• Members
• Coverage Decisions

Call: 1-800-892-3351.
TTY/TDD should call
1-800-216-1307.
Hours of operation are: 8 a.m. to 8 p.m. local time, Monday through Friday.

Coverage Decisions

Coverage decisions are “determinations” about what tests, treatment services, and prescription drugs are covered or paid for under your health plan. These decisions are guided by Medicare coverage guidelines as well as what is medically necessary, appropriate, and safe. Your physician makes most decisions about your medical care, and HealthMarkets Care Assured^SM works with providers to help ensure that you receive the covered benefits you need.