Appeals & Grievance  Information 

UPDATED as of 4/24/18

Mail / in-person

Address to Request and or File Appeals

Phone/Fax/Email to Request Appeal (UPDATED as of 4/24/18) Aetna Better Health

Appeal info  here.

Member handbook  here.

Aetna Better Health
Grievance Systems Manager
55 West 125th Street, Suite 1300
NYC, NY 10027

TEL: 855-456-9126

FAX: 855-264-3822


Appeal  info  here.

Member handbook   here.

AgeWell New York
Appeals and Grievances Department
1991 Marcus Avenue. Suite M201
Lake Success, NY 11042

TEL: 866-586-8044

Archcare Community Life Member handbook  here. Appeals & Grievances Department, 33 Irving Place, 11th Floor, New York, NY 10003

TEL: 855-467-9351

FAX: 212‑524‑5163

Centers Plan for Healthy Living

Grievance & Appeals Appeal info here  

Where to request appeals here.

Member handbook here (4 languages) (3/2017)

 Centers Plan for Healthy Living Advantage Care HMO
75 Vanderbilt Avenue
Staten Island, NY 10304
Attention: Grievance and Appeals Department

TEL:  855-270-1600 ext 3792

FAX:  347-505-7089


ElderServe Health Inc. Corporate Policy – MLTC – Appeals from Adverse Determinations, undated. Corporate Policy – MLTC – Grievance Procedure, undated.

Quality Department        80 West 225 St, 2nd floor, Bronx, 10463

TEL: 800-370-3600

FAX: 888-341-5009 (To Pamela Baez)

Extended MLTC Member Handbook Effective 5/01/2018 Extended MLTC, LLC, 21 Penn Plaza 360 West 31st Street, Suite 304, New York, NY 10001 ATTN: Membership Services Department.

TEL: 855-299-6492

FAX: 718-761-5948

Fidelis Care at Home

Corporate Policy – MLTC – Appeals from Adverse Determinations, last revised August 22, 2011.  Appeals information begins on p. 8.

Corporate Policy – MLTC – Greivance Procedure, p. 1

Member handbook   here.

Fidelis Care at Home, 95-25 Queens Boulevard, Rego Park, New York 11374

TEL: 800-688-7422

FAX: 716-803-8727

Guildnet MLTC

Corporate Policy – MLTC – Appeals from Adverse Determinations, dated Dec. 21, 2005.

Corporate Policy – MLTC – Grievance Procedure, dated July 2005.

Corporate Policy – MLTC – Appeals of Grievances, dated July 2005.

Guildnet MLTC

250 West 64th Street
New York, NY 10023

TEL: 800-932-4703


HealthPlus MLTC (Empire BlueCross Blue Shield)

Corporate Policy – MLTC  – Appeals of Adverse Determinations, last revised March 24 , 2011 

Corporate Policy – MLTC – Grievance Procedure, last revised Dec. 28, 2011.

Grievance and Appeals Empire BlueCross BlueShield HealthPlus P.O. Box 1198 New York, NY 10116

TEL: 800-950-7679

FAX: 866-495-8716

HomeFirst, Inc. MLTC (ElderPlan)

Member Handbook for Appeals and Complaints

Member Handbook – General (English)

Elderplan Attn: Appeals & Grievances Department 745 64th Street, Brooklyn, N.Y. 11220

TEL: 877-771-1119

FAX: 718-765-2027

Independence Care System

Member handbook available in English and Spanish. (2012)

Director of Advocacy Independence Care System 257 Park Ave. South, 2nd floor New York, N.Y. 10010

TEL: 877-427-2525

FAX: 212-584-2555.

Integra MLTC

Member Handbook English

Member Handbook Appeals and Complaints (05/01/2018)

Member Services Integra MLTC, Inc. 1981 Marcus Avenue, Suite 100 Lake Success, NY 11042 TEL: 855-661-0002 MetroPlus Appeals and Grievance info starts on page 19 of the member handbook – English and Spanish (2014) MetroPlus Health Plan Managed Long Term Care 160 Water Street, 3rd Floor New York, NY 10038

TEL: 800-303-9626          

FAX: 212-908-5282

Montefiore Diamond Care (Bronx) Member Handbook Montefiore Diamond Care Grievances and Appeals Department Box 500 200 Corporate Blvd. South, Suite 200 Yonkers, NY 10701

TEL: 855-556-6683

FAX: 915-457-9516

RiverSpring at Home Member Handbook (English) RiverSpring Star, ATTN: Appeals & Grievance Dept. 94 W 225th St. 2nd Floor; Bronx, NY 10463

TEL: 800-580-7000

FAX: 888-810-0215

Senior Health Partners (Healthfirst ) Member Handbook Senior Health Partners Attn: Appeals and Grievances PO Box 5166 New York, NY 10274-5166

TEL: 800-633-9717

FAX: 646-313-4603

Senior Whole Health of New York – MLTC

Member handbook available here.

Senior Whole Health of New York Quality Improvement Department
58 Charles Street
Cambridge, MA 02141
TEL: 877-353-0185

UnitedHealthcare Personal Assist

Member handbook  beginning page 30. Spanish. (2014)

UnitedHealthcare Community Plan Attn: UM Appeals and Grievance Coordinator P.O. Box 31364 Salt Lake City, UT 84131-0364

TEL: 877-512-9354

VillageCare Max Member handbook  beginning page 29.

VillageCareMAX Appeals 112 Charles Street New York, NY 10014

TEL: 800-469-6292

FAX: 212-337-5711


Member handbook  beginning page 58.

MLTC Grievance and Appeals
P.O. Box 445
Elmsford, NY 10523

TEL: 800-469-6292


WellCare Advocate MLTC Appeals information available here.  Member handbook    here. WellCare Appeals Department
P.O. Box 31384
Tampa, FL 33631-3384

TEL: 877-395-4282

FAX: 866-201-0657

Go to Source

Grievance and Appeal Contacts for Managed Long Term Care Plans