How and When to File an Appeal

What is an Appeal?

An appeal is when you or your authorized representative ask us in writing to review a decision that denied a benefit or service.

The Appeal Process

If you believe a decision we have made adversely affects your coverage or benefits, you have a right to file an appeal. You need to let us know within 60 calendar days from the date of your Notice of Action to ask for an appeal.

Online:      File an appeal by signing into your CareSource MyLife account.

Phone:      Call Member Services at  1-833-230-2057 (TTY: 1-833-711-4711 or 711).

Mail:           Write a letter telling us what you are unhappy about. Please include your first and last name, your member ID number, your address, phone number and any information that helps explain your problem. Mail the form or letter to:

HAP CareSource
Attn: Member Grievance & Appeals
P.O. Box 1947
Dayton, OH 45401-1947

If you have chosen an authorized representative to appeal on your behalf, remember to fill out the Appointment of Representative Form.

Learn more about appeals in your Evidence of Coverage.