Medicare is broad in scale and complex in nature. It comprises an alphabet soup of parts and plans.
Then there are the many policy combinations, eligibility guidelines, and enrollment periods.
We understand Medicare.
Here, we take on common questions and answer them in detail. Our goal is to remove any confusion or doubts you have about Medicare, so you can move forward with making your decision.
Medicare In-Depth FAQ’s
If you have Original Medicare and your health service or item was denied, you have the right to appeal. Check your Medicare Summary Notice (MSN) to see if Medicare has paid for your services and how much you may owe your provider.A Medicare Summary Notice is a summary...read more
If you have a Medicare Advantage Plan and you were denied coverage for a health service or item before you received the service or item, you can appeal to ask your plan to reconsider its decision. Follow the steps below if you feel that the denied health...read more
If you have a Medicare Advantage Plan and were denied coverage for a health service or item that you have already received, you may choose to appeal to ask your plan to reconsider its decision. Follow the steps below if you think the denied health service...read more
Below are some general rules to follow when appealing the denial of a health service or item:Try to understand the reason that your plan is denying coverage for your health service or item.Address any relevant coverage rules in your appeal letter, and...read more
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...read more
If you are dissatisfied with your Medicare Advantage or Part D prescription drug plan for any reason, you can choose to file a grievance. A grievance is a formal complaint that you file with your plan. It is not an appeal. Times when you may wish to file a...read more
In many cases, you can still appeal if you signed an Advance Beneficiary Notice (ABN). An ABN, also known as a waiver of liability, is a notice a provider should give you before you receive a service if, based on Medicare coverage rules, your provider has...read more