Quality

Commitment to Excellence in Quality

El Paso Health Medicare Advantage is committed to delivering high-quality services and benefits. Our goal is to ensure you receive the care you need—and the best care possible. We also want you to be fully satisfied with your care, our service, and the benefits we provide.

Visit our Quality Improvement Program to learn more.

Participate in Your Care

Your participation is important to making sure that you are receiving care you need. Here is what you can do:
‍
  • Let us know about any problems or questions you may have.
  • Talk with your doctor about your health. Get answers to your questions. Make sure you understand your treatment plan, so you can follow it.
  • Use the extra services we provide.
  • You may be asked to take part in one more of our programs to improve your care. Please consider using them.
  • Give us feedback

You Have Rights

It is important to us that you understand your rights, your responsibilities, and our process to file complaints and appeals. Make sure to learn more.

Grievance and Appeals
You have the right to file a complaint (grievance) or appeal.

Rights and Responsibilities
Learn about your rights and responsibilities.

If you have questions, please call El Paso Health Medicare Advantage Member Services toll free at 1-833-742-3125 (TTY 711).

We are Available

October 1 – March 31
8 a.m. to 8 p.m. Mountain Time (MT) daily.
‍
April 1 – September 30
8 a.m. to 8 p.m. Mountain Time (MT) Monday through Friday.

Other Important Information

Medical Necessity Criteria
Clinical Practice Guidelines for Medicare are evidence-based recommendations used by the Centers for Medicare & Medicaid Services (CMS) to support coverage decisions, policy development, and care delivery within the Medicare program.

Clinical Practice Guidelines
El Paso Health (EPH) utilizes the Care Guidelines to determine medical necessity for the plans that we manage.
Back to Top
1145 Westmoreland Drive
El Paso, TX 79925-5615

El Paso Health Medicare Advantage Dual (HMO D-SNP)
1-833-742-3125

El Paso Health Giveback (HMO)
El Paso Health Total (HMO)
‍1-833-742-2121

See Hours of Operation here.
Facebook
Youtube
The information posted on this website may be available in other formats such as large print, Braille, and audio. You can request the materials in other formats by calling Member Services.
Last Updated: 10/01/2025
Member Support
Member Quality of Care Grievances and Appeals Clinical Practice Guidelines Medical Necessity Criteria
General Correspondence
P.O. Box 971100
El Paso, TX 79997-1100
You can also report fraud, waste and abuse directly to the Texas Office of Inspector General.
© El Paso Health Medicare Advantage
Fraud, Waste, and Abuse | Privacy Notice under the HIPAA | Non-Discrimination Notice | Privacy Policy | Medicare Compliance Program | Interoperability API Gateway
Notice
You are about to leave the El Paso Health Medicare website to visit:
Go Back Continue
Recorded Link Display