Appeal
An Appeal is a chosen action people take if they disagree with a payment or coverage decision made by a Medicare health plan, Medicare Prescription Drug Plan or by Medicare. Appeals can be available if Medicare or your plan denies one of the following:
- A request for a prescription drug, health care service, supply, or item that you believe you should be able to get.
- A request for payment for a prescription drug, health care service, supply, or item you already received.
- A request to change the amount you must pay for a prescription drug, health care service, supply, or item.
People can also appeal if your plan or Medicare stops providing or paying for part or all of a prescription drug, service, supply, or item you feel is still needed.
