What do I do if my Medicare Advantage plan says "no" to the care I need?
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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.
This information was provided by the Medicare Rights Center (MRC), the largest independent
source of health care information and assistance in the United States for people with Medicare.
Founded in 1989, MRC is a nonprofit organization that helps older adults and people with
disabilities get good, affordable health care.
You can learn more about MRC at www.medicarerights.org