Get to Know Your Plan

We Have You Covered

Depending on the type of plan you have, Traditional or Non-Traditional, you may have coverage for these services:

  • Preventive care
  • Eye care
  • Labs
  • X-rays
  • Newborn coverage
  • Over-the-counter drugs

If you’re already a member and want to know more about what’s covered by your plan, log in to My Health. While certain benefits may not be covered by SelectHealth Community Care, they may be available through state Medicaid. These include mental health, dental, and chiropractic, and transportation services.

Your Rights and Responsibilities

As a SelectHealth Community Care member, you are entitled to a set of rights to make sure you are treated fairly. You are also accountable to stick to a set of responsibilities to make sure you’re following the rules of your plan.

We do not discriminate in hiring or in supplying healthcare because of existing health issues, color, creed, age, national origin, handicap, religion, sex, or sexual orientation. If you have questions or want to file a complaint or Grievance about a claimed discrimination, please call the SelectHealth Civil Rights Coordinator at 801-442-9950.

Get informed. Review a full list of your member rights and responsibilities.

Actions, Appeals, and Grievances

You’ll have 60 days from the date we take action to ask for an appeal. If you need help filing an Appeal, call the Appeals department at 844-208-9012. We have interpreters and help for those with hearing problems.

If you have a concern or complaint, you can file an action, appeal, or grievance. Read more about each one to decide which one best
meets your needs.

What is an Action?

An Action is when SelectHealth:

  • Denies care or approves less care than you wanted
  • Denies a covered service you have had
  • Lowers the number of services you can get or ends a service we approved
  • Denies payment for care that you may be responsible to pay for
  • Does not take care of an Appeal or Grievance as soon as we should

If you have a problem with an Action we have taken, call Member Services. They can solve most problems. If you are unhappy with how things work out with Member Services, you can file an Appeal or Grievance.

What is an Appeal?

An Appeal is when you write and ask us to review an Action we have taken to see if we made the right ruling on your claim. See our Appeal form.

What is a Grievance?

A Grievance is a complaint about anything other than an Action. Some Grievances are:

  • The quality of care you received
  • A doctor was rude to you
  • Your rights were not respected by a SelectHealth staff member
  • A doctor won’t see you in a reasonable amount of time
  • You were not treated fairly, or you feel you were denied your member rights or discriminated against

See our Grievance form or contact Member Services at 800-538-5038 to file a verbal Grievance.

Our mailing address:

     SelectHealth Appeals
     P.O. Box 30192
     Salt Lake City, Utah 84130-0192

Medicaid Handbook

Read more about your plan in the Medicaid Member Handbook. You’ll find phone numbers, information about programs we offer, details about what is—or isn’t—covered by your plan, and more.

Medicaid Member Handbook – English
Medicaid Member Handbook – Spanish

Lost your paper copy or need this information in a different language? Member Services can help.