Refer to the Evidence of Coverage for information about:

  • Part C organization determinations - SECTION 9
    Part C grievances - SECTION 8
    Part C appeals - SECTION 9
    Part D coverage determinations - SECTION 10
    Part D grievances - SECTION 8
    Part D appeals - SECTION 10

For questions about the appeals, grievances and exceptions processes,
please call:

  • Members:
    For all inquiries:
    Care1st Member Services
    1-800-544-0088 (TTY 1-800-735-2929).
  • Physicians:
    Appeals and Grievance Inquiries:
    Care1st Member Services
    1-800-544-0088 (TTY 1-800-735-2929)
  • Pharmacy Inquiries:
    1-877-RXCARE1 (1-877-792-2731)
  • UM Inquiries:
Explore Care1st Medicare
Care1st Health Plan is an HMO that contracts with the federal government to provide Medicare services and benefits.

All Medicare Advantage and Medicare Prescription Drug Plans agree to stay in the program for a full year at a time. Each year, the plans decide whether to continue for another year. Even if a Medicare Advantage or Medicare Prescription Drug Plan leaves the program, you will not lose Medicare coverage.

If a plan decides not to continue, it must send you a letter at least 90 days before your coverage will end. The letter will explain your options for Medicare coverage in your area.
Senior Choice Gold Award for Excellence Care1st Health Plan Receives Senior Choice Gold Award for Excellence in 2009 Medicare Plan Benefits in Riverside, San Bernardino & San Diego