Medicare Rights

Have you been denied coverage, services, or payment by Medicare?

Call us for information on your Medicare rights!

HICAP staff may be able to help you with your Medicare grievance, or your Medicare appeal.

If you have Medicare, you have rights if you disagree with a decision on your care or coverage. These rights include appealing the decision, filing a grievance with a Medicare health or drug plan, filing a quality of care complaint, and filing complaints with regulatory agencies.

Common Scenarios that trigger Medicare rights include:

Your Medicare Summary Notice (MSN) shows Medicare denial of coverage.

Your Medicare health plan (Medicare Advantage) says it will not cover or pay for a health care service.

You can't get prescriptions that you and your doctor agree you need.

You have a Medicare Late Enrollment Penalty that you disagree with.

You get a notice that says Medicare will stop paying for a medical service.

You don't think you're getting the right care at the right time, or have another concern about the quality of the care you're getting.

HICAP counseling services are provided by Counselors registered by the California Department of Aging who are acting in good faith to provide information about health insurance polices and benefits. This information shall not be construed to be legal advice, and the volunteer HICAP Counselor is generally not liable for acts and omissions in providing counseling to recipients of this service. (W&I Code, Section 9541(f).) If you choose a plan and have difficulty with the enrollment process, the HICAP Counselor may assist you. However, you will be responsible for the actual plan contract. The HICAP Counselor will NOT choose your plan for you.