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Grievance & Appeals

We want you to be happy with services you get from IlliniCare Health and our providers. If you are not happy, you can file a grievance or appeal.

For more information about grievance and appeals, please read your Member Handbook.

grievance is a complaint about any matter other than a denied, reduced, or terminated service or item. We take member grievances very seriously. We want to know what is wrong so we can make our services better. Filing a grievance will not affect your services or your benefits. 

You can file your grievance on the phone by calling IlliniCare Health at 866-329-4701 (TTY: 711). 

You can also file your grievance in writing via mail or fax:

IlliniCare Health
Attn: Grievance & Appeals Dept.
PO Box 92050
Elk Grove Village, IL 60009-2050

Fax: 1-877-668-2076

We will try to resolve your grievance right away. If we cannot, we may contact you for more information. 

An appeal is a way for you to ask for a review of our actions.

If we decide that a requested service or item cannot be approved, or if a services is reduced or stopped, you will get a "Notice of Action" letter from us. If you disagree with the "Notice of Action" letter, you can appeal. You may appeal within sixty (60) calendar days of the date on the "Notice of Action" letter. If you want your services to stay the same while you appeal, you must say so and you must file your appeal within ten (10) calendar days of the date on the "Notice of Action" letter. 

There are two ways to file an appeal.

  1. Call Member Services at 866-329-4701 (TTY: 711). If you file an appeal over the phone, you must follow it with a written signed appeal request.
  2. Mail or fax your written appeal request to:

IlliniCare Health
Attn: Grievance & Appeals Dept.
PO Box 92050
Elk Grove Village, IL 60009-2050

Fax: 1-877-668-2076

IlliniCare Health will send our decision in writing to you within fifteen (15) business days of the date we received your appeal request.

If you need to file an expedited appeal call Member Services at 866-329-4701 (TTY: 711) and ask for an expedited appeal. We will let you know within 24-hours if we need more information. We will make a decision within 24-hours after getting all the needed information. We will notify you and the provider orally and in writing of the decision.