Medicare Appeals
Patients with Medicare coverage have a guaranteed right to appeal decisions about their health care coverage. You can appeal a denial of coverage of a medical service or a refusal to reimburse your medical costs. Regardless of which type of Medicare you are appealing (Part A, B, C, or D), the appeal process starts out with a request for your Plan provider or Medicare administrator to reconsider the initial decision. Next you can ask a specific outside review body to review your claim. If you are still denied, you can request a hearing with an administrative law judge at the Office of Medicare Hearings and Appeals.
Medicaid appeals are much different, since Medicaid is a state-run program.
If you are denied Medicare coverage or payment for a hospital stay or doctor's visit, here's how to appeal.
You can quickly appeal the decision if your hospital stay or other health care services are being cut short.
If you applied for Medicaid and your state Medicaid agency denied your application, then you can appeal the denial.
If you receive a notice of action that you are being denied Medicaid, appeal.
Nolo's book explains how Medicare works and discusses Medicare coverage, premiums, and co-insurance in detail.
Written by a former SSA medical consultant, Nolo's Guide to Social Security Disability discusses all medical conditions eligible for Social Security disability.
Fill out this form to arrange a consultation with a Social Security lawyer in your area.
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