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Complaints, Grievances & Appeals

Plans that are currently available effective on or after January 1, 2018 are underwritten by Banner Health and Aetna Health Insurance Company.

How to file a complaint, grievance or appeal

You have the right to file a complaint, grievance or appeal about:

  • Banner|Aetna
  • Your plan
  • A health care service, provider or professional

Use our online form to file today

You may also mail or fax your information by printing the following form: 
Member Complaint and Appeal FormPDF will open in new window

Get help from your state

Your state insurance office can help you if you don’t agree with a decision made by your health plan or if you decide to appeal a decision.

  • Choose the state you live in if your medical plan is self-funded.
  • Choose the contract state if your medical plan is insured.

If you are not sure, ask your employer or call the toll-free number on the back of your medical plan ID card to find out which type of plan you have.

Get help from the federal government

The Health Care Reform law includes rules about appeals. Many plans have to follow these rules. If your plan is covered by the law, contact the Employee Benefits Security Administration (EBSA) at 1-866-444-EBSA (3272) for help with an appeal.

Learn more about the EBSA

Living outside the United States?

You may have a medical plan that covers you or your family while you’re living outside the United States. If it's subject to the U.S. health care reform law, choose the state where the plan sponsor has its main place of business. Call the toll-free number on the back of your medical plan ID card if you're not sure.

Arizona

Arizona Department of Insurance

Consumer Services
2910 N. 44th Street, Ste. 210
Phoenix, AZ 85018-7269

  • 800-325-2548

  • 602-364-2499 (Phoenix)

  • 602-364-2977 (Spanish)

http://www.id.state.az.us/
E-mail: consumers@azinsurance.gov

Transforming health care, together

Banner|Aetna aims to offer access to more efficient and effective member care at a more affordable cost. We join the right medical professionals with the right technology, so members benefit from quality, personalized health care designed to help them reach their health ambitions.

Contact us

What's New

Health benefits and health insurance plans are offered, underwritten, and/or administered by Banner Health and Aetna Health Insurance Company and/or Banner Health and Aetna Health Plan Inc. (Banner|Aetna). Banner|Aetna is an affiliate of Banner Health and of Aetna Life Insurance Company and its affiliates (Aetna). Each insurer has sole financial responsibility for its own products. Aetna and Banner Health provide certain management services to Banner|Aetna. Aetna, CVS Pharmacy® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies.

On-Demand Virtual Care with 98point6 by Transcarent

Banner|Aetna offers access to 98point6 by Transcarent, a virtual care solution that enables members to connect to care anytime, anywhere via secure in-app messaging.

Treatment is provided by a U.S.-based care team, including board-certified doctors, who can diagnose and treat over 1,000 conditions, outline care options, prescribe* medication, and order labs or imaging when appropriate—all through the convenience of a mobile app.

Key Features:

  • Audio, video, and Spanish translation support available as needed
  • Access to care plans and lab results directly within the app
  • Referrals to in-network resources and specialists
  • Care is available in all 50 states and Washington D.C.
  • 24/7/365 access with an average wait time of under 2 minutes—no appointment required.

Available to enrolled Banner|Aetna members and covered dependents age 1+* in an eligible plan.

Cost: Low-to-no-cost per visit*, depending on plan details.

*FOR ENROLLED MEMBERS AND COVERED DEPENDENTS AGE 1+: 98point6 by Transcarent is available to members age 1-17 when an adult parent or guardian is also enrolled in the plan. Access to 98point6 by Transcarent is not included in all plans.

*FOR LOW-TO-NO-COST WITH 98POINT6 BY TRANSCARENT: Members enrolled in a health savings account (HSA) or qualified high-deductible health plan (HDHP) must pay the applicable cost-share for virtual care visit until their deductible is met, after which services will be provided at no cost-share. All other health plan members pay $0 per virtual care visit regardless of whether their deductible has been met. Please refer to your plan documents for your applicable cost-share amounts.

*FOR 98POINT6 BY TRANSCARENT PRESCRIBING: 98point6 by Transcarent providers do not prescribe controlled substances (such as opioids), lifestyle medications (such as Viagra and Propecia) or weight loss medications (Wegovy or Ozempic). 98point6 by Transcarent and Transcarent Clinic clinicians are independent contractors and are neither agents nor employees of Banner|Aetna or plans administered by Banner|Aetna, and does not guarantee that a prescription will be written. Transcarent Clinic providers will not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. Clinicians reserve the right to deny care for potential misuse of services

This material is for information only. An application must be completed to obtain coverage. Rates and benefits vary by location. Providers are independent contractors and are not agents of Banner|Aetna. Provider participation may change without notice.

Health insurance plans contain exclusions and limitations.