How to Find a Medicare Number
Look at your social security card. Your social security number is the first part of your Medicare number for part A and B benefits. The second part is the letter A or B, depending on which benefit you are needing the number for. Part A is inpatient hospital benefits and Part B is outpatient medical benefits. For example, if your social security number is 111-22-3333, then your Medicare number for Part A benefits is 111-22-3333-A. If you do not have a social security card or your Medicare card, contact your local SSA office for a list of documents required for obtaining a replacement card.
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For all others, the standard Medicare Part B monthly premium will be $110.50 in 2011, which is a 15% increase over the 2009 premium. The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $110.50 per month. For additional details, see the FAQ titled: "2011 Part B Premium Amounts for Persons with Higher Income Levels".
Coventry Medicare: Grievances & Appeals
How do I submit a Part C Organization Determination to request coverage for medical services? You, your doctor, or representative can call, fax or mail your request to us. Phone and Fax: Our contact information (phone number, address, and fax number) is available to you on the contact us page of this website and in the plan’s Evidence of Coverage (EOC). You can also call us using the number on the back of your ID card. Fax: 855-788-3994 Mail: Part C Appeal & Grievance P.O. Box 7776 London, KY 40742-7776 What can I do if my Part C Organization Determination request is denied? If we don’t cover or pay for your benefits or services, you, your doctor, or representative can appeal our decision. You need to submit your name, address, member number and reason for appealing. Any evidence you want us to review, such as medical records, doctor’s letter or other information that explains why you need the item or services, can be submitted. Call your doctor if you need this information . For a standard appeal, mail or fax deliver your appeal to: Part C Appeal & Grievance P.O. Box 7776 London, KY 40742-7776 Fax: 855-788-3994 For an expedited appeal: Phone: 866-613-4977 Fax: 855-788-3994 How do I submit a Coverage Determination for my prescription drug? If you’re a member, you can request an exception if a drug has a prior authorization, quantity limit or step therapy. Not an Aetna member yet? You can call 1-877-988-3589 (TTY: 711) to get answers to your questions. You, your doctor, or representative can submit the online form, or download the form for your type of plan, and fax or mail deliver your request to us. You may also call us. Submit online form If we don’t currently cover your medication or you need prior authorization before we cover your medication, you can ask for this coverage by completing one of the forms below: First Health Part D Prescription Drug Plans Medicare Advantage Plans Fax: 1-800-639-9158 Mail: Part D – Medicare Appeals & Grievances P.O. Box 7773 London, KY 40742 Phone: Our phone numbers (standard and expedited) are on the contact us page of this website, in the plan’s Evidence of Coverage (EOC), and on your ID card. What can I do if my Coverage Determination is denied? If we deny your Prescription Drug request, you can appeal our decision. You, your doctor, or representative can submit the online form, or download the form below and mail or fax deliver it to us. Submit online form Download: Request for Redetermination of Medicare Prescription Drug Denial Fax: 1-800-535-4047 Mail: Part D Medicare Appeals & Grievances – Redeterminations P.O. Box 7773 London, KY 40742 If your request needs to be “Expedited” you can call or fax us. Expedited Phone Line: 1-800-536-6167 Expedited Fax Number: 1-800-535-4047 What can I do if I have a complaint (also called a “grievance”)? If you have a complaint about your medical or pharmacy coverage, you, your representative , or your doctor can call, fax, or write to us. For Part C Appeal and Grievance: Phone : Our phone numbers are on the contact us page of the website, in the plan’s Evidence of Coverage (EOC), and on the back of your Member ID card. Mail: Part C Appeal & Grievance P.O. Box 7776 London, KY 40742-7776 Fax #: 855-788-3994 For Part D Appeal & Grievance: Phone : Our phone numbers are on the contact us page of the website, in the plan’s Evidence of Coverage (EOC), and on the back of your Member ID card. Fax #: 1-800-535-4047 Mail: Part D Appeal & Grievance P.O. Box 7773 London, KY 40742 You can contact the Office of the Medicare Ombudsman for help with a complaint, grievance, or information request. To learn more, visit https://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html. How long does it take to get a decision? You can request either a “Standard” or “Expedited” (fast) decision process. If your health requires it, you can ask us to give you a "fast coverage decision". A "fast coverage decision" is called an "expedited coverage determination" or an “expedited organization determination”. When we give you our decision, we will use the "standard" deadlines unless we have agreed to use the "fast" deadlines. We will respond to your request no later than the below timeframes. Request for an Coventry Medicare Advantage Plan (Part C) Organization Determination Standard Process = Pre-service: 14 days Claims: 60 days Expedited Process = Pre-service: 72 hours Claims: n/a Request for a Coventry Medicare Advantage Plan (Part C) Organization Determination Denial Standard Process = Pre-service: 30 days Claims: 60 days Expedited Process = Pre-service: 72 hours Claims: n/a Request for Prescription Drug Coverage Determination Standard Process= 72 hours Expedited Process= 24 hours Request for Redetermination for a Coventry Medicare Prescription Drug Denial Standard Process= 7 days Expedited Process= 72 hours Coventry Medicare Advantage Plan Grievance Standard Process= 30 days Expedited Process= 24 hours Prescription Drug Plan Grievance Standard Process= 30 days Expedited Process= 24 hours