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Be Aware of Your Medicare Rights

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 Be Aware of Your Medicare Rights
Be Aware of Your Medicare Rights

Be Aware of Your Medicare Rights

As a policy holder you must be aware of various legal rights you have, if you are covered under Medicare. Here's information on your rights: you can appeal if your insurance provider denies you any of the offered services, you have right to acquire information, right to file an appeal if unsatisfied with prescription drug decision, right to be treated by specialized health care provider(s) or physician(s), right to fast-track appeal decision, right to participate in any decision making process concerning your health care, right to take benefit of emergency medical services whenever needed, to file a complaint against your Medicare or health care provider, right to be treated fairly without any prejudice, right to know about every treatment option available to you and lastly, to keep your personal information confidential.

All the aforementioned rights may or may not apply your Medicare Supplement Insurance plan, but they do regulate traditional Medicare plan.

Majority to health care insurance customers frequently uses their right to get well-timed response to their appeals, made on health care decisions with which they are unsatisfied. Keep it in mind that irrespective of the kind of Medicare plan chosen by you, you still have the right to make an appeal against the decision(s) of your Medicare/insurance provider. Make an appeal: if you found out that medical treatment or services you require are not covered under your plan or if you health care provider denies you payment after you have gone through the treatment. Also, if, at any point, you feel that Medicare didn't pay you fair compensation against your claim. The information on how to submit your appeal against your health insurance provider is listed in your insurance policy. Your physician/hospital can guide on how to make an appeal against Medicare or your health care insurance company.

Your physician, if have a contract with Medicare or your health insurance provider, then s/he should be aware of the services that are covered or not covered under your plan. They can request to know about these services before going ahead with treatment. If certain medical services aren't covered by your Medicare plan, then the hospital or physician could ask you to sign a statement, before treatment, stating that you solely will be responsible for paying the medical expense even if your insurance provider denies your claim. To effectively keep track of your medical expenses and what's been billed to Medicare plan, you should always request detailed statement from your health care provider.

You also have the right to make Fast-Track appeal, in case services provided by your health care provider are reaching their end as your benefits have run out. This option is available to you, if you being discharged from a skilled nursing facility, hospice, a hospital, a rehab or a home health care agency and if you feel as if services have come to end way before their time.

Make an appeal against any decision made by your prescription drug plan, if your pharmacy notify you that your drug plan doesn't cover certain drug you have asked for, or if the co-payment for the medicine required gets higher than what should be covered under your drug plan. In such scenario, your health care provider/Medicare is under obligation to provide you with an explanation, so ask for it when in doubt. You can request special exception for the drug, not covered under your drug plan. But to get this benefit, your physician needs to suggest that particular drug is needed and its substitute is not available. Your health care provider is under obligation to reply to your request within 72 hours. You can file an appeal if you are unsatisfied with explanation you have received. For this you have up to 60 days from the date of decision.

As per State and Federal HIPPAA laws, health care providers are under obligation to keep your personal and health data confidential. The information can be accessed by you or anyone, who has legal right to obtain it. However, your personal information could be provided to the Department of Health and Human Services, to make sure it's well-protected.

Others circumstances that could lead to the disclosure of your personal and health information are: court orders, state and Federal agencies have the right to access it, it can be released to law enforcement agencies if they need it while solving certain case, for research and study purposes and to government agencies that monitor insurance claim frauds.

Excluding aforementioned reasons, otherwise Medicare or your health care company cannot release your personal or health information to anyone without getting prior written permission from you. Even after consenting to release the information, you can cancel the authorization.

Also, you have the right to be protected against all forms of discriminations that could be based on your nationality, race, age, color, religion, sex, or disability, while seeking medical attention.

Check www.medical-insurance-quotes.us to compare insurance quotes from various.

Be Aware of Your Medicare Rights


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