Medicare appeals

As a beneficiary in Original fee-for-service Medicare, you have important appeal rights if Medicare denies payment of services received.

You have similar rights to appeal denied services or payment of services if you are in a Medicare Advantage plan and/or in a Medicare Part D prescription drug plan. These rights as well as your rights to file a grievance are described below.

In this section:

1. If your Part A or Part B Medicare 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 Part C Medicare Advantage claim is denied – If you are in a Medicare Advantage plan, different rules apply when a service or treatment is denied by your plan. Review these important rules and your rights to appeal such decisions.
3. If your Part D Medicare Prescription Drug Coverage claim is denied - Medicare Part D has its own appeals process for denied coverage. Review important steps for making appeals.
4. Resources – Helpful tools and resources to support you when making an appeal or filing a grievance.

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