If you are in Original Medicare, the appeals process for Part A and Part B denials is as follows:

How you begin the process is different if you feel a hospital is asking you to leave too soon (until the level of Administrative Law Judge). For more information, click on the link in the GO TO box.

• Appeals must be decided within specific timeframes. If these deadlines are missed, your case could be elevated to the next level.
• Deadlines for requesting appeals can be extended if good cause exists.

Redetermination (Appeal)

• Must be requested within 120 days of receipt of the Medicare Summary Notice (MSN) denying coverage (unless you have "good cause" for filing late).
  To find out what a Medicare Summary Notice (MSN) is, click on the link in the GO TO box.

• Amount in question does not matter.
• Carrier or fiscal intermediary has 60 days to respond.

Reconsideration (Review by a Qualified Independent Contractor)

• Must be requested within 180 days of receipt of the redetermination decision.
• Amount in question does not matter.
• QIC has 60 days to respond.

Administrative Law Judge (ALJ) Hearing

• Must be requested within 60 days of receipt of reconsideration decision.
• Amount in question must be at least $140 in 2013.
• ALJ has 90 days to respond.

Medicare Appeals Council (MAC) Review

• Must be requested within 60 days of receipt of the ALJ decision.
• Amount in question does not matter.

Judicial Review (Federal District Court)

• Must be requested within 60 days of receipt of the MAC decision.
• You must have at least $1,400 in question in 2013.