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A Full Spread of Medicare Rights and Protections

Medicare serves up a buffet of rights for all enrollees. And includes added rights under certain plans—protecting you from bias, immoral or unlawful treatment. Hopefully, you’ll never need to use these rights. But you need to know and understand them.

Your Rights, Briefly

You have the right to:

  • Dignity: You’re treated with respect and protected from prejudice.
  • Privacy: Your personal and health information is kept private.
  • Understanding: You get clear and simple information from Medicare, health care providers, and contractors. Such as questions about what’s covered, your cost, and how to file a complaint or appeal.
  • Access: You have access to doctors, specialists, and hospitals. And includes emergency care.
  • Appeals: You have the right with requesting an appeal if you don’t agree with health care payments and coverage.
  • Complaints: You can file complaints about the quality of your care.

You have other rights depending on your plan:

  • If you have Original Medicare, you have the right to buy Medicare Supplement Insurance, also known as Medigap.
  • If you have Medicare Advantage, you have the right to get a treatment plan from your doctor. And you can see a specialist as often as needed. You also have the right with knowing how to get coverage information before getting services.

Keep These Helpful Numbers

If you feel your rights have been abused, it’s important you reach out. Here are important contacts you need to know.

If you have a question about Medicare:

  • Visit Medicare.gov.
  • Call 1‐800‐MEDICARE (1‐800‐633‐4227; TTY: 1‐877‐486‐2048).
  • Call your State Health Insurance Assistance Program (SHIP). For the most up‐to‐date SHIP phone numbers, visit ShiptaCenter.org opens a new window . Or call 1‐800‐MEDICARE.
  • Call your plan if you have a Medicare Advantage Plan, other Medicare health plan, or a Medicare Prescription Drug Plan.

If you have a complaint:

  • For Original Medicare, call your Beneficiary and Family Centered Care Quality Improvement Organization (BFCC‐QIO). Visit Medicare.gov/contacts. Or call 1‐800‐MEDICARE to get your BFCC‐QIO’s phone number.
  • For a Medicare Advantage Plan, Medicare drug plan, or other Medicare health plan, call the BFCC‐QIO, your plan, or both.
  • If you have End-Stage Renal Disease (ESRD), call the ESRD Network for your state. To get this phone number, visit Medicare.gov/contacts. Or call 1‐800‐MEDICARE.
  • If you feel you’ve been discriminated against, call the Department of Health and Human Services, Office for Civil Rights, 1‐800‐368‐1019 (TTY: 1‐800‐537‐7697). Or visit hhs.gov/ocr/civilrights/complaints opens a new window .

If you want to appeal a coverage decision:

  • Visit Medicare.gov/appeals.
  • Visit Medicare.gov/publications to view or print the “Medicare Appeals” booklet. Call 1‐800‐MEDICARE (1‐800‐633‐4227; TTY: 1-877-486-2048) for a mailed copy.
  • If you have a Medicare Advantage Plan, other Medicare health plan, or a Medicare Prescription Drug Plan, read your plan materials.
  • Call your State Health Insurance Assistance Program (SHIP). For the most up‐to‐date SHIP phone numbers, visit ShiptaCenter.org. Or call 1‐800‐MEDICARE.

The Medicare Beneficiary Ombudsman also helps with resolving issues. Visit go.cms.gov/ombudsman. Or call 1‐800‐MEDICARE (1‐800‐633‐4227; TTY: 1‐877‐486‐2048).

At Your Service

You’ve earned your rights under Medicare. And you’re not alone at the table. Our licensed insurance agents are at your service. They’ll answer your questions and guide you through your entire spread of Medicare rights and protections.

Give us a Call

1-844-672-0317 (TTY: 711)
Monday-Friday
9 AM to 6 PM ET

MR511 7/2022