Medicare Advantage

Prior Authorizations, Exceptions, Appeals and Grievances (2014)

Health First Health Plans wants to make sure you get the care you need, and you understand how to get care under special circumstances.

More information

PDF Notice of privacy practices

Also, the Evidence of Coverage (EOC) includes more details about grievances, coverage determinations, appeals procedures, and exceptions in Chapter 9, and your rights and responsibilities upon disenrollment are listed in Chapter 8.

 Florida Hospital SunSaver (HMO) Evidence of Coverage

 Florida Hospital Explorer (HMO-POS) Evidence of Coverage

 Medicare Rx Prescription Drug Coverage
How to appoint a representative

If you want to name someone (such as a relative, friend, advocate, doctor, lawyer, or anyone else) to handle appeals and grievances with us on your behalf, the person you name would be your appointed representative. You can use this form:

 Appointment of representation form 

If you want to give someone permission to access your personal health information (for example claims, medical, or financial information) please use this form:

Authorization to disclose your Protected Health Information (PHI) form

Please send your completed form(s) to us at:

Health First Health Plans
6450 US Highway 1
Rockledge, Florida, 32955

Y0089_MP3536FH Approved 11/06/2013
Last updated: 10/01/2013