Like all insurance programs, Medicare has many rules and regulations. As a result, even people who work with Medicare daily often do not understand all the rules and exceptions. That's why it is important for you to know what Medicare covers, your Medicare rights and how to exercise them. Then, you can make sure you get the health care you need.
Sometimes mistakes are made; sometimes your situation is new or unusual and doesn't fit nicely within the rules. In these instances you might not get the services you need or Medicare may not pay for them. It is in your best interest to make use of the rights and protections given to you as a person with Medicare, to make sure mistakes are corrected and to know how to properly explain your situation.
Remember, you have rights no matter which type of Medicare plan you choose. If you are in the Original Medicare Plan, a Medicare private health plan (HMO, PPO, PFFS) or have a Medigap policy, you have legal rights to get the care to which you are entitled.