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Understanding Your Rights with Medicare and How Knowing Helps You Get the Best Coverage
Beneficiaries participating in the federal government healthcare coverage program Medicare should be aware of rights they have for protection purposes. Your rights with Medicare provide protection under specific circumstances you should know about. Those who enroll for coverage will be made aware of this information in further detail based on what plan they qualify for. When this information is received you should review it carefully and ask questions if you need clarity. You can get additional details about your rights through Medicare.gov and through local legal services. The following points give insight on rights and protections beneficiaries should know about with Medicare coverage.
• Your rights with Medicare include different areas related to healthcare coverage and services received. These rights help protect patients when health care services are received. There are rights in place to ensure patients receive services the law says you are entitled to. Such rights also provide protection against healthcare practices deemed unethical. More importantly, you have rights that keep your information private.
• There are rights in place for everyone and anyone who receives Medicare coverage. These include general yet important details beneficiaries are entitled to as a Medicare recipient. For instance, you have rights that ensure you are treated fairly, protection from discrimination, have access to qualified health professionals, answers to questions you have, and rights to ensure you get as much information as possible about the health coverage itself to help you make the best decision about your health care.
• Under original Medicare you have rights in relation to health care you receive. You have rights that allow you to purchase additional coverage for health care needs (Medigap), get details of when Medicare does not cover a service, and the right to obtain services from a Medicare-approved provider or facility.
• Under Medicare Advantage plans you have a variety of rights that allow you to select your doctor of choice to ensure you get the care necessary, obtain treatment from the doctor or facility of choice (especially under special medical situations), and you have the right to know how doctors receive payment. If there are differences in the plan you have selected you have a right to appeal them. You have the right to file a grievance or complaint if there are issues with your plan. You also have rights that let you get information about coverage prior to receiving services.
• Under the Medicare prescription drug plan (Part D) beneficiaries have specific rights including an appeal to resolve concerns related to determining coverage, filing a grievance or complaint, and your rights with Medicare include keeping prescription drug details related to your health private.
How to Get More Information Regarding Medicare Rights
There are several source options available to help you understand your rights as a beneficiary. These options include insurance assistant programs offered in your state (SHIP), the Medicare Beneficiary Ombudsman, and your state survey agency that oversee program activity related to Medicaid and Medicare.