with the Massachusetts Office of Patient Protection (OPP) if you have a problem getting the services you need, including quality and affordable health care. To file a complaint you must first complete your health plan’s grievance process.

  • File a complaint with the OPP using the external review request form here.
  • Call the OPP by phone: (800) 436-7757.

  My Patient Rights can help guide you in resolving issues so you can get the health care you deserve.

  Find answers to commonly asked questions.

  State and federal law protects your rights. When you sign up for a health plan and/or if you have problems accessing care through your health plan, it is important to know your rights.

  

  The California Chronic Care Coalition (CCCC) launched this website in California and expanded it nationwide to help people who have been denied treatment or medicines, experienced delays or are dissatisfied with the decisions made by their health plan.

  The information found here including but not limited to, text, graphics, images and all other material contained on this website is for informational purposes only and is not intended to provide medical advice, diagnosis or treatment recommendations. Talk to your doctor or a qualified healthcare provider about any health or medical questions you may have, and to determine the correct course of action for your individual needs.

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