2008 Care Wisconsin Formulary (H5209-002 H7475-001 H5893-001)
A list of covered drugs representing the prescription therapies believed to be a necessary part of a quality program. 

 2008 Community Living Alliance Formulary (H5204-001)
A list of covered drugs representing the prescription therapies believed to be a necessary part of a quality program. 

Grievances, Appeals and requests for Coverage Determinations and Exceptions may be
submitted in writing or by contacting us by telephone.

In the event you wish to file a Grievance or Appeal, or request a Coverage Determination or Exception, we encourage you to contact Customer Service right away for assistance.

If you prefer to submit your request in writing, Grievances and Appeals may be submitted by simply sending us a letter describing your concern. Requests for Coverage Determinations or Exceptions may be submitted by printing the Medicare Part D Coverage Determination and mailing the completed form to Care Wisconsin.

To appoint an individual to represent you in the Grievance, Appeal and Coverage Determination process, you will need to complete the Appointment of Representative.

You can find brief definitions of a Grievance, Appeal, Coverage Determination and Exception in the  Glossary of Terms. Definitions also are included in Section 15 of the Evidence of Coverage you received at the time of your enrollment.

Detailed information regarding your Grievance and Appeal rights and about Coverage Determinations may be found in Section 12 of the Evidence of Coverage for your plan. You received a printed copy of your Evidence of Coverage at the time of your enrollment. You also may access the Evidence of Coverage for your plan through the link on this Web site.

Customer Service
Members in need of assistance may contact us, Monday-Friday, 8 a.m. to 4:30 p.m., CT.

Partnership Customer Service
Call: (608) 240-0035 or 1-800-963-0035
WI Relay 711
Fax: (608) 241-5230

Provider Services
Providers should call Provider Services at (608) 245-3053 or 1-800-963-0035.

Mail written Grievance and Appeal to:
Care Wisconsin Health Plan
Attn: Grievances and Appeals
2802 International Lane
Madison, WI 53704.

Mail written request for a Coverage Determination to:
Care Wisconsin Health Plan
Attn: Coverage Determinations
2802 International Lane
Madison, WI 53704