Medicare Appeals

If you are a beneficiary in Original fee-for-service Medicare, you have the right to appeal if Medicare denies payment for the services you receive. You have similar rights if you are in a Medicare Advantage (MA) plan and/or Medicare Part D prescription drug plan. Here, we explain these rights as well as your rights to file a grievance.

In this section:

1. If Your Medicare Part A or Part B Claim Is Denied

   If you have Original fee-for-service Medicare and have been denied coverage for a claim, you have specific protections and appeal rights.

2. If Your Medicare Part C (Medicare Advantage) Claim Is Denied

   If you are enrolled in a Medicare Advantage (MA) plan, different rules apply when a service or treatment is denied by your plan. Learn about these rules and your rights to appeal such decisions.

3. If Your Medicare Part D (Prescription Drug Coverage) Claim Is Denied

   Medicare Part D has its own appeals process for denied coverage. Learn the important steps in appealing decisions.

4. Resources

   Helpful tools and resources to support you when appealing a decision or filing a grievance.

Also, listen to our podcast: Medicare & Appeals — English and Spanish MP3s

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Updated March 13, 2009