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IX. Medicare Rights and Protections
      e. Appealing Medicare Private Health Plan (HMO, PPO, PFFS, PSO) Denials

1. What do I do if my Medicare private health plan says "no" to the care I need?   Go to
2. What can I do if my HMO doctor refuses to provide me care or refuses to refer me to a specialist?   Go to
3. What can I do if my Medicare private health plan refuses to pay for care I already received?   Go to
4. What can I do if my Medicare private health plan refuses to let me get care I need?   Go to
5. What can I do if my Medicare private health plan refuses to let me get care I need immediately?   Go to
6. If I win my appeal, how long can it take for my Medicare private health plan to approve or pay for my care?   Go to
7. Timeline for filing a Medicare private health plan appeal (standard)   Go to
8. Timeline for filing a Medicare private health plan appeal (expedited)   Go to
9. How do I appeal if my home health agency, skilled nursing facility, or comprehensive outpatient rehabilitation facility wants to end my care (and I am in a Medicare private health plan)?   Go to
10. How can I appeal at upper levels if my home health agency, skilled nursing facility, or comprehensive outpatient rehabilitation facility wants to end my care (and I am in a Medicare private health plan)?   Go to

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