If you are dissatisfied with your Unity health plan, you have the right to share your thoughts. Contact Unity Customer Service at 800.362.3310 to discuss your complaint.

Unity welcomes member input. We work hard to resolve problems that our members share with us. Sometimes our Customer Service staff cannot clear up the matter. In that case, Unity’s Member Advocate will help you with the appeal process.   Unity will respond to your appeal within 30 days. Please check your Certificate of CoverageMyChart link for a full description of your appeal rights.


Please review Important Information about Your Appeal Rights.

Download the Appointment of Authorized Representative for Appeal Form.

You may receive a copy of your grievance case, free of charge, by sending in a completed Access Request for Grievance File form.​

 

Formal grievance process

  • Unity's Member Advocate will review your concern. If the concern is about a medical problem, it will be reviewed by medical staff
  • If the matter still cannot be resolved, your matter will be sent to Unity’s Reconsideration Committee

What if I don’t agree with an appeal decision?

At times, members finish Unity’s internal grievance process and are still dissatisfied. Members may be able to go outside of Unity for a review of the decision. If so, the member can file an independent external review. To do so –

  • Go to http://www.externalappeal.com and follow the directions online
  • Or fax to: 888.866.6190
  • Or mail to: HHS Federal External Review Request MAXIMUS Federal Services 3750 Monroe Ave., Suite 705 Pittsford, NY 14534

If your claim doesn’t meet the rules for independent external review, you have another option. You can contact the state insurance regulator.  The regulator can explain your rights and may be able to help you with the claim.


For questions about your rights, or for assistance, you can contact:

Office of the Commissioner of Insurance
Complaints Department
PO Box 7873
Madison, WI 53707-7873

If your coverage is group health plan, you may also contact the Employee Benefits Security Administration at 866.444.EBSA (3272).


If you are on a Medicare Select Policy and you have questions about the external review process, please contact Unity directly at –