There are certain times each year when you can enroll in a Medicare Advantage Plan. It is usually best to enroll in a plan by calling 1-800-MEDICARE, rather than by calling the new plan. To join an MA Plan, you must be enrolled in Medicare Parts A and B. You
Medicare Advantage
Emergency room services
If you have Original Medicare, Part B covers emergency room services anywhere in the U.S. Medicare Advantage Plans also must cover emergency room services anywhere in the country. Emergency room services are typically provided when you have a medical condition that requires immediate action, such as an injury or sudden
Resources if you need dental coverage
If you need dental coverage, you may be able to get assistance through the programs listed below. Medicare Advantage Plans: Some Medicare Advantage Plans offer routine dental coverage. Contact your plan to learn about services it may cover, any rules or restrictions, and costs. If you are considering joining Medicare
Help understanding Medicare benefits and options
If you need help understanding your Medicare rights and how to exercise them, there is free information and assistance that you can access. Below are examples of places you can get help: State Health Insurance Assistance Program (SHIP) – Each state offers a SHIP, partly funded by the federal government,
Medicare Advantage appeals if your care is ending
If you are receiving care from a hospital, skilled nursing facility (SNF), Comprehensive Outpatient Rehabilitation Facility (CORF), hospice, or home health agency and are told that your Medicare Advantage Plan will no longer pay for your care (meaning that you will be discharged), you have the right to a fast
Explanation of Benefits (EOB)
An Explanation of Benefits (EOB) is the notice that your Medicare Advantage Plan or Part D prescription drug plan typically sends you after you receive medical services or items. You only receive an EOB if you have Medicare Advantage or Part D. An EOB is not the same as a
Medicare Advantage post-service standard appeals
If you have a Medicare Advantage Plan and were denied coverage for a health service or item that you have already received, you may choose to appeal to ask your plan to reconsider its decision. Follow the steps below if you think the denied health service or item should be
Medicare Advantage pre-service standard appeals
If you have a Medicare Advantage Plan and you were denied coverage for a health service or item before you received the service or item, you can appeal to ask your plan to reconsider its decision. Follow the steps below if you feel that the denied health service or item
Medicare Advantage appeals
Medicare Advantage appeals Medicare Advantage pre-service standard appeals Medicare Advantage post-service standard appeals Explanation of Benefits (EOB) Medicare Advantage appeals if your care is ending
Filing a grievance
If you are dissatisfied with your Medicare Advantage or Part D prescription drug plan for any reason, you can choose to file a grievance. A grievance is a formal complaint that you file with your plan. It is not an appeal, which is a request for your plan to cover