If you think there is something wrong with a bill for a Medicare Medicare is the federal government health insurance program that provides health care coverage if you are 65 or older, are under 65 and receive Social Security Disability Insurance (SSDI) for 24 months, begin receiving SSDI due to ALS/Lou Gehrig’s Disease, or have End-Stage Renal Disease (ESRD) no matter your age. You can receive health coverage directly through the federal government (see Original Medicare) or through a private company (see Medicare Advantage). service, call your doctor, provider See Health Care Provider. , or the facility first to check if there was an error. You may want to speak to the billing department as well.
If you are still concerned and have Original Medicare Original Medicare, also known as Traditional Medicare, is the fee-for-service health insurance program offered through the federal government, which pays providers directly for the services you receive. Almost all doctors and hospitals in the U.S. accept Original Medicare. , you can contact the Medicare Administrative Contractor (MAC) Medicare Administrative Contractors (MACs) are private companies that process Part A and Part B medical claims or Durable Medical Equipment (DME) claims for Original Medicare beneficiaries. Each MAC serves a defined geographic area. To find the MAC in your region, call 1-800-MEDICARE. . The MAC is the company that processed your Medicare claim A claim is a bill that health care providers submit to Medicare to ask for payment for services you received. Medicare Part A and Part B claims are processed by Medicare Administrative Contractors (MACs). Medicare Advantage Plan and Part D plan claims are processed by those private plans. See also: Medicare Administrative Contractor (MAC) and Durable Medical Equipment Medicare Administrative Contractor (DME MAC). , and their information can be found on your Medicare Summary Notice (MSN). Alternatively, you can call 1-800-MEDICARE (1-800-633-4227).
If you are still concerned and have a Medicare Advantage Medicare Advantage, also known as Part C, Medicare Private Health Plan, or Medicare Managed Care Plan, allows you to get Medicare coverage from a private health plan that contracts with the federal government. All Medicare Advantage Plans must offer at least the same benefits as Original Medicare (Part A and Part B), but can do so with different rules, costs, and coverage restrictions. Plans typically offer Part D drug coverage as part of Medicare Advantage benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs), and Medicare Medical Savings Accounts (MSAs). Plan, contact your plan directly. Your plan’s phone number should be on the back of your benefit card and on your Explanation of Benefits (EOB).
To report fraud, contact 1-800-MEDICARE, the Senior Medicare Patrol (SMP) Resource Center (877-808-2468), or the Inspector General’s fraud hotline at 1-800-HHS-TIPS (447-8477). Medicare will not use your name while investigating if you do not want it to.