The Medicare Appeal: Resources to Help Get the Process StartedPosted by Medicare Made Clear
If you are a Medicare beneficiary and Medicare, your Medicare health plan, or your Medicare prescription drug plan has denied coverage or payment for a health care service, item, or prescription drug, you may have the right to file a Medicare appeal.
Below is a List of Several Medicare Appeals Resources.
If you have Original Medicare and you don’t agree with a Medicare decision, read about the five ways to file an appeal.
If you are receiving Medicare-covered services from a hospital, skilled nursing facility, home health agency, outpatient rehab facility or hospice and you think your services are ending too soon, learn how to file a fast appeal.
If you don’t agree with a Medicare prescription drug decision, learn how to file a Medicare prescription drug appeal.
Learn more about the Medicare appeals process through a video series created by The Centers for Medicare & Medicaid Services.
If you have coverage through Programs of All-inclusive Care for the Elderly (PACE), your appeal rights are different from those of a Medicare appeal. Find a PACE Organization near you to help file your appeal.
Contact your State Health Insurance Assistance Program (SHIP) if you need help filing an appeal. You can also appoint a representative, such as a family member, friend, advocate, attorney, doctor or someone else to file an appeal for you. Learn more.
For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
Medicare Made Clear: Find information, tools and resources to help you make informed Medicare decisions.