How can I resolve a problem with my HMO coverage?

Who is this for?

Michigan Health Insurance – Customer Service – HMO Plans

If you’re a Blue Care Network member and have a problem with a claim, this explains how to report it, and the grievance and appeals process.

It’s important to us that you’re satisfied with the service you receive and the way a claim or request for benefits is handled. If you have a problem, we want to help.

Who should I contact?

If you have questions about health care you received from a doctor, hospital or other facility, get in touch with your primary care physician.

If you’re not sure who your primary care physician is, or need the contact info:

  • Log in to your account at bcbsm.com. If you’ve haven’t used your account before, you’ll need to register first.
  • Click Doctors and Hospitals in the blue bar at the top of the page.
  • Click Primary Care Physicians.

If it’s about service you received from Blue Care Network, or a problem with a claim, please contact us.

I talked to my primary care physician or Customer Service, and I still have a problem. Now what?

We have a formal grievance and appeals process you can follow. You can begin this process up to two years from when the problem started. It doesn’t cost you anything to file a grievance or appeal a decision.