2024 Medicare Part D appeals and grievances 

Appeals and grievances 

Requesting a Part D Appeal or Grievance

If you would like to file an appeal or grievance contact us:

Phone: (888) 609-0692

Fax: (617) 509-4232

Mailing address:
Harvard Pilgrim Health Care
Appeals & Grievances
P.O. Box 328
Canton, MA 02021

Medicare Prescription Drug Redetermination Request Form (pdf)

Level 2 Appeals
If we have denied your prescription drug appeal, the next step is to request a reconsideration by an Independent Review Organization. The following form contains the information you will need to make this request:

Medicare Part D Reconsideration Form (pdf)

Links on this page may take you away from the Harvard Pilgrim Health Care website.

H6750_24007                                                        Last updated: 1/1/2025