Caring Starts with Your Rights
Care Wisconsin protects member rights and has clear policies and procedures to address the concerns of members if they or their representatives are ever dissatisfied with decisions or services. We have a well-defined process that meets all Wisconsin Department of Health Services (DHS) requirements. We encourage members to exercise their rights and our goal is for the member to have a positive experience.
If you are unhappy or dissatisfied with a decision, first discuss it with your care team. Talking with your team is usually the fastest and easiest way to address your concerns.
If you do not want to talk with your team, call our Member Rights Specialist at 1-800-963-0035 ext. 3448 Monday-Friday. 8 a.m.-4:30 p.m. Our Member Rights Specialist can tell you about your rights, attempt to informally resolve your concerns, and help you file a grievance or appeal.
Understanding Grievances & Appeals
Grievances & Appeals Process
Contact Information By Program
Resource Downloads For Grievances & Appeals
June 12, 2018 | pdf (95.08 KB)
Learn how to address your concerns or problems with Care Wisconsin, one of our providers, or the quality of your care or services.
June 12, 2018 | pdf (57.44 KB)
Learn how to request a review of your care team's decision about your services.
June 12, 2018 | pdf (69.47 KB)
If you want someone else to represent you in a grievance or appeal, print out and complete this form.
June 12, 2018 | pdf (79.10 KB)
Learn about the grievance process for Medicaid-only Partnership members.
June 12, 2018 | pdf (39.50 KB)
Use this form to file a grievance with Care Wisconsin.
June 12, 2018 | pdf (103.25 KB)
Ask for a coverage determination or exception by completing this form.
June 12, 2018 | pdf (44.19 KB)
Ask for a coverage redetermination (appeal) of a Medicare Part D prescription drug by completing this form.