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How to Name a Representative to File an Appeal

You, or someone you name to act for you (your authorized representative), may file an appeal. The representative you authorize can be a relative, friend, advocate, attorney, doctor, or someone already appointed by the State to act on your behalf.

If you need assistance naming a representative, you can call Customer Service to learn how to appoint an authorized representative.

If you want someone to act for you, you and your authorized representative must sign, date, and send us a statement naming the person to act for you. You can also use the Medicare form, Appointment of a Representative.

You or your authorized representative should mail or deliver your written appeal to the address below.

Mail to:

True Blue HMO Appeal and Grievance Coordinator
Blue Cross of Idaho
P.O. Box 8406
Boise, ID 83707-2406

Deliver to:

True Blue HMO Appeal and Grievance Coordinator

Blue Cross of Idaho
3000 E. Pine Avenue
Meridian, ID 83642

Fax to:

1-208-331-8829

Y0010_MK 13121 Approved 12-31-2012
Last updated 11-14-2012