Medicare appeals issues, claims, problems, etc.
Filing an appeal with Medicare
How to file a complaint – Medicare.Gov
Medicare Appeals Publication # 11525 60 pages
HICAP (Health Insurance Counseling and Advocacy Program) provides free, confidential one-on-one counseling, education, and assistance to individuals and their families on Medicare, Long-Term Care insurance, other health insurance related issues, and planning ahead for Long-Term Care needs. HICAP also provides legal assistance or legal referrals in dealing with Medicare or Long-Term Care insurance related issues.
HICAP counselors are trained in Medi-Cal and Medicare and can help you understand the complex insurance options to find the best fit for you. You can also learn about Medicare or Medi-Cal by attending community presentations or conferences conducted by HICAP counselors.
***Sure they might be of help, but how much training and experience do licensed agents have. Look at all the information on this site!
Rights & Protections for
Everyone with Medicare
Medicare Advantage Plan or Other Medicare Health Plan
Prescription Drug Plan
The Medicare Beneficiary Ombudsman
- This is NOT sales literature, but is provided as a public service for educational purposes.
- AARP Procedures on problems, complaints & appeals from EOC
See our general section on Appeals & Grievances
Question FAQs / Ask Us a Question
With all your experience, is there any effective [grievance] agency for me to go to with the HMO Medicare advantage plan [UHC – AARP] I have? One of UCLA, Endocrinologists made a huge medication error, from which I am very ill. UCLA has denied me a second opinion or a higher level of care.
***One of the very best places to view your rights and procedures for claim problems, appeals, grievances is in the full EOC – Evidence of Coverage that you have a right to view before purchasing or when you get it in the enrollment paperwork or shortly thereafter. Get your EOC go to Table of Contents – Then look for Appeals, claims procedures, etc. and of course the explanation of benefits and if your issue is actually covered.
Sibling & Child Pages
Our general section on Appeals & Grievances
Medicare Appeals # 11525
This official government booklet has important information about:
■ How to file an appeal if you have Original Medicare
■ How to file an appeal if you have a Medicare Advantage Plan or other Medicare health plan
■ How to file an appeal if you have Medicare prescription drug coverage
■ Where to get help with your questions