Coverage Decisions, Appeals & Grievances


Requesting an Organization Determination (for Medical Services)

  • Call: (888) 609-0692, TTY 711
  • Fax: (866) 874-0857
  • Mail:
    Harvard Pilgrim Health Care
    Medicare Advantage Organization Determinations
    1600 Crown Colony Drive
    Quincy, MA 02169


Requesting a Coverage Determination (for a Part D Drug)

  • Call: (888) 807-5745, TTY 711
  • Fax: (888) 807-6643
  • Mail:
    MedImpact Healthcare Systems, Inc.
    Prior Authorization Department
    10181 Scripps Gateway Court
    San Diego, CA 92131


Filing an Appeal or Complaint

  • Call: (888) 609-0692, TTY 711
  • Fax: (617) 509-4232
  • Mail
    Harvard Pilgrim Health Care
    Medicare Advantage Stride
    Appeals & Grievances
    P.O. Box 690345
    Quincy, MA 02269


Contacting the Centers for Medicare & Medicaid Services (CMS)

For more information about appeals and grievances, see your Evidence of Coverage.

You have the right to obtain an aggregate number of grievances, appeals and exceptions that members have filed against our plan in the past. To get this information, ask questions about our process or check the status of an issue, call us at (888) 609-0692, TTY users please call 711.

Harvard Pilgrim is an HMO plan with a Medicare contract. Enrollment in Stride℠ (HMO) depends on contract renewal. This information is not a complete description of benefits. Call Member Services at 1-888-609-0692 for more information. TTY users, call 711.


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

Y0098_19172 Last updated: 10/01/18