Member Grievances and 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.
Grievance or Appeal?
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 calling Member Services at:
US Family Health Plan Member Services: 1-888-674-8734
Generations Advantage Member Services: 1-866-544-7504 (TTY: 711)
Written grievances for either plan may be mailed to:
Martin's Point Health Care
P.O. Box 9746
Portland, ME 04104-5040
How to Submit an Appeal
Written grievances for either plan may be mailed to:
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 visit: