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Medicare: Know Your Rights as a Medicare Beneficiary Print E-mail

As a person with Medicare, you have guaranteed rights. You have the right to:

  • Be treated with dignity and respect at all times.
  • You have the right to considerate, respectful care from all doctors, specialists, and hospitals.
  • Be protected from discrimination. You can't be treated differently or receive different benefits because of your race, ethnicity, national origin, age, religion, sex, sexual orientation, or if you have a mental or physical disability. If you think you haven't been treated fairly, call the Office of Civil Rights at 1-800-368-1019 or visit www.hhs.gov/ocr for more information.
  • Get information on Medicare that you can understand to help you make health care decisions.
  • You have the right to receive information that is accurate and easy to understand. This information includes:
    • What is covered
    • What costs will be paid by Medicare
    • How much you have to pay
    • How to file a complaint
  • Have your questions about Medicare answered. You can call 1-800-MEDICARE (1-800-633-4227) to get your questions answered, or you can call the Michigan Medicare Medicaid Assistance Program at 1-800-803-7174.
  • Get emergency care when and where you need it. A medical emergency is when you think your health is in serious danger. If you think your health is in danger because of a bad injury, sudden illness, or an illness that is getting much worse, you can get emergency care anywhere in the United States. If you get emergency care, you will have to pay your share of the cost (copayment). Then, your plan will pay its share.
  • Learn about all of your treatment choices.
    You have the right to fully participate in all of your health care decisions. If you can't participate, you can ask family members, friends, or anyone you trust to help you make a decision about what treatment is right for you.
  • Receive culturally competent services.
    You have the right to get health care services in a language you can understand in a culturally sensitive way, and to have an interpreter for American Sign Language if you are hearing impaired. For information on getting health care services in a language other than English, call the Office of Civil Rights in your state. You may also call 1-800-368-1019 or visit the U.S. Department of Health & Human Services Office for Civil Rights website http://www.hhs.gov/ocr for more information.  A TTY line is available for individuals with a hearing impairment. TTY users should call 1-800-537-7697.
  • Have your personal and health information kept private.
    Medicare may collect information about you as part of its regular business, such as paying for health care bills and making sure you get quality health care. Medicare keeps the information it collects about you private. When Medicare asks for you health information, they must tell you the following:
    • Why it is needed
    • Whether it is required or optional
    • What happens if you don't give the information
    • How it is used

      If you want to know more about how Medicare uses your personal information, call 1-800-MEDICARE.
  • File complaints (sometimes called grievances), including complaints about the quality of your care.
    You can file a complaint about payment, services you received, other concerns or problems you have getting health care, and the quality of health care you received. If you have a complaint regarding payment or services you received under an Original Medicare plan, call 1-800-MEDICARE. If you have a complaint regarding payment or services you received under a Medicare Advantage plan, call the plan directly. If you think you aren't getting quality services or you have quality of care issues with either an Original Medicare plan or a Medicare Advantage plan (this is called a grievance), call MPRO, Michigan's Quality Improvement Organization at 1-800-365-5899, or visit www.mpro.org/. Also, the following link provides additional information about what to do if you have concerns about the care you received on Medicare (click here to download).
  • Get a review of (appeal) certain decisions about health care payment, coverage of services, or prescription drug coverage.
    You have the right to appeal decisions relating to your claims for benefits. An appeal is the action you can take if you disagree with a coverage or payment decision by Medicare you your Medicare plan. You can appeal if Medicare or your plan denies one of the following:
    • A request for a health care service, supply, or prescription that you think you should be able to get.
    • A request for payment for health care or a prescription drug you already got
    • A request to change the amount you must pay for a prescription drug.

You can also appeal if Medicare or your plan stops paying for an item or service you think you still need. Call the Michigan Medicare Medicaid Assistance Program at 1-800- 803-7174 for more information on filing an appeal.