Determinations, Appeals and Grievances
For Medica Signature Solution® and Medica Select Solution® members
Do you have a concern?
If you have a concern, call Member Services first. We'll do everything we can to resolve your concern over the phone.
1-866-810-5032 (TTY: 711)
We’ll try to resolve any complaints that are delivered verbally — over the phone or in person — within 10 days.
What if my concern isn't resolved?
You can take extra steps, including:
- Filing a written complaint (grievance)
- Submitting a complaint to the Minnesota Commissioner of Commerce
Below, we'll walk you through how to complete these next steps.
Written complaints
A written complaint (grievance) is a complaint you formally submit in writing. Filing a written complaint with us means you want us to address it.
Complaints can include:
- Member services
- Other concerns
Within 30 days of receiving your written complaint and all necessary information, we'll notify you in writing of our decision and the reasons for it.
If we can't make a decision within 30 days due to circumstances outside our control, we may take up to 14 additional days to decide. If that happens, we'll let you know the reasons for the extension in advance.
To submit a written complaint, send your written concerns to the address below. Please make sure to indicate your Medicare Supplement policy number in your correspondence:
Medica Member Services
Mail Route CP520
PO Box 9310
Minneapolis, MN 55440-9310
For full information on your rights for complaints, please see your Policy of Coverage.
Complaints about Medicare Payment of Services
If your complaint involves a dispute about payment of services covered by Medicare, you can file an appeal through Medicare. You’ll find the process for this in the Explanation of Medicare Benefits or Medicare Summary Notice forms, which you can get from Medicare.gov. You can also contact the Social Security office at 1-800-772-1213.
Submitting a complaint to the Commissioner of Commerce
You also have the right to direct complaints about benefits to the Minnesota Commissioner of Commerce, either in person or in writing.
Commissioner of Commerce — Minnesota Department of Commerce
Mailing address
Minnesota Department of Commerce
Attn: Consumer Services Center
85 Seventh Place E., Suite 280
St. Paul, MN 55101
Appoint a representative
You can authorize an individual to act on your behalf. Just download and complete the Appointment of Representative form below. Both you and your representative will need to sign the form. When it's complete, you can submit it along with your determination or grievance or send it to the same the location where you already sent your determination or grievance.