Nonprofit ยท Medicare Rights Center
Medicare Interactive: Medicare appeals
Free plain-language guides to appealing a Medicare denial, split by Original Medicare, Medicare Advantage and Part D drug coverage, from the Medicare Rights Center. Covers Medicare only.
Know before you go
This is the entry page of a larger Medicare appeals section. It explains that an appeal is a formal request to review a decision, that each level has its own filing and decision deadlines, and that a grievance is a different thing: a complaint to your plan. Which steps apply depends on whether you have Original Medicare, a Medicare Advantage plan or Part D, and for Medicare Advantage on whether care is before or after you got it. It does not cover job-based or Medicaid-only coverage. Your notice states your deadline and controls.
- Cost
- Free to read. The site also sells paid training courses for professionals, as our research review found.
- Where
- Nationwide
- How to start
- Read the appeal basics page, then follow the link for your kind of Medicare. Call 1-800-MEDICARE or your plan to learn why coverage was denied if the notice does not say.
- Have ready
- The denial notice; Your plan name, if you have a private Medicare plan; A letter from your doctor supporting the care
Where this comes from
- Provider
- Medicare Rights Center
- Source we read
- https://www.medicareinteractive.org/understanding-medicare/denials-appeals/introduction-to-appeals/appeal-basics
- Date we read it
- . This is not a fresh check.
- Date the provider printed
- 2025-03-31
- What we checked
- We read the provider's public page. We have not verified availability, eligibility or outcomes for any individual.
Other starting points
- Program or service
Beneficiary and Family Centered Care Quality Improvement Organizations: find yours
The Medicare contractors that handle fast appeals when hospital or other care is ending too soon, and complaints about the quality of care. Each state is assigned to one of two organizations.
From Centers for Medicare & Medicaid Services
- Program or service
California Department of Managed Health Care: Independent Medical Review
California's regulator for managed care plans reviews denials of medical services, emergency payment and experimental treatment through Independent Medical Review. One form starts either a review or a consumer complaint.
From California Department of Managed Health Care
- Program or service
Center for Medicare Advocacy self-help materials
Downloadable self-help toolkits for Medicare denials involving home health care, outpatient therapy and skilled nursing facility care, from a nonprofit law organization. The page describes materials, not a helpline.
From Center for Medicare Advocacy