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Medicare Advantage Authorizations, 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.

More information

PDF Notice of privacy practices

Also, the Evidence of Coverage (EOC) includes more details about grievances, coverage determinations, appeals procedures, and exceptions in Chapter 9, and your rights and responsibilities upon disenrollment are listed in Chapter 8.

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:

Health First Health Plans
6450 US Highway 1
Rockledge, Florida 32955

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

Y0089_EL8540M | Accepted date: 10/01/2020
Last updated: 10/01/2020