Medicare Advantage
Prior Authorizations, Exceptions, Appeals and Grievances

Health First Health Plans wants to make sure you get the care you need, and you understand how to get care under special circumstances.

• Medical Authorizations, Appeals, and Grievances
• Part D Authorizations, Exceptions, Appeals, and Grievances

More information

Notice of privacy practices

How to appoint a representative

If you want to name someone (such as a relative, friend, advocate, doctor, lawyer, or anyone else) to handle appeals and grievances with us on your behalf, the person you name would be your appointed representative. You can use this form:

Appointment of representation form 

If you want to give someone permission to access your personal health information (for example claims, medical, or financial information) please use this form:

Authorization to disclose your Protected Health Information (PHI) form

Please send your completed form(s) to us at:

AdventHealth Advantage Plans
Attn: Concierge Department
PO Box 60788
Phoenix, AZ 85082

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AdventHealth Advantage Plans is administered by Health First Health Plans. Health First Health Plans is an HMO plan with a Medicare Contract. Enrollment in Health First Health Plans depends on contract renewal.

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Y0089_EL9652AH_M | Accepted date: 10/01/2021
Last updated: 10/01/2021