What are
MY MEDICARE RIGHTS? All people with Medicare have certain rights and protections. You have the right to: • Be treated with courtesy, dignity, and respect at all times. • Be protected from discrimination. • Have personal and health information kept private. • Get information in a way you understand from Medicare, health care providers, and, under certain circumstances, contractors. • Learn about your treatment choices in clear language you can understand, and participate in treatment decisions. • Get Medicare information and health care services in a language you understand. • Get your Medicare information in an accessible format, like braille or large print. Note: If you need plan information in a language other than English or in an accessible format, contact your plan. • Get answers to your Medicare questions. • Have access to doctors, specialists, and hospitals for medically necessary services. • Get Medicare-covered services in an emergency. • Get 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 comes from one of these: • Medicare • Your Medicare Advantage Plan (Part C) or other Medicare health plan • Your Medicare drug plan for Medicare drug coverage (Part D) If you disagree with the decision of your claim, you have the right to file an appeal. • Request a review (appeal) of certain decisions about health care payment,coverage of items and services, or drug coverage. • Be able to file complaints (sometimes called “grievances”), including complaints about the quality of your care. You can file a complaint if you have 12
Aging Times Magazine | April 2022
concerns about the quality of care and other services you get from a Medicare provider.
What are my rights if my plan stops participating in Medicare?
Medicare health and drug plans can decide not to participate in Medicare for the coming year. In these cases, your coverage under the plan will end after December 31. Your plan will send you a letter explaining your options. If this happens: • You can choose another plan between October 15 –December 7. Your coverage will begin January 1. • You’ll also have a special right to join another Medicare plan until February 28, 2022. • You may have the right to buy certain Medigap policies within 63 days after your plan coverage ends.
YOUR RIGHT TO ACCESS YOUR PERSONAL HEALTH INFORMATION
By law, you or your legal representative generally has the right to view and/or get copies of your personal health information from health care providers who treat you, or by health plans that pay for your care, including Medicare. In most cases, you also have the right to have a provider or plan send copies of your information to a third party that you choose, like other providers who treat you, a family member, a researcher, or a mobile app you use to manage your personal health information. This includes: • Claims and billing records • Information related to your enrollment in health plans, including Medicare • Medical and case management records (except psychotherapy notes) • Any other records that have information that doctors or health plans use to make decisions about you You may have to fill out a health information “request” form, and pay a cost-based fee for copies. Your providers or plans should tell you about the fee when you make the request. If they don’t, you should ask. The fee can only be for the labor to make the copies, copying supplies, and postage (if needed). In most
