Member Grievances & Appeals

Martin's Point plan members or their authorized representatives have the right to express complaints, frustrations, and disagreement about their experience interacting with health care providers, the plan and/or its administrators.

Under state and federal law, members can express those complaints through the Martin's Point grievance and appeals process.

Providers may also file a grievance or appeal on behalf of a current or former member by obtaining authorization from the member.

A grievance is a member complaint about the way the health plan or drug plan is giving care.

For example, a member may file a grievance if they have a problem calling the plan or if they’re unhappy with the way a staff person at the plan behaved towards them.

However, if they have a complaint about a plan’s refusal to cover a service, supply, or prescriptions, they file an appeal.


How to Submit a Grievance

Members or their authorized representatives may submit a grievance by phone or mail:

Medicare icon
Generations Advantage
Grievances

Phone:: 1-866-544-7504 (TTY: 711)

Written grievances can be mailed to:

Martin's Point Health Care
P.O. Box 9746
Portland, ME 04104-5040

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US Family Health Plan
Grievances

Phone: 1-888-674-8734

Written grievances can be mailed to:

Martin's Point Health Care
P.O. Box 9746
Portland, ME 04104-5040

How to Submit an Appeal

Appeals can be submitted by mail at the address below:

Martin's Point Health Care
P.O. Box 8832
Portland, ME 04104-9861

 

For more details on the Grievance and Appeals process for each plan, please see: