Grievances and Appeals Under 65 Members Home Member Resources Help and Support Grievances and Appeals You have the right to file a grievance or complaint and appeal a decision made by us. Use the links below to review the appropriate appeal document, which presents important information on how to file, timeframes and additional resources. Medicare Members: access grievance and appeals information here. Grievances and Appeals First Level Complaint Appeal Rights Important information about your rights and how to file a complaint appeal. Learn More First Level Grievance Appeal Rights Important information about your rights and how to file a grievance appeal. Learn More Final Level Grievance Appeal Rights Important information about your completed final level of internal review and other resources to help you. Learn More Medicaid Grievance and Appeals Rights Important information about your rights and other resources to help you. Learn More HARP Grievance and Appeals Rights Important information about your rights and other resources to help you. Learn More Medicare Appeal Information Important information about your rights and other resources to help you. Learn More EmblemHealth Plan, Inc. Hospital and Medical Claim Appeal Information Important information about your rights and other resources to help you. Learn More HIP Claim Appeal Information Important information about your rights and other resources to help you. Learn More NYS EmblemHealth Plan, Inc. Dental Claims Appeal Information Important information about your rights and other resources to help you. Learn More If you have any questions or need help reading or understanding these documents, please call EmblemHealth Customer Service. KNOW YOUR RIGHTS Member Rights and Responsibilities Understanding your rights and responsibilities as a plan member can help you and us make the most of your membership. Learn More SUPPORT Consumer Protections Learn about certain protections which are effective with dates of service on or after March 31, 2015, as well as what to do if you feel you have received a surprise bill. Learn More HELP AND SUPPORT Pharmacy Support Search your plan formulary, find participating pharmacies, and access forms. Get Help Find a doctor or medical office Why EmblemHealth Find a Doctor Our Plans Member Resources Live Well Individual & Family Medicare Advantage Medicare Supplement Medicaid, HARP, and CHPlus (State-Sponsored Programs) News and Updates Featured Events Events Pharmacy Payments and Accounts Blog Contact Us Locations Neighborhood Care Legal Information Careers myEmblemHealth Member Portal Sign In Legal Accessibility Statement EmblemHealth Privacy & Security Policies Nondiscrimination Policy Stop Fraud Interoperability Information LANGUAGE ASSISTANCE: Español 中文 Pусский Kreyòl 한국어 Italiano אידיש বাংলা Polski العربية Français اردو Tagalog Ελληνικά Shqip ©2021 EmblemHealth. All Rights Reserved. Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office. Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.