What action can members take if they are dissatisfied with their Medicare Advantage plan's performance?

Members who are dissatisfied with their Medicare Advantage plan's performance have the option to submit an appeal through the plan's internal grievance process. This action is important because it allows members to formally communicate their concerns to the plan and receive a review of the specific issues they are facing. The grievance process is structured to address complaints regarding services, coverage decisions, or any aspect of care that the member believes is not being met according to the plan's standards.

Utilizing the internal grievance process can lead to a resolution that may improve the member's experience within the plan. It is a proactive way for members to engage with their health plan and advocate for themselves rather than simply waiting for an opportunity to change plans or rely on external entities for resolution. Engaging directly with the plan can sometimes yield faster results and is an essential step before considering other options such as contacting state insurance commissions or waiting for the next enrollment period.