Do You Know Your Medicare Rights?


If you have Medicare insurance, you are automatically guaranteed a number of specific rights, no matter what plan you have enrolled in. The set of rights pertain both to recipients of the original Medicare Plan (regardless of whether or not they have a Medigap policy) and to recipients of Medicare Advantage Plans.

You have the right to be treated with dignity at all times, whatever the circumstances. You also have the right to be protected from discrimination. Legally, no company should be treating you differently than other recipients due to your race, national origin, religion, disability, age, and gender (unless for certain medical reasons). Additionally, you can expect to receive culturally competent service, in terms of language and cultural sensitivity. If you are concerned that your rights are being violated, or if you need information on health care services in other languages, you can call your state’s Office for Civil Rights (1-800-368-1019).

You also have the right to obtain information about Medicare to help you make sound health care choices. Relating to coverage, costs, and complaint procedures, this information can help you understand your options. If you have questions about the Medicare program, you have the right to receive a response. For answers, you can contact your State Health Insurance Assistance Program, or call 1-800-MEDICARE. If you’re using a Medicare Advantage Plan, you can get in touch with your plan.

You have the right to learn about your treatment options in a way you can understand. Plans cannot have any rules which will hinder your doctor in disclosing treatment information. If you don’t understand something, or need more information, ask. You should be given clear information.

Another expectation you can hold when signing onto a Medicare plan is that you will be able to get emergency care when necessary. Different plans may have different procedures, and some may involve copayments, but all plans should provide some coverage for your emergency medical situation. If it doesn’t, you can appeal the decision. You have the right to know your appeal rights, appeal benefit decisions, and file a complaint about payments, services, quality of care, or other problems.

Finally, you have the right to your privacy. Medicare must keep your health information private, and any time they ask health questions of you, they must stipulate why they need it, whether or not it is optional, what will result if you don’t give the information, and how the information will be used. Your health care provider or Medicare Health Plan must follow federal law protecting your privacy rights. Your state may have other privacy laws as well, which can protect your personal information. You have the right to know what your privacy rights are. Your plan should describe them in writing, and you have the right to find out more by asking questions about them, exercising them, and filing a complaint if you feel these rights are being violated.

Medicare Advantage Plans and Original Medicare may also promise other rights, in addition to these ones, to further protect you.


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