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Know the Process

As a member of Granite Alliance you have the right to ask for a coverage determination, redetermination, or to file a grievance about your coverage. Your Granite Alliance plan also has several beneficial programs in place - such as medication therapy management, transition fills, and opioid protections. Learn about all of these services below!

Coverage Determinations

A coverage determination is a decision that we make about your benefits and coverage, or about the amount we will pay for a prescription drug. 

Learn More about
 Coverage DeterminatiONs

Appeals (or Redeterminations)

If we make a coverage determination and you are not satisfied with our decision you can “appeal” the decision. An appeal is also known as a plan “redetermination”. 

Learn More about appeals


A grievance is a complaint you file with Granite Alliance. If you contact us with a complaint, we will file a grievance on your behalf.

learn more about grievances

Opioid Policy

Granite Alliance is committed to help combat the opioid epidemic. Learn more about the protections in place to ensure proper care when prescribed opioid medications. 

learn more about Opioids

Transition Policy

Granite Alliance's Transition Policy provides new enrollees access to prescription drugs within 90 days of enrollment for non-formulary drugs and drugs with certain requirements.

learn more about transition

Last Updated Date: ​​​01/01/2024

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