Your Medicare Rights

If you have Medicare

You have the right to be:

• Treated with courtesy, dignity and respect at all times.
• Protected from discrimination. Every company or agency that works with Medicare must obey the law. They can’t treat you differently because of your race, color, national origin, disability, age, religion, or sex.

You have the right to have:

• Your personal and health information kept private.
• Access to doctors, specialists, and hospitals for
  medically necessary

  services.

You have the right to get:

• Medicare-covered services in an emergency.
• Information in a way you understand from Medicare, health care providers, and, under certain circumstances, contractors.
• Information about your treatment choices in clear language that you can understand, and participate in treatment decisions.
• Medicare information and health care services in a language you understand.
• Your Medicare information in an accessible format, like braille or large print.
• Answers to your Medicare questions.
• A decision about health care payment, coverage of items and services, or drug coverage.

When you or your provider files a claim, you’ll get a notice letting you know what will and won’t be covered. This notice may come from:

• Medicare
• Your Medicare Advantage Plan (Part C) or other Medicare health plan
• Your Medicare drug plan

If you disagree with the decision on your claim, you have the right to file an appeal. You may:

• Request a review (appeal) of certain decisions about health care payment, coverage of items and services, or drug coverage.
• File complaints (sometimes called “grievances”), including complaints about the quality of your care. You may decide to do this if you have concerns about the quality of care and other services you get from a Medicare provider.
• Work with End-Stage Renal Disease (ESRD) Networks and State Survey Agencies to help you with complaints (grievances) about your dialysis or kidney transplant care.

Access to your personal health information

By law, you or your legal representative generally have the right to view and/or get copies of your personal health information from these groups:

• Health care providers who treat you and bill Medicare for your care
• Health plans that pay for your care, including Medicare

These types of personal health information include:

• Claims and billing records
• Information related to your enrollment in health plans, including Medicare
• Medical and case management records
• Other records that doctors or health plans use to make decisions about you

Generally, you can get your information on paper or electronically. If your providers or plans store your information electronically, they generally must give you electronic copies, if you ask for them. You have the right to get your information in a timely manner, but it may take up to 30 days to get a response. Keep in mind, if your information is electronic, you also have the right to have it sent to a third party of your choosing. A third party may be a:

• Health care provider who treats you

• Family member
• Researcher

You may have to fill out a form to request copies of your information and pay a fee. This fee can’t be more than the total cost of:

• Labor for copying the information requested
• Supplies for creating the copy
• Postage (if you ask your health care provider to mail you a copy)

In most cases, you won’t be charged for viewing, searching, downloading, or sending your information through an electronic portal.

Get more information about your rights under HIPAA.

https://www.medicare.gov/basics/your-medicare-rights/your-rights