If a Medicare beneficiary is in an HMO, he or she has some extra Medicare rights. If he or she feels they can' t get the care they need, they have the right to appeal to the HMO. The Medicare beneficiary can appeal things like:
- Referral to a specialist
- Approval to get tests (like x-rays or blood tests)
- Payment of a bill
Contact the HMO for information about how to start the appeal. If a Medicare beneficiary feels he or she may get worse if they wait too long, they can ask for an expedited appeal. This means the HMO must decide about the appeal within 3 days. If a Medicare beneficiary needs an expedited appeal, be sure to ask for it.
Medicare Appeals Information
