Alert
Close

Help Disrupt Aging. Join White House Live Stream Today at 8:30 a.m. ET. Learn more

HIGHLIGHTS

Close
AARP Staying Sharp: Keep Your Brain Healthy

AARP VETERAN MEMBERSHIP

Military and Veterans Discount

AARP REALPAD

The tablet with free 24/7 customer support. Learn More

CONTESTS AND SWEEPS

You Could Choose Your Dream Vacation

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

AARP Books

Medicare for Dummies book cover

Get the answers you need, from Patricia Barry, AARP's Ask Ms. Medicare

Share Your Thoughts

Reader stories help us fine-tune our education efforts and strengthen our calls for action on issues that matter most to you. We read and learn from every story and may use yours (with permission) to brief legislators, inspire other readers and more. Please share your story with us. Do

Most Popular

Viewed

Appealing a Medicare Claim Decision

Why, when and how to challenge a denial of benefits

Filing an initial appeal if you have a Medicare Advantage (or Part C) health plan

 

Medicare Advantage plans, which are administered by private insurance companies, are required by Medicare to have an appeals process by which you can get a redetermination if your plan denies you a service or benefit you think should be covered.

If you disagree with the decision, you can request an independent review.

If that decision is not in your favor, you can proceed up the appeals levels to an administrative law judge, the Medicare Appeals Council and federal court.

In addition, Medicare Advantage companies must give patients a way to report grievances about the plan and the quality of care they receive from providers in the plan.

If you have a Medicare Advantage plan, look at your plan materials or contact the plan administrator for information about filing a grievance or an appeal. For more details, see the Medicare publication “Your Medicare Rights and Protections” or "Medicare Advantage Plans and Medicare Cost Plans: How to File a Complaint (Grievance or Appeal)."

Next: Appealing a Medicare Part D claim decision. >>

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Advertisement

Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

Walgreens 1 discount membership aarp

Members can earn 50 points per $1 spent on select products at Walgreens.

member benefit aarp hear usa

Members can save 20% on hearing aids with the AARP® Hearing Care Program provided by HearUSA.

AARP membership discount Man trying on eyeglasses at optometrists smiling

Members save up to 60% on eye exams and 30% on glasses at LensCrafters.

Membership Benefits Discounts Email Genius

Brain boost? Get AARP email for access to memory exercises & more that help you focus.

Advertisement