Resolving Problems for HMO Members

What is this about?

If you have a problem with your Blue Care Network service, this information explains what group and individual customers can do to resolve it.

Blue Care Network and your primary care physician want you to be satisfied with the services you receive as a group or individual member. If you have a problem relating to your care, we encourage you to first discuss it with your PCP. Often your PCP can correct the situation to your satisfaction. Of course, you are always welcome to contact us with any questions or problems you may have. Just call the customer service number on the back of your enrollee ID card and we'll try to help.

In the event you are unable to resolve your concern through your PCP or customer service, we have established a formal grievance process. If you're a group or individual customer, you have two years from the date of discovery of a problem to file a grievance with or appeal a decision of BCN. There are no fees or costs charged to you when filing a grievance. At any step of the grievance process, you may submit any written materials to help us in our review.

Choose from the options below to get started.

Do you get your health insurance through your employer, union or other group?

Did you buy your own insurance plan for you or your family?

Do you have a medical condition that requires a quick decision? Did we deny your request for coverage of a service that you haven’t had?

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