Alert
Close

How far could you travel with $10,000? Enter AARP’s Winter Escapes sweeps now!

HIGHLIGHTS

Close

AARP VETERAN MEMBERSHIP

Military and Veterans Discount

CONTESTS AND SWEEPS

AARP REALPAD

Introducing RealPad by AARP

AUTO BUYING PROGRAM

AARP Auto Buying Program

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Download the ipad App

AARP-iPad-ePub-app

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

Most Popular

Viewed

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

Appealing a Medicare Claim Decision

Why, when and how to challenge a denial of benefits

If you disagree with a decision about one of your Medicare claims, you have the right to challenge that decision and file an appeal.

Situations in which you can appeal include:

  • Denials for health care services, supplies or prescriptions that you have already received. For example: During a medical visit your doctor conducts a test. When the doctor submits a claim to be reimbursed for that test, Medicare determines it was not medically necessary and denies payment of the claim.

  • Denials of a request you or your doctor made for a health care service, supply or prescription. For example: Medicare determines that a wheelchair is not medically necessary for your condition.

  • Denials of a request you and your doctor have made to change the price you pay for a prescription drug. For example: Your Medicare Part D drug plan rejects your doctor’s recommendation that you receive a discount on an expensive medication because the available lower-cost drugs are not effective for your condition.


The time limits and requirements for filing an appeal vary depending on which part of Medicare (A, B, C or D) you are appealing.

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.

Discounts & Benefits

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

Membership Discount Benefit Pet Plan Dog

Members save 10% or more on Petplan pet insurance premiums.

Senior couple working on laptop. Medicare open enrollment. (David Jakle/Corbis)

Medicare Open Enrollment Period Ends Dec. 7 ─ AARP® Medicare Plans from UnitedHealthcare.

Grandson (8-9) whispering to grandfather, close-up

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

Member Benefits

Join or renew today! AARP members receive exclusive member benefits & affect social change.

Rewards for Good

Your Points Balance:

Learn More

Earn points for completing free online activities designed to enrich your life.

Find more ways to earn points

Redeem your points to save on merchandise, travel, and more.

Find more ways to redeem points