When initially filing an appeal and for each subsequent level, you have a limited amount of time to file. That said, after the deadline has passed, if you can show good cause for not filing on time, your late appeal may be considered. You can request a good cause extension at any level of appeal, and it is available for Original Medicare, Medicare Advantage, and Part D appeals. Extension requests are considered on a case-by-case basis, so there is no complete list of acceptable reasons for filing a late appeal, but some examples include:
- The notice you are appealing was mailed to the wrong address.
- A Medicare representative gave you incorrect information about the claim you are appealing.
- Illness—either yours or a close family member’s—prevented you from handling business matters.
- The person you are helping appeal a claim is illiterate, does not speak English, or could not otherwise read or understand the coverage notice.
If you think you have a good reason for not appealing on time, send in your appeal as you normally would and include a clear explanation of why your appeal is late. If the reason has to do with illness or other medical condition, a letter or supporting documentation from your health care provider can be helpful.
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