Your Rights in Medicare Health Plans


Know Your Rights

If you’re in a Medicare Advantage Plan (Part C) or other Medicare health plan, in addition to the rights and protections for all people with Medicare, you have the right to:

1. Choose health care providers within the plan, so you can get the health care you need.

2. Get a treatment plan from your doctor.

- If you have a complex or serious medical condition, a treatment plan lets you directly see a specialist within the plan as many times as you and your doctor think you need.

- Women have the right to go directly to a women's health care specialist without a referral within the plan for routine and preventive health care services.

3. Know how your doctors are paid.

- When you ask your plan how it pays its doctors, the plan must tell you.

- Medicare doesn't allow a plan to pay doctors in a way that could interfere with you getting the care you need.

4. Request an appeal to resolve differences with your plan.

5. File a complaint (called a "grievance") about other concerns or problems with your plan.

6. Get a coverage decision or coverage information from your plan before getting services.

For any questions or further information visit www.rjclarity.com and speak with a local agent.

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