Have a Complaint About My Plan With Medicare; When Should I File?In some cases, if you have an issue with your Medicare Advantage or Part D prescription drug plan that has not been resolved through the grievance process, or if you want to make Medicare aware of other issues, you can file a complaint at 1-800-MEDICARE. Medicare uses a system called the Complaint Tracking Module (CTM) to handle beneficiary concerns with Medicare health and drug plans. You might want to call Medicare to make a formal complaint in order to escalate an issue to Medicare’s attention. For example, if a plan fails to respond to appeals according Medicare’s specified deadlines, preventing you from accessing medically necessary services, you should call 1-800-MEDICARE to make a complaint.

The Centers for Medicare & Medicaid Services (CMS), the government agency that oversees the Medicare program, use information from the complaint tracking module in setting Medicare Advantage and Part D star ratings each year. Star ratings measure how well Medicare Advantage and Part D plans perform. Medicare scores how well plans perform in several categories, including quality of care and customer service. Ratings range from one to five stars, with five being the highest and one being the lowest. Making a complaint to Medicare about a problem with a private plan is a way to make sure that plan is held accountable.

Read More: If I Have a Concern About The Quality of Care I Have Received; What Should I Do?
Learn About: If I Have a Complaint About My Durable Medical Equipment Supplier; What Should I Do?
Return to: Medicare In-Depth

Have a Complaint About My Plan With Medicare; When Should I File?In some cases, if you have an issue with your Medicare Advantage or Part D prescription drug plan that has not been resolved through the grievance process, or if you want to make Medicare aware of other issues, you can file a complaint at 1-800-MEDICARE. Medicare uses a system called the Complaint Tracking Module (CTM) to handle beneficiary concerns with Medicare health and drug plans. You might want to call Medicare to make a formal complaint in order to escalate an issue to Medicare’s attention. For example, if a plan fails to respond to appeals according Medicare’s specified deadlines, preventing you from accessing medically necessary services, you should call 1-800-MEDICARE to make a complaint.

The Centers for Medicare & Medicaid Services (CMS), the government agency that oversees the Medicare program, use information from the complaint tracking module in setting Medicare Advantage and Part D star ratings each year. Star ratings measure how well Medicare Advantage and Part D plans perform. Medicare scores how well plans perform in several categories, including quality of care and customer service. Ratings range from one to five stars, with five being the highest and one being the lowest. Making a complaint to Medicare about a problem with a private plan is a way to make sure that plan is held accountable.

Read More: If I Have a Concern About The Quality of Care I Have Received; What Should I Do?
Learn About: If I Have a Complaint About My Durable Medical Equipment Supplier; What Should I Do?
Return to: Medicare In-Depth

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