What Are My Rights Under Medicare?
As a Medicare beneficiary, you have certain guaranteed rights. These rights protect you when you get health care, they assure you access to needed health care services, and protect you against unethical practices. You have these rights whether you are in Original Medicare or another Medicare health plan.
Your rights include, but are not limited to:
The Right to Receive Emergency Care
If you have severe pain, an injury, or a sudden illness that you believe may cause your health serious danger without immediate care, you have the right to receive emergency care. You never need prior approval for emergency care, and you may receive emergency care anywhere in the United States.
The Right to Appeal Decisions About Payments or Services for Medical Care
If you are enrolled in Original Medicare, you have the right to appeal denial of a payment for a service you have been provided. If you are enrolled in another Medicare health plan, you have the right to appeal the plan's denial for a service to be provided.
The Right to Information About All Treatment Options
You have the right to know about all your health care treatment options from your health care provider. Medicare forbids its health plans from making any rules that would stop a doctor from telling you everything you need to know about your health care. If you think your Medicare health plan may have kept a provider from telling you everything you need to know about your health care options, then you have the right to appeal.
The Right to Know How Your Medicare Health Plan Pays Its Doctors
You must request this information. If you request information on how a Medicare health plan pays its doctors, then the plan must give it to you in writing. You also have a right to know whether a doctor has a financial interest in a health care facility since it could affect the medical advice he or she gives you.
Your other rights include:
- The right to protection from discrimination in marketing and enrollment practices.
- The right to information about what is covered and how much you have to pay.
- The right to choose a women's health specialist.
- The right, if you have a complex or serious medical condition, to receive a treatment plan that includes direct access to specialists.