How can I join?
1-877-566-3526 (Toll-free)
TTY/TDD 711

Member Services
1-877-794-7268 (Toll-free) 
TTY/TDD 711

Reconsideration Request Forms

If you are interested in filing an appeal of a denial of services or medications, please complete the applicable form below or have your physician complete the form.

For appeals related to clinical matters, please complete the Reconsideration Form and mail to:

Senior Whole Health
Quality Department
58 Charles Street
Cambridge, MA 02141

Download the Medicare Reconsideration Request Form (PDF).

For appeals related to medications, please complete the Redetermination Form and mail to:

Senior Whole Health
Pharmacy Department
58 Charles Street
Cambridge, MA 02141

Download the Medicare Redetermination Request Form (PDF)

Last Updated 09/29/2016
H2224_2014_112 Approved 01/13/2014