If you have a complaint about your care or the service you receive from Gundersen Lutheran Health Plan or any of our doctors, clinics or hospitals, please call our Customer Service Department at 1-866-537-1477 or 608-775-0150. You can also send a complaint to us in writing at:

Gundersen Lutheran Health Plan
Attention - Customer Service
Mailstop NCA2-01
1836 South Avenue 
La Crosse, WI 54601

If we do not resolve your problem, you have the right to file a formal written grievance or appeal to Gundersen Lutheran Health Plan’s Member Advocate at:

Gundersen Lutheran Health Plan
Attention - Member Advocate
Mailstop NCA2-01
1836 South Avenue
La Crosse, WI 54601

If you want to talk to someone outside of Gundersen Lutheran Health Plan about the problem, call the HMO Enrollment Specialist at 1-800-291-2002. The Enrollment Specialist may be able to help you solve the problem, or can help you file a formal grievance to the BadgerCare Plus program. The address to complain to the Wisconsin BadgerCare Plus program is:

BadgerCare Plus Managed Care Ombuds
P.O. Box 6470
Madison, WI 53716-0470
Phone: (800) 760-0001

If your complaint, grievance or appeal needs action right away because a delay in treatment would greatly increase the risk to your health, please call Gundersen Lutheran Health Plan as soon as possible. We will require verification from your doctor that a delay in treatment is a health risk.

You have the right to appeal to the State of Wisconsin Division of Hearings and Appeals (DHA) for a fair hearing if you believe that your benefits are wrongly denied, limited, reduced, delayed or stopped by Gundersen Lutheran Health Plan. An appeal must be made no later than 45 days after the date of the action being appealed. If you appeal an action to DHA before the effective date, the service may continue. You may need to pay for the cost of the services if the hearing decision is not in your favor. You may file an appeal to DHA at any time, even if you have already filed an appeal with Gundersen Lutheran Health Plan. If you want a fair hearing, send a written request to:

Department of Administration Division of Hearings and Appeals
P.O. Box 7875
Madison, WI 53707-7875

The hearing will be held in the county where you live. You have the right to bring a friend or be represented at the hearing. If you need a special arrangement for a disability, or for English language translation, please call 1-608-266-3096 (voice) or 1-608-264-9853 (hearing impaired). If you need help writing a request for a fair hearing, please call either the BadgerCare Plus Ombudsman at 1-800-760-0001 or the HMO Enrollment Specialist at 1-800-291-2002.

Gundersen Lutheran Health Plan cannot treat you differently than other members because you file a complaint, grievance, appeal or request a fair hearing. Your healthcare benefits will not be affected.