If your Medicare private health plan (HMO, PPO, PFFS) refuses to provide care that you need, you should appeal the decision. Appealing is easy and free. If you receive a denial in the mail from your private plan, you should follow the instructions on the letter to start the appeals process.
You can receive a denial of payment after you receive a service, or you can receive a denial before you receive the service. The timeline for the appeals process is different depending on whether or not you have already received the service.
For more information on appealing Medicare private health plan denials, click on the related link in the GO TO box.