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Get City Of Wenona Council Meetingjan132016 Form

For a redetermination (appeal) of our decision. You have 60 days from the date of our Notice of Denial of Medicare Prescription Drug Coverage to ask us for a redetermination. This form may be sent to us by mail or fax: UnitedHealthcare Part D Appeal and Grievance Department PO Box 6106 Cypress, CA 90630-9948 MS: CA124-0197 Fax: (866) 308-6294 You may also ask us for an appeal through our website at: www.UHCMedicareSolutions.com Expedited appeal requests can be made by phone at: (800) 595-9532 W.

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