Your Rights in Medicare Health Plans
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.